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RISK OF HYPOGLYCEMIA FROM PENTAMIDINE THERAPY.

A rare but feared side effect of pentamidine therapy -- one that has emerged with its increasing use in patients with pneumocystis pneumonia -- is hypoglycemia. Prompted by three fatal cases, these investigators reviewed the records of 164 patients who were treated with pentamidine in 1984.

Complications occurred in 94 cases (57 percent); the commonest side effects were azotemia (23 percent), hypotension (14 percent), and hypoglycemia (14 percent). The risk factors for hypoglycemia included prolonged use of pentamidine, increasing drug dosage, previous pentamidine therapy, and the presence of azotemia during treatment. Review of the fatal cases demonstrated that this side effect can be abrupt in onset, as hypoglycemia was first detected when the patients could not be aroused.

The presumed mechanism of this complication is toxicity to pancreatic islet cells, leading to inappropriate insulin release. The possibility of prophylaxis against hypoglycemia remains unclear.

— THL

Published in Journal Watch General Medicine July 19, 1988

Citation(s):

Waskin H; Stehr Green J K; Helmick C G; Sattler F R. Risk factors for hypoglycemia associated with pentamidine therapy for Pneumocystis pneumonia. JAMA 1988 Jul 15 260 345-347.

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