What are the major adverse effects of amphotericin B?
Common side effects may include:
- nausea, vomiting, stomach pain, diarrhea;
- upset stomach, loss of appetite;
- muscle or joint pain;
- headache, ringing in your ears;
- pain, bruising, or swelling where the medicine was injected;
- weight loss; or.
- flushing (warmth, redness, or tingly feeling).
What is the mechanism of amphotericin B induced nephrotoxicity?
Amphotericin B binds to sterols in cell membranes, thereby creating pores that compromise membrane integrity and increase membrane permeability. It binds not only to ergosterol in fungal cell walls but also to cholesterol in human cell membranes; this is what accounts for its nephrotoxicity.
What should you monitor when taking amphotericin B?
Amphotericin B is associated with renal insufficiency, hypokalemia, hypomagnesemia, hypocalcemia, and hypophosphatemia. Thus, patients treated with amphotericin B should have daily monitoring of serum creatinine and electrolytes.
What causes amphotericin B toxicity?
Because mammalian and fungal membranes are similar in structure and composition, this is one mechanism by which amphotericin B causes cellular toxicity. Amphotericin B molecules can form pores in the host membrane as well as the fungal membrane. This impairment in membrane barrier function can have lethal effects.
How is amphotericin B toxicity treated?
Administering 500–1000 mL bolus of normal saline before and after amphotericin B infusion can reduce the incidence and severity of nephrotoxicity. (8) Fevers, chills, and rigors are also minimized by providing acetaminophen, diphenhydramine, and/or hydrocortisone 30–60 minutes prior to amphotericin B administration.
Why is amphotericin B so toxic?
How do you manage nephrotoxicity of amphotericin B?
At this time, the use of sodium supplementation (eg, intravenous saline and/or ticarcillin disodium, which contains 5.2 mEq of sodium per gram of drug) along with avoiding dehydration appears to be a safe and effective means of reducing the risk of nephrotoxicity associated with amphotericin B administration; however.
How do you monitor amphotericin B toxicity?
Patients on outpatient amphotericin B must be monitored 2-3 times weekly because of its high incidence of adverse effects. The parameters that need to be monitored include CBC count with differentials; electrolyte evaluations; and serum magnesium, BUN, and serum creatinine levels.
What is amphotericin B used for and what are the risks of its use?
Amphotericin B injection is used to treat serious and potentially life-threatening fungal infections. Amphotericin B injection is in a class of medications called antifungals. It works by slowing the growth of fungi that cause infection.
Is amphotericin B an azole?
Abstract. The interactions of the azole antifungal agents fluconazole, itraconazole, ketoconazole, or miconazole with amphotericin B (AmB) in their effect on Candida albicans were investigated. These four azoles antagonized the fungistatic activity of AmB at sub-MICs if both substances acted simultaneously.
What makes amphotericin B toxic?
What are the side effects of amphotericin B?
General. Intravenous amphotericin B will lead to some intolerance in most patients, even at less than the full therapeutic dose. Tolerance can be improved by treatment with antipyretics, antihistamines, or antiemetics. Meperidine may decrease the duration of chills and fever that accompany infusion.
Does amphotericin B cause nephrotoxicity in fungal infections?
Amphotericin B remains the anti-fungal drug of choice for most systemic infections, but a limiting factor for its use is the development of nephrotoxicity. Amphotericin B-induced nephrotoxicity is manifested as azotaemia, renal tubular acidosis, impa … The frequency of fungal infections is increasing.
What are the side effects of AmB deoxycholate?
The principal acute toxicity of AmB deoxycholate includes nausea, vomiting, rigors, fever, hypertension or hypotension, and hypoxia. Its principal chronic adverse effect is nephrotoxicity. AmB probably produces renal injury by a variety of mechanisms.
What is the half life of amphotericin B?
Additionally, amphotericin B also produces oxidative damage to the cells with the formation of free radicals and subsequently increased membrane permeability. Additionally, amphotericin B has a stimulatory effect on phagocytic cells, which assists in fungal infection clearance. The half-life of amphotericin B is from 24 hours to 15 days.