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Pharm 3
Antifungals- Amphotericin B
| Question | Answer |
|---|---|
| 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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