“PAPAHOOD”

Pamidronate

Pamidronate belongs to a family of drugs called Bisphosphonates that reduce bone turnover. Bone turnover occurs in all of us and is the process of breaking down and rebuilding bone. By reducing the rate of bone loss in thin or inflamed bones, bisphosphonates increase bone strength; reduce fractures and bone pain; and improve mobility. Pamidronate is known to stay bound to the bones for many years. Procedure: Pamidronate is given by a drip (infusion) over 4 hours daily for 3 days, without having to stay in hospital overnight. In patients with osteogenesis imperfecta this is repeated every 3-4 months. After arrival in the ward, the doctor will insert a very small plastic tube (called a cannula) into your child’s arm, or the back of their hand. EMLA cream may be applied to numb the skin. The cannula will be used to take a small blood sample at the beginning of the test and to give the infusion of pamidronate. Hopefully we will be able to give all three infusions through the same cannula over the three days. Some children stay in hospital for the whole 3 days but most prefer to go home overnight between the infusions. If you choose to go home we will bandage the cannula securely so that we can keep using it for all the 3 infusions. Side effects: Like all medicines Pamidronate may cause some side effects. If any occur they are usually mild and short-lived. The most common side effects are:

• Flu-like symptoms – with aches and pains, a high temperature, headache, nausea and vomiting. Paracetamol is often helpful but ibuprofen shouldn’t be given as this interferes with the way the pamidronate works. It is rare for flu-like symptoms to occur after the first course of pamidronate and subsequent courses of treatment should go ahead as planned.
• Low calcium levels (hypocalcaemia) can occur during the infusions. This is more likely if your child is deficient in vitamin D or already has reduced calcium levels in the blood and we will check this before we plan the first cycle. Your child may be prescribed vitamin D beforehand and we will monitor the calcium level in your child’s