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Gallium NitratePronouncation: (GAL-ee-uhm NYE-trate)
Class: Hypocalcemic agent
Mechanism of Action
Exerts hypocalcemic effect by inhibiting calcium resorption from bone, possibly by stabilizing bone matrix, thereby reducing increased bone turnover.
Steady state is achieved in 24 to 48 hr.
Vd is 1.27 L/kg.
Plasma Cl is 0.12 to 0.2 L/hr/kg. The t ½ is 24 to 115 hr. Major route of elimination is kidney.
Median is 6 to 8 days.
Indications and Usage
Treatment of symptomatic, cancer-related hypercalcemia unresponsive to adequate hydration.
Severe renal impairment (serum creatinine more than 2.5 mg/dL).
Dosage and AdministrationAdults
IV 100 to 200 mg/m 2 /day for 5 consecutive days.
Store unopened vials at controlled room temperature (68° to 77°F). Diluted solutions can be stored for up to 48 hr at ambient room temperature (59° to 86°F) or 7 days if stored under refrigeration (36° to 46°F).
Drug InteractionsNephrotoxic drugs (eg, aminoglycosides, amphotericin B)
May increase risk for development of renal insufficiency.
Laboratory Test Interactions
None well documented.
Tachycardia; lower extremity edema; asymptomatic hypotension.
Lethargy, confusion, dreams, hallucinations, paresthesia.
Acute optic neuritis; visual impairment; tinnitus; decreased hearing.
Nausea or vomiting; diarrhea; constipation.
Increased BUN and creatinine (13%); acute renal failure.
Mild to moderate transient hypophosphatemia (79%); decreased serum bicarbonate concentrations (50%); hypocalcemia.
Shortness of breath; rales and rhonchi; pleural effusion; pulmonary infiltrates.
Hypothermia; fever; skin rash.
Category C .
Safety and efficacy not established.
Hypercalcemia in cancer patients is commonly associated with impaired renal function. Evaluate renal function (BUN, creatinine) before starting therapy and frequently during therapy.
Asymptomatic or mild to moderate hypocalcemia
Ensure that patient is adequately hydrated using oral and/or IV fluids (preferably saline) and that a satisfactory urine output (eg, 2 L/day) is established before beginning therapy. Ensure that adequate hydration is maintained during therapy but avoid overhydration in patient with compromised CV function.
Visual and auditory disturbances
Acute optic neuritis and decreased hearing have occurred in some patients treated with multiple high doses of gallium combined with investigational anticancer drugs.
Nausea, vomiting, renal insufficiency.
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