Pentamidine
**Pentamidine** is an antiprotozoal agent primarily used in veterinary medicine as a second-line or salvage treatment for **leishmaniosis** in dogs, particularly when resistance to pentavalent antimony drugs (e.g., meglumine antimonate and sodium stibogluconate) has occurred. > **Warning:** Pentamidine is a highly toxic drug with a narrow therapeutic index. The potential to cause severe toxic damage, particularly to the kidneys and liver, must be carefully weighed against the benefits. **Clinical Pearl:** Due to its significant toxicity profile and the availability of safer alternatives (like allopurinol and miltefosine), pentamidine is rarely used as a first-line agent. Expert advice should always be sought prior to initiating therapy.
Mecanismo: Pentamidine kills protozoans by interacting with **parasite DNA**. It is rapidly taken up by the parasites via a **high-affinity energy-dependent carrier** → disrupts DNA, RNA, and protein synthesis → leads to protozoal death.
Dosificación por especie
- Leishmaniosis (resistant cases) · 4 mg/kg · IM · q48-72h · Seek expert advice on treatment duration · Use only when resistance to pentavalent antimony drugs has occurred. Highly toxic.
Las dosis son una referencia clínica para médicos veterinarios. Confirme siempre con la información vigente del producto y el paciente individual.
Vías de administración
Contraindicaciones
- Impaired liver function
- Impaired kidney function
- Rapid intravenous (IV) injection (due to severe cardiovascular effects)
Efectos adversos
- Pain at the injection site
- Necrosis at the injection site
- Hypotension
- Nausea
- Salivation
- Vomiting
- Diarrhoea
- Hypoglycaemia
- Blood dyscrasias
Interacciones farmacológicas
- Nephrotoxic drugs (e.g., Aminoglycosides, NSAIDs) · Increased risk of severe nephrotoxicity · major
Monitoreo
- Renal function (BUN, Creatinine, Urinalysis)
- Liver enzymes (ALT, AST, ALP) and Bilirubin
- Blood glucose concentrations
- Blood pressure (especially around the time of administration)
- Complete Blood Count (CBC) for dyscrasias
- Injection site for signs of necrosis
Sobredosis
Overdosage significantly increases the risk of severe **hypotension**, **hypoglycaemia**, **acute renal failure**, and **hepatotoxicity**. Treatment is largely supportive and symptomatic, including IV fluid therapy to support blood pressure and renal perfusion, and dextrose supplementation for hypoglycaemia.
La referencia de fármacos de VetSheet está destinada a médicos veterinarios como apoyo a la decisión clínica; no sustituye el juicio profesional ni la información vigente del fabricante.