Chapter 21: Haematological procedures
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Post‐procedural considerations
All pentamidine and salbutamol nebulizer masks are single use only and must be discarded appropriately after each use, according to COSHH ([24]) guidance. Staff should refrain from entering rooms in which pentamidine has been administered for a further 30 minutes to allow for the drug to settle or be extracted via the ventilation system.
All linen from these rooms should be dealt with as infected and placed in a water‐soluble bag within a red plastic bag.
Rooms should be damp dusted, including all furniture around the nebulizer or patient's chair. The wipes should then be discarded into the purple‐lidded cytotoxic/cytostatic waste stream.
Immediate care
During the procedure, the patient may experience severe reactions, sometimes fatal, due to hypotension. They may also experience nausea and vomiting, dizziness, syncope, flushing, hyperglycaemia, rash, taste disturbances, bronchoconstriction, cough and shortness of breath (Joint Formulary Committee [62]). The patient should be advised prior to administration to alert a healthcare professional, using the call bell, if any reaction is experienced. The healthcare professional will need to stop the nebulizer and monitor and stabilize the patient, who will require a medical review. Any adverse reaction must be documented in accordance with the NMC ([86]). The patient must have recovered as fully as possible before being allowed to leave the facility.
Ongoing care
In the longer term, pentamidine isetionate is known to cause hypoglycaemia, pancreatitis, arrhythmias, leucopenia, thrombocytopenia, acute renal failure and hypocalcaemia in some patients. The patient's full blood count and urea and electrolytes should be monitored regularly to detect any early signs of deterioration following the administration of pentamidine in the longer term.
