Inj. Pamidronate is indicated in?

Appeared in: KPSC Staff Nurse - 2021

Explanation

Pamidronate is a bisphosphonate medication specifically indicated for the treatment of hypercalcemia (abnormally high blood calcium levels).
It is most commonly used to manage hypercalcemia of malignancy, a condition where cancer causes excessive release of calcium from the bones.
The drug's mechanism of action is to inhibit osteoclast-mediated bone resorption, thereby reducing the amount of calcium entering the bloodstream.
The therapeutic effect starts within 1-2 days and can last for several weeks, making it a mainstay for managing this condition.

Option A: Hyperkalemia is an elevation of potassium in the blood, not calcium. Pamidronate has no effect on serum potassium levels.
Option B: Organophosphorous poisoning is a medical emergency treated with specific antidotes, Atropine and Pralidoxime (2-PAM), which counteract the poison's effects on the nervous system.
Option C: Organocarbamate poisoning is managed with Atropine to block the excessive stimulation of the parasympathetic nervous system.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Pharmacology: Indications for Pamidronate as background academic context rather than a clinical decision trigger.
A key nursing responsibility is to administer Pamidronate as a slow intravenous infusion, typically over 2 to 4 hours. Rapid infusion significantly increases the risk of renal toxicity and kidney injury.
Nurses must monitor for potential side effects, including a flu-like reaction (fever, body aches) within 24-48 hours of infusion, and electrolyte imbalances like hypocalcemia, hypophosphatemia, and hypomagnesemia.
What if? If a patient with hypercalcemia of malignancy also has pre-existing severe chronic kidney disease, the dose of pamidronate would need to be adjusted, or an alternative like denosumab might be preferred, as bisphosphonates are cleared by the kidneys and can worsen renal function.

How to Approach the Question

First, identify the drug mentioned in the question: 'Inj. Pamidronate'.
Recognize this as a pharmacology question asking for the drug's primary use or 'indication'.
Recall or deduce the drug class. The '-dronate' suffix is characteristic of bisphosphonates.
Connect the bisphosphonate class to its main function: regulating calcium and bone metabolism.
Evaluate the given options: Hyperkalemia (potassium disorder), two types of poisoning (toxicology), and Hypercalcemia (calcium disorder).
Conclude that Hypercalcemia is the only logical and correct indication for a bisphosphonate among the choices.

Concept Tested & Keywords

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E6 Medicine Harrison 22e Part 2 p. 1188-1190

E6 Pharmacology Katzung 16e p. 1219-1221

Practise the full KPSC Staff Nurse - 2021

Attempt every question from this paper in a timed mock, then review the full solution for each one.