When administering inhaled pentamidine, stringent precautions are necessary to mitigate occupational exposure risks and ensure patient safety. Key measures include:
Administration Setup
Use a Respirgard II Nebulizer exclusively, as other devices may not adequately contain aerosols.
Administer in a negative-pressure room or with HEPA filtration to minimize airborne dispersion.
Personal Protective Equipment (PPE)
Healthcare workers must wear:
N95 respirators or higher-grade masks.
Nitrile gloves, chemo gowns, and eye protection (e.g., goggles).
Pregnant staff should avoid handling pentamidine due to potential teratogenicity.
Patient Preparation
Pre-treat with a bronchodilator (e.g., albuterol) 5–10 minutes prior to reduce bronchospasm risk, especially in patients with asthma or smoking history.
Ensure the patient uses a closed-mouth breathing technique to limit aerosol escape.
Post-Administration Protocols
Keep the room closed for 30 minutes post-treatment to allow aerosol settling.
Clean surfaces with wet methods to avoid disturbing residual drug particles.
Monitoring and Contraindications
Monitor patients for hypoglycemia, bronchospasm, or extrapulmonary infections.
Avoid use in pregnant patients unless absolutely necessary.
These steps align with NIOSH hazardous drug guidelines and institutional safety policies to prevent respiratory or dermal exposure.
References
[1] https://www.mayoclinic.org/drugs-supplements/pentamidine-inhalation-route/description/drg-20065369
[2] https://www.drugs.com/pro/pentamidine-inhalation.html
[3] https://www.pogo.ca/satellite-manual/4-0-supportive-care-practice-tools/4-2-pentamidine-administration/4-2-1-inhaled-pentamidine/
[4] https://medlineplus.gov/druginfo/meds/a601208.html
[5] https://www.webmd.com/drugs/2/drug-18174/pentamidine-inhalation/details
[6] https://www.utmb.edu/policies_and_procedures/4230115
[7] https://my.clevelandclinic.org/health/drugs/19920-pentamidine-inhalation
[8] https://www.ncbi.nlm.nih.gov/books/NBK557586/
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