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/