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Thursday, November 10, 2011

AMPHOTERICIN B, LIPID COMPLEX

Antifungal activity

Indicated in Rx of aspergillosis or any type of progressive fungal infection in patients who are refractory to or intolerant of conventional amphotericin B therapy
Effective against Candida sp. and Aspergillus sp.
Active in animal models against Aspergillus fumigatus, Candida albicans. C. guillermondii, C. stellatoideae, C. tropicalis, Cryptococcus sp., Coccidioidomyces sp., Histoplasma sp., and Blastomyces sp

Pregnancy Risk Factor

Class B

Contraindication/Precaution

Hypersensitivity to amphotericin , or any component
Anaphylaxis has been reported; facilities for cardiopulmonary resuscitation should be available
Should not be use while nursing
Use caution if impaired renal function
Overdose has been reported to result in cardio-respiratory arrest.

Mechanism of Action

Fungistatic or fungicidal depending on the concentration in body fluids and the susceptibility of the fungus. 
Acts by binding to sterols in the cell membrane of susceptible fungi with a resultant change in membrane permeability allowing leakage of intercellular components. 

Pharmacodynamics

Metabolism: N/A
Half-life: ~24 hours, changes with renal function:
Elimination: excreted in urine

Dosage

Children and Adults:

2.5-5 mg/kg IV qd as a single infusion at rate of 2.5mg/kg/h

Dose VS renal function

Cr. clearance (ml/min):
<10: give q24h 10-50: give q24h 50-80: give q24h >80: give q24h

Dialysis
Hemo: none
CAPD: give q24h

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