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Pharm 3

Antifungals- Amphotericin B

Drug of choice for most syste,ic mycoses Amphotericin B
Used only against infections that are progressive and potentially fatal Amphotericin B
Treatment time and route for Amphotericin B Treatment is prolonged weeks to months. Why adverse reaction takes place?Absorption from GI is poor; oral therapy not effective
Action of Amphotericin B Static or cidal. Acts on fungi cell membrane (does not harm bacteria [no sterols]). More selective to fungi than mammalian
Infusion reaction for Amphotericin B Fever, Chills, Rigors, Nausea, headache. Symptoms start in 1-3 hours and persist 1 hour.
Why side effects take place in Amphotericin B Release of cytokines from monocytes and macrophages.
Amphotericin B: Controlling side effects Mild reactions can be reduced by premedicating with Benadryl and ASA or acetaminophen. Hydrocortisone can be used in severe but ruduces immune system.
Amphotericin B: Kidney damage Nephrotoxicity can be reversed unless dose exceeds 4gm. Kidney damage can be minimized by infusing 1L of saline on days of therapy and avoid other nephrotoxic drugs.
Prototype of the azole family, broad spectrum Ketoconazole (Nizoral)
Oral alternatice for amphotericin B for less sever systemic mycoses, safer, less toxic, somewhat less effective Kretoconazole (Nizoral)
Created by: Keller_KI



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