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AmB kills yeast via ion channel-mediated membrane permeabilization. This channel model has been extended to also rationalize the unique lack of resistance to AmB as well as its dose-limiting toxicity. This perceived understanding has stimulated extensive research toward the goals of developing new channel-forming compounds as putative resistance-refractory antimicrobial agents and/or less toxic derivatives of AmB that more selectively form channels in fungal cells versus human cells. This drug should be used primarily for treatment of patients with progressive and potentially life-threatening fungal infections; it should not be used to treat noninvasive forms of fungal disease such as oral thrush, vaginal candidiasis, and esophageal candidiasis in patients with normal neutrophil counts.
Expected Pharmacological Action
AmphotericinB deoxycholate is an antifungal agent that acts on fungal cell membranes to cause cell death. Depending on concentration, these agents can be fungistatic (slows growth on the fungus) or fungicidal (destroys the fungus).
● Therapeutic Uses
Antifungals are the treatment of choice for systemic fungal infection (Candidiasis, Aspergillosis, Cryptococcosis, Mucormycosis) and nonopportunistic mycoses, (Blastomycosis, Histoplasmosis, Coccidioidomycosis).
Some antifungal treat superficial fungal infections: dermatophytic infections (tinea pedis [ringworm of the foot], tinea cruris [ringworm of the groin]); candida infections of the skin and mucous membranes; and fungal infections of the nails (Onychomycosis).
Adverse effects Nursing Intervention
infusion reactions (fever, chills, rigors, and
headache) 1 to 3 hr after initiation • pretreat with diphenhydramine (benadryl)
• meperidine (demerol), dantrolene, or
hydrocortisone may be given for rigors.
thrombophlebitis observe infusion sites for signs of
erythema, swelling, and pain.
• rotate injection sites.
• administer in a large vein and administer
heparin before infusing amphotericin b.
nephrotoxicity obtain baseline kidney function (bun and
creatinine) and do weekly kidney function
• monitor i&o.
• infuse 1 l of saline on the day of
amphotericin b infusion.
hypokalemia • monitor electrolyte levels, especially
• administer potassium supplements
bone marrow suppression obtain baseline CBC and hematocrit, and
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Antifungals, RTT, Rare diseases, Amphotericin B, Mycosis, Fungistatics, Candidiasis, Tinea, Dermatophytosis, Esophageal candidiasis, Athletes foot, Mucormycosis
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