Patricia Dwyer Schull, MSN, RN

Handbook

pantoprazole sodium

Protium , Protonix IV

Kelas farmakologi : PPI

Kelas terapi : GI antisecretory agent

Pregnancy risk category B

Action

Suppresses gastric acid production and secretion and increases gastric mucus and bicarbonate production, creating a protective coating on gastric mucosa(menekan produksi dan sekresi asam lambung dan meningkatkan mucus lambung dan produksi bikarbonat,membentuk lapisan pelindung mucosa lambung)

Pharmacokinetics

Drug is extensively metabolized in the liver to several metabolites with little or no antisecretory activity. It is about 98% protein-bound. Approximately 71% of dose is excreted in urine; remainder is excreted in feces.(obat secara ekstensif di metabolisme di hati dengan beberapa metabolisme aktifitas antisecretori sedikit atau tidak. sekitar 98% terikat dengan protein.

Onset

Peak

Duration

15 min

Unknown

>24 hr

How supplied

Powder for reconstitution for injection

(freeze-dried): 40 mg/vial

Indications and dosages

Short-term treatment of erosive esophagitis caused by gastroesophageal reflux disease (GERD)

Adults: 40 mg I.V. daily for 7 to 10 days

Pathologic hypersecretory conditions, short-term treatment of GERD in patients with a history of erosive esophagitis as an alternative to oral therapy

Adults:, 80 mg I.V. q 12 hours, up to a maximum of 240 mg/day (80 mg q 8 hours)

Administration

Dilution and compatibility

For 15-minute infusion, reconstitute with 10 mL normal saline solution for injection; then further dilute in D5W, normal saline solution, or lactated Ringers solution, to a final concentration of approximately 0.4 mg/mL.

For 2-minute infusion, reconstitute with 10 mL normal saline solution for injection to a final concentration of approximately 4 mg/mL.

Infusion considerations

a. Do not administer through same line with other I.V. solutions.

b. Know that inline filter (provided) must be used to remove precipitate that may form when reconstituted drug is mixed with I.V. solutions.

Administer 15-minute I.V. infusion at a rate of approximately 7 mL/minute.

c. If Y-site is used, place filter below Y-site closest to patient.When administering through Y-site, immediately stop infusion if precipitation or discoloration occurs

Flush I.V. line before and after administration with either D5W, normal saline solution, or lactated Ringers solution.

Monitoring

Assess patient for symptomatic improvement.

Monitor blood glucose level in diabetic patient.

Storage

Refrigerate at 2_ to 8_C (36_ to 46_F); protect from light.

Know that reconstituted solution for 2-minute infusion may be stored for up to 24 hours at room temperature before I.V. infusion and does not need to be protected from light.

Be aware that reconstituted solution for 15-minute infusion may be stored for up to 6 hours at room temperature before further dilution. Admixed solution may be stored at room temperature; it must be used within 24 hours of initial reconstitution. Neither reconstituted solution nor admixed solution need be protected from light.

Contraindications and precautions

Contraindicated in hypersensitivity to drug.

Use cautiously in severe hepatic disease, pregnant or breastfeeding patients, and children.

Adverse reactions

CNS: dizziness, headache

CV: chest pain

EENT: rhinitis

GI: vomiting, diarrhea, abdominal pain, dyspepsia

Metabolic: hyperglycemia, hyperlipemia

Skin: rash, pruritus

Other: injection site reaction

Interactions

Drug-diagnostic tests. Aspartate aminotransferase, glucose: increased Tetrahydrocannabinol test: false-positive result

Toxicity and overdose

In overdose (rare), expect extension of adverse reactions.

Know that drug is not readily dialyzable.

Patient teaching

Instruct diabetic patient to monitor blood glucose level carefully and stay alert for signs and symptoms of hyperglycemia.

As appropriate, review all other significant adverse reactions and interactions, especially those related to the tests mentioned above.