Amphotericin B: Difference between revisions
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Amphotericin B is an antifungal agent, generally reserved for very serious infections (disseminated disease, invasive aspergillosis, cryptoccoccal meningitis, coccidioidomycosis, infection/sepsis in immunocompromised hosts) due to significant associated toxicities. It comes in several formulations; conventional, cholesteryl sulfate complex, lipid complex, and liposomal. The newer formulations tend to have fewer adverse effects. | |||
==Administration== | ==Administration== | ||
*Type: Antifungal | *Type: Antifungal | ||
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==Adult Dosing== | ==Adult Dosing== | ||
''Dosing is '''NOT''' interchangeable between different formulations of amphotericin B | ''Dosing is '''NOT''' interchangeable between different formulations of amphotericin B due to significant variations in pharmacokinetics. Call your institution's pharmacy (or ID) if unsure about correct dose. | ||
==Pediatric Dosing== | ==Pediatric Dosing== | ||
Revision as of 23:48, 15 July 2016
Amphotericin B is an antifungal agent, generally reserved for very serious infections (disseminated disease, invasive aspergillosis, cryptoccoccal meningitis, coccidioidomycosis, infection/sepsis in immunocompromised hosts) due to significant associated toxicities. It comes in several formulations; conventional, cholesteryl sulfate complex, lipid complex, and liposomal. The newer formulations tend to have fewer adverse effects.
Administration
- Type: Antifungal
- Dosage Forms:
- Routes of Administration: IV
- Common Trade Names: AmBisome, "ampho-terrible"
Adult Dosing
Dosing is NOT interchangeable between different formulations of amphotericin B due to significant variations in pharmacokinetics. Call your institution's pharmacy (or ID) if unsure about correct dose.
Pediatric Dosing
Special Populations
- Pregnancy Rating: B
- Lactation risk: Infant risk cannot be ruled out
Renal Dosing
- Adult:
- Pediatric:
Hepatic Dosing
- Adult:
- Pediatric:
Contraindications
- Allergy to class/drug
Adverse Reactions
Serious
- Nephrotoxicity/renal failure, hemorrhagic cystitis
- Anaphylaxis
- Cardiac arrest
Common
- Hypokalemia, hypomagnesemia, hyperglycemia (check BMP at least daily)
- Rigors
- Nausea/vomiting, diarrhea
- Anemia
- Rash
- Dyspnea
- Insomnia
Pharmacology
- Half-life: Depends on formulation, 1-14 days
- Metabolism: unknown
- Excretion:
Mechanism of Action
- Binds to ergosterol in fungal cell membranes-> intracellular contents leak out--> cell dies