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Antimicrobials
Amphotericin B Deoxycholate (conventional)

Amphotericin B Deoxycholate (conventional)

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N/A
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Spectrum of Activity

General Spectrum of Activity
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General Information

Fungicidal therapy of yeast or mold infection.

Induction therapy for dimorphic fungii (cocci, blasto, histo).

Liposomal formulation is preferred for systemic use to minimize toxicity. Conventional formulation is used for any local administrations.

  • Renal function
  • K+
  • Mg++
  • Liver enzymes
  • CBC

Frequency depends on course, but daily reasonable during initiation.

  • Nephrotoxicity ++
  • Anemia, leukopenia, thrombocytopneia
  • Phlebitis
  • Paresthesias

Infusion related symptoms

  • Fever
  • Rigors
  • N/V
  • Headache

Electrolyte abnormalities

  • HypoK and HypoMg

Main concern is concomitant nephrotoxins. Use should be minimized during amphotericin therapy.

  • Increased digoxin toxicity with hypokalemia
  • Increased risk of nephrotoxicity with cyclosporine
  • Increase risk of seizures with bupropion
  • Premedication with acetaminophen, diphenhydramine or hydrocortisone are used. Meperidine may be used for rigors
  • Pay careful attention to electrolyte and fluid status with boluses (usually 500mL) of NS before and after infusion, as well as K and Mg supplementation PRN
  • Cost based on average adult dose (70kg) of 50mg IV q24h

Antimicrobial class: Antifungal. Polyene

Pregnancy category: B

Average serum half life: 24 hours

Urine penetration: Therapeutic

Lung penetration: Therapeutic

CSF penetration: Suboptimal unless locally administered