Description overdue on 05.02.2012

Antifungal agent . Is a macrocyclic, polyene antibiotics with significant antifungal activity. Amphotericin B produce Streptomyces nodosus. The drug has fungistatic or fungicidal effect, depending on the sensitivity of the microorganism and on the concentration in a biological fluid. The drug binds to ergosterol Which are located in the cell membrane of the fungus. Effect of the drug is directed to permeabilised for removing intracellular components that lead to lysis of the fungal cells. No effect on the life of viruses, Rickettsia bacteria. It does not cause irritation. Available in the form of ointments, lyophylate tablets.

Indications:

Amphotericin B is indicated for fungal diseases: disseminated aspergillosis , Invasive aspergillosis, cryptococcal meningitis , Disseminated cryptococcosis, intestinal kandidozonositelstvo , North American blastomycosis, paracoccidioidomycosis , Chronic mycetoma, gialogifomikoz, disseminated sporotrichosis, mold mycosis chromomycosis, phycomycosis, histoplasmosis , Fungal sepsis, endophthalmitis, visceral leishmaniasis.

Contraindications:

Amphotericin B is not indicated in patients with chronic renal pathology system hypersensitive to the components. When amyloidosis, glomerulonephritis , Anemia, liver cirrhosis, diabetes, agranulocytosis, breastfeeding, pregnancy used with caution.

Side effect:

Senses : diplopia , Taste perversion, blurred vision. Digestive system : Gastralgia, diarrhea, dyspepsia, loss of appetite, liver toxicity. Nervous system : Seizures, polyneuropathy , headache.   Cardiac System : Blood pressure instability, arrhythmia. Respiratory system:   rhinitis, cough, sore throat. Urinary system:   acidosis, azotemia, hypercreatininemia, nephrotoxicity. Perhaps the development of allergies, arthralgia, myalgia, hypomagnesemia, hypokalemia, anaphylaxis .

Mode of application:

Amphotericin B is administered intravenously, 0, 1 mg / ml, the infusion duration of 2-4 hours. Under the control of blood pressure injected test dose of 1 mg. Intracavitary instillation: initially 5 mg dissolved in 10-20 ml of 5% dextrose solution, is then introduced into the base 50 mg, dissolved in 10-20 ml of 5% dextrose. Instillation carried out every day. For bladder irrigation solution was prepared: 5 mg dissolved in 1 liter of sterile water, washed with a catheter 5-10 days. Heading dose sporotrichosis is 2, 5 grams, the rate - 9 months. Aspergillosis Amphotericin B is shown at 3, 6 grams for 11 months.

Special instructions:

With increasing duration of therapy increases the risk of toxic effects. During antifungal therapy monitoring the state of blood, urine and the weight of the patient, assess the ECG, the state of renal and hepatic systems. Strict adherence to all the rules of asepsis required. With the development of anemia antifungal therapy is stopped.

Drug Interactions:

Amphotericin B is incompatible with the electrolyte solution, sodium chloride, heparin. Availability bacteriostatic additives leads to precipitation of drug. FROM nitrofurans   observed a synergistic effect. Amphotericin increases the efficiency of flucytosine, sulfonylureas , Theophylline. Inductors of microsomal oxidation in the liver system, increase the metabolism of the drug. Marked increase in toxicity cardiac glycosides   curariform and muscle relaxants. Invalid simultaneous with nephrotoxic antibiotics.