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Pamidronate Treatment for Hypercalcemia in an Infant Receiving Parenteral Nutrition
Author(s) -
Bryowsky Jason J.,
Bugnitz Mark C.,
Hak Emily B.
Publication year - 2004
Publication title -
pharmacotherapy: the journal of human pharmacology and drug therapy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.227
H-Index - 109
eISSN - 1875-9114
pISSN - 0277-0008
DOI - 10.1592/phco.24.9.939.36103
Subject(s) - medicine , parenteral nutrition , saline , furosemide , calcium , necrotizing enterocolitis , adverse effect , gastroenterology , surgery , anesthesia
A 17‐day‐old infant who was delivered 8 weeks premature underwent small bowel resection for necrotizing enterocolitis. During treatment with continuous infusions of furosemide and hydrocortisone, his total calcium concentration had increased. The calcium dose in his parenteral nutrition solution was decreased and then finally withheld. At 7 weeks of age and after 10 days of calcium‐free parenteral nutrition, pamidronate 3 mg (1.1 mg/kg) in 60 ml of normal saline was infused over 6 hours. The infant's total serum calcium concentration decreased, but then 6 days later it had increased again; pamidronate 2 mg (0.7 mg/kg) in 40 ml of normal saline over 4 hours was administered. The patient demonstrated no signs or symptoms of adverse reactions to pamidronate. His serum calcium concentration returned to normal, and calcium‐containing parenteral nutrition was tolerated. The use of pamidronate for treatment of hypercalcemia and chronic conditions that affect normal bone growth is increasing in children. Clinical trials in pediatric patients are necessary to determine how best to use bisphosphonates in this patient population.