Home Drug Guide Pentostatin

Drug Guide

Generic Name

Pentostatin

Brand Names Nipent

Classification

Therapeutic: Antineoplastic agent

Pharmacological: Purine analog Antimetabolite

FDA Approved Indications

  • Hairy cell leukemia

Mechanism of Action

Pentostatin inhibits adenosine deaminase, leading to accumulation of deoxyadenosine triphosphate, which is toxic to lymphocytes, thus suppressing lymphocyte proliferation.

Dosage and Administration

Adult: 4 mg/m² IV every 2 weeks for up to 6 doses; dosage may vary based on response and tolerability.

Pediatric: Use not well established; consult specialist.

Geriatric: Dosage adjustments not usually required but monitor renal function closely.

Renal Impairment: Adjust dose based on renal function; consult specific guidelines.

Hepatic Impairment: Use with caution; no specific adjustment guidelines available.

Pharmacokinetics

Absorption: Not applicable (intravenous administration).

Distribution: Widely distributed; crosses blood-brain barrier.

Metabolism: Minimal metabolism; mainly excreted unchanged.

Excretion: Renally excreted; monitor renal function.

Half Life: Approximately 20 hours.

Contraindications

  • Hypersensitivity to pentostatin or its components.

Precautions

  • Use with caution in patients with renal impairment, as drug is renally excreted.
  • Monitor blood counts regularly due to risk of myelosuppression.
  • Use caution in patients with active infections or immunodeficiency.

Adverse Reactions - Common

  • Myelosuppression (neutropenia, thrombocytopenia, anemia) (Common)
  • Nausea, vomiting (Common)
  • Rash, fever (Common)

Adverse Reactions - Serious

  • Severe myelosuppression leading to infection or bleeding (Less common)
  • Liver toxicity (Rare)
  • Pulmonary toxicity (Rare)
  • Secondary malignancies (Rare)

Drug-Drug Interactions

  • Other myelosuppressive agents, immunosuppressants, nephrotoxic drugs.

Drug-Food Interactions

N/A

Drug-Herb Interactions

N/A

Nursing Implications

Assessment: Monitor complete blood counts frequently, renal function, and signs of infection.

Diagnoses:

  • Risk for infection related to myelosuppression
  • Risk for bleeding due to thrombocytopenia

Implementation: Administer as scheduled, monitor blood counts, and observe for adverse effects.

Evaluation: Assess for hematologic response and adverse effects; adjust therapy accordingly.

Patient/Family Teaching

  • Report signs of infection (fever, chills), bleeding, or severe fatigue immediately.
  • Adhere to scheduled blood tests.
  • Use caution to prevent injury due to bleeding risk.

Special Considerations

Black Box Warnings:

  • Myelosuppression may be severe and life-threatening.
  • Infection risk is increased.
  • Secondary malignancies, including skin cancers, may occur.

Genetic Factors: N/A

Lab Test Interference: May cause anemia, leukopenia, thrombocytopenia, which requires careful interpretation of CBCs.

Overdose Management

Signs/Symptoms: Severe myelosuppression, infection, bleeding.

Treatment: Supportive care, blood product transfusions, antibiotics if infections develop, and monitoring in an intensive setting.

Storage and Handling

Storage: Store at room temperature, protected from light.

Stability: Stable for specified period as per manufacturer guidelines.

🛡️ 5 Critical Medication Safety Tips for Nurses

1

Triple-Check High-Risk Medications

Always have another nurse verify insulin, heparin, warfarin, and chemotherapy drugs. These "high-alert" medications cause the most serious errors. Check concentration, dose calculation, and pump settings twice.

2

Know Look-Alike, Sound-Alike Drugs

Common mix-ups: hydromorphone/morphine, Celebrex/Celexa, Zyprexa/Zyrtec. Always use BOTH generic and brand names, read labels twice, and use barcode scanning when available. One wrong letter can be fatal.

3

Assess Before AND After Giving Meds

Check vitals before cardiac meds, pain levels before analgesics, and blood glucose before insulin. Always reassess within 30 minutes to evaluate effectiveness and watch for adverse reactions.

4

Watch for Drug Interactions

Common dangerous combinations: warfarin + aspirin (bleeding), ACE inhibitors + potassium (hyperkalemia), digoxin + diuretics (toxicity). Always check drug interactions before administering new medications.

5

Educate Your Patients

Teach patients medication names, purposes, major side effects, and what to report. Informed patients catch errors and improve compliance. Always encourage questions - an educated patient is a safer patient.

⚡ Remember: When in doubt, don't give it out! It's always safer to double-check than regret later.

⚠️ Medical Disclaimer

This drug guide is for educational purposes only and is NOT intended for clinical use. Always consult current prescribing information, healthcare providers, and institutional protocols before administering any medication. Do not use this information for patient care decisions.