Amphotericin B Deoxycholate

제한된
1
C. difficile 위험도
Low
경구생체이용률
N/A

Dosing

Life-threatening fungal infection (aspergillosis, mucormycosis, sporotrichosis, disseminated candidiasis, cryptococcosis, blastomycosis, coccidioidomycosis, leishmaniasis)Recommended cumulative doses0.5-1 mg/kg/d IV infusion over 2-6h as of max concentration of 0.1 mg/mL- 3.5 g for invasive aspergillosis

  • 3.0 g for rhinocerebral mucormycosis

  • 2.5 g for sporotrichosisNo renal dose adjustment서울병원에서만 사용함

Safety and efficacy in pediatric patients have not been established서울병원에서만 사용함

No dose adjustment

General Information

Fungicidal therapy of yeast/fungus/mold infection, especially of the urinary tract as lipid formulations are otherwise preferred to minimize toxicity.

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

Black Box Warning:

  • This drug should be used primarily for treatment of patients with progressive and potentially life-threatening fungal infections. Amphotericin B for injection should not be given at doses greater than 1.5 mg/kg.

  • Exercise caution to prevent inadvertent overdosage, which can result in potentially fatal cardiac or cardiopulmonary arrest.

Monitor renal and liver functions; serum electrolytes (K and Mg levels).

Evaluate CBC and hemoglobin concentrations.

Monitor and record temperature, pulse, respiration, and blood pressure every 30 minutes for 2-4 hours following a single IV test dose.

Monitor pulmonary function in patients with recent or concomitant leukocyte transfusion.

Close clinical observation by medically trained personnel is recommended during infusion.

  • Nephrotoxicity ++

  • Anemia

  • Phlebitis

  • Arachnoiditis

  • Urinary retention

  • Paresthesias

Infusion-related symptoms

  • Fever

  • Rigors

  • N/V

  • Headache

Electrolyte abnormalities -

  • HypoK and HypoMg

  • Loss of bicarb

  • See "Additional Information"

  • Main concern is concomitant nephrotoxins; use should be minimized during amphotericin therapy.

  • Increased digoxin toxicity with hypokalemia.

  • Arsenic trioxide- increased risk of QT prolongation

  • Foscarnet - nephrotoxicity

Antimicrobial class: Antifungal, Polyene

Pregnancy category: B

Average serum half life: 24 hours

CSF penetration: Therapeutic

Lung penetration: Therapeutic

Urine penetration: Therapeutic

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.

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