帕米膦酸二鈉

用途

• Control of hypercalcemia
• Refractory hypercalcemia
• Control of hypercalcemia
• Treatment of cholecalciferol-induced toxicosis
• Attempting to reduce bone pain associated with osteosarcoma in combination with an NSAID
• Pain associated with skeletal neoplasias
• Calcipotriene toxicosis
• Control of hypercalcemia

給藥方式

可能的副作用

• Electrolyte abnormalities (hypomagnesemia, hypocalcemia, hypophosphatemia)
• Cardiac arrhythmias (secondary to electrolyte shifts)
• Renal toxicity (especially with rapid infusion)
• Transient bone pain
• Anemia
• Thrombocytopenia
• Granulocytosis
• Ophthalmic syndromes (e.g., scleritis - reported in humans)

注意事項與禁忌

• Hypersensitivity to pamidronate or other bisphosphonates
• Severe renal impairment (use with extreme caution; not tested in humans with serum creatinine > 5 mg/dL)
• **Important Warnings and Precautions:** * **Renal Toxicity**: Pamidronate can cause acute renal failure. The risk is minimized by ensuring adequate patient hydration and infusing the drug slowly over at least 2 to 4 hours. * **Fluid Compatibility**: **Do NOT mix** with any intravenous fluid containing calcium (e.g., Lactated Ringer's). Must be diluted in 0.9% NaCl, 0.45% NaCl, or D5W. * **Pregnancy**: FDA Category D. Has produced maternal and embryo/fetal toxicity in laboratory animals. Use only if benefits outweigh risks, with informed owner consent. * **Nursing**: Unknown if excreted in milk; use with caution. * **Electrolyte Shifts**: Can cause profound hypocalcemia and hypomagnesemia. Baseline and post-infusion monitoring is critical.

藥物相互作用

• Calcium-affecting drugs (e.g., furosemide, corticosteroids): Can affect calcium levels; requires careful monitoring when used concurrently.
• Nephrotoxic drugs (e.g., cisplatin, aminoglycosides): Potential for increased risk of nephrotoxicity; use with caution.

常見問題