pamidronate disodium

pamidronate disodium

Aredia

Pharmacologic class: Bisphosphonate, hypocalcemic

Therapeutic class: Bone resorption inhibitor

Pregnancy risk category C

Action

Inhibits normal and abnormal bone resorption and decreases calcium levels

Availability

Injection: 30 mg/vial, 90 mg/vial

Indications and dosages

Hypercalcemia caused by cancer

Adults: For moderate hypercalcemia, 60 to 90 mg as a single-dose I.V. infusion over 2 to 24 hours. For severe hypercalcemia, 90 mg as a single-dose I.V. infusion over 2 to 24 hours.

Osteolytic lesions caused by multiple myeloma

Adults: 90 mg I.V. as a 4-hour infusion q month

Osteolytic bone metastases of breast cancer

Adults: 90 mg I.V. as a 2-hour infusion q 3 to 4 weeks

Paget's disease

Adults: 30 mg I.V. daily as a 4-hour infusion for 3 days

Contraindications

• Hypersensitivity to drug, its components, or other bisphosphonates

Precautions

Use cautiously in:

• renal impairment

• pregnant or breastfeeding patients

• children (safety not established).

Administration

• Hydrate patient with saline solution as needed before starting therapy.

• Because of risk of renal failure, give no more than 90 mg in single doses.

Reconstitute vial using 10 ml of sterile water for injection. When completely dissolved, dilute in 250 to 1,000 ml of half-normal or normal saline solution or dextrose 5% in water.

Don't mix with solutions containing calcium, such as lactated Ringer's solution.

• Administer in I.V. line separate from all other drugs and fluids.

Adverse reactions

CNS: anxiety, headache, insomnia, psychosis, drowsiness, weakness

CV: hypertension, syncope, tachycardia, atrial flutter, arrhythmias, heart failure

EENT: sinusitis

GI: nausea, vomiting, diarrhea, abdominal pain, constipation, dyspepsia, stomatitis, anorexia, GI hemorrhage

GU: urinary tract infection

Hematologic: anemia, neutropenia, leukopenia, granulocytopenia, throm-bocytopenia

Metabolic: hypothyroidism

Musculoskeletal: bone pain, joint pain, myalgia

Respiratory: crackles, coughing, dyspnea, upper respiratory infection, pleural effusion

Other: fever, generalized pain, injection site reaction

Interactions

Drug-diagnostic tests. Creatinine: increased level

Electrolytes, hemoglobin, magnesium, phosphorus, platelets, potassium, red blood cells, white blood cells: decreased levels

Patient monitoring

• Monitor hydration status carefully.

• Monitor vital signs and ECG. Evaluate cardiovascular and respiratory status closely.

• Assess hematologic studies and creatinine level before each treatment course.

• Assess electrolyte levels, especially calcium, magnesium, and phosphorus.

• Closely monitor fluid intake and output. Watch for signs and symptoms of urinary tract infection.

Patient teaching

• Instruct patient to weigh himself regularly and report sudden gains.

Advise patient to promptly report significant respiratory problems, peripheral edema, or GI bleeding.

Inform patient that drug lowers resistance to some infections. Tell him to immediately report fever and other signs and symptoms of infection.

• Explain importance of undergoing laboratory tests before, during, and after therapy.

• Caution patient to avoid driving and other hazardous activities until he knows how drug affects concentration, cognition, and alertness.

• Tell patient to minimize GI upset by eating small, frequent servings of food and drinking plenty of fluids.

• As appropriate, review all other significant and life-threatening adverse reactions and interactions, especially those related to the tests mentioned above.

McGraw-Hill Nurse's Drug Handbook, 7th Ed. Copyright © 2013 by The McGraw-Hill Companies, Inc. All rights reserved

pamidronate disodium

(păm-ĭ-drō′nāt)
A drug used to treat hypercalcemia associated with malignancy, with or without bone metastases, and moderate to severe Paget's disease. In the U.S., it is approved for intravenous use.

CAUTION!

This drug should not be mixed with calcium-containing solutions such as Ringer's solution.
Medical Dictionary, © 2009 Farlex and Partners
References in periodicals archive ?
Meanwhile, as two representative drugs among the bisphosphonates, pamidronate disodium and zoledronic acid have been studied by more and more researchers [13, 14].
In this paper, a new turn-off sensor based on carbon dots from black tea was established to quantitatively characterize the two kinds of bisphosphonate drugs, pamidronate disodium and zoledronic acid.
Effective Quenching of Fluorescence of CDs by Pamidronate Disodium and Zoledronic Acid: Turn-Off Process.
where [F.sub.0] and [F.sub.1] were the fluorescence intensities of CDs in the absence and presence of the drugs, respectively; [M] was the concentration of pamidronate disodium, and the quenching constant [K.sub.sv] defines the quenching efficiency of pamidronate disodium.
Selectivity of the Sensor for Pamidronate Disodium and Zoledronic Acid Detection.
Table 1 First-Generation Drugs Second Generation Non-nitrogen containing BPs (NNBP) (Aminobisphosphonate Drugs) Nitrogen containing BPs (NBP) Bonefos (clodronate) Actonel (risedronate sodium) Relative potency of 10 PO and IV Relative potency of 5000 PO formulations Aredia (pamidronate disodium) Didronel (etidronate disodium) Relative potency 100 IV Relative potency of 1 PO Boniva (ibandronate sodium) Skelid (tiludronic disodium) Relative potency 10000 Relative potency of 10 PO PO and IV formulations Fosamax (alendronate sodium) Relative potency 1000 PO Reclast (zoledronic acid) Relative potency 100000 IV Formulation Infused annually for osteoporosis FDA approval pendin Zometa (zoledronic acid) Relative potency 100000 IV Table 2 Risk factors Literature Of Review 1.
Uses and effectiveness of pamidronate disodium for treatment of dogs and cats with hipercalcemia.
Recently, the FDA and the drug company Novartis warned that the intravenous versions of the bisphosphonates zoledronic acid (Zometa) and pamidronate disodium (Aredia) can lead to a rare and potentially serious jaw condition called osteonecrosis.
2004;62:527-34) has prompted warnings from the Food and Drug Administration, as well as from Novartis, which manufactures the intravenous bisphosphonates pamidronate disodium (Aredia) and zoledronic acid (Zometa).
2004; 62:527-34) has prompted warnings about the risk of ONJ from the Food and Drug Administration, as well as from Novartis, which manufactures the intravenous bisphosphonates pamidronate disodium (Aredia) and zoledronic acid (Zometa).
* Aredia [R] (pamidronate disodium) -- Intravenous; approved regimen 30 mg infusion over 4 hours on 3 consecutive days; more commonly used regimen 60 mg over 2-4 hours for 2 or more consecutive or non-consecutive days.