What is the toxicity of amphotericin B?

The principal acute toxicity of AmB deoxycholate includes nausea, vomiting, rigors, fever, hypertension or hypotension, and hypoxia. Its principal chronic adverse effect is nephrotoxicity. AmB probably produces renal injury by a variety of mechanisms.

What is the most serious toxic effect of amphotericin B?

The principal acute toxicity of AmB deoxycholate includes nausea, vomiting, rigors, fever, hypertension or hypotension, and hypoxia. Its principal chronic adverse effect is nephrotoxicity.

What is the major side effect of amphotericin B?

Side Effects Fever, shaking, chills, flushing, loss of appetite, dizziness, nausea, vomiting, headache, shortness of breath, or fast breathing may occur 1 to 3 hours after the infusion is started.

How do you treat amphotericin toxicity?

Administering 500–1000 mL bolus of normal saline before and after amphotericin B infusion can reduce the incidence and severity of nephrotoxicity. (8) Fevers, chills, and rigors are also minimized by providing acetaminophen, diphenhydramine, and/or hydrocortisone 30–60 minutes prior to amphotericin B administration.

How does amphotericin B cause nephrotoxicity?

Amphotericin B binds to sterols in cell membranes, thereby creating pores that compromise membrane integrity and increase membrane permeability. It binds not only to ergosterol in fungal cell walls but also to cholesterol in human cell membranes; this is what accounts for its nephrotoxicity.

Does amphotericin B affect the liver?

Although in clinical use for more than 35 years, impairment of liver function is not considered to be a typical adverse effect of amphotericin B. Experimental data suggest that the drug may interfere with the hepatic cytochrome P450 and may thus influence the metabolic capacity of the liver.

How long does it take for amphotericin B to work?

The medicine must be given slowly through an IV infusion, and can take from 2 to 6 hours to complete. Tell your caregivers if you feel any burning, pain, or swelling around the IV needle when amphotericin B is injected.

How do you reduce the side effects of amphotericin B?

Although some patients may tolerate full intravenous doses of amphotericin B without difficulty, most will exhibit some intolerance, often at less than the full therapeutic dose. Tolerance may be improved by treatment with aspirin, antipyretics (e.g., acetaminophen), antihistamines, or antiemetics.

Is amphotericin B Safe for Kidneys?

However, adverse effects are common, with nephrotoxicity being the most serious, occurring early in the course of treatment, and usually being reversible in most patients. Tubular damage is a well known problem associated with amphotericin B therapy but acute renal failure is the most serious complication.

How can amphotericin B nephrotoxicity be prevented?

At this time, the use of sodium supplementation (eg, intravenous saline and/or ticarcillin disodium, which contains 5.2 mEq of sodium per gram of drug) along with avoiding dehydration appears to be a safe and effective means of reducing the risk of nephrotoxicity associated with amphotericin B administration; however.

Why does amphotericin B affect the kidneys?

Amphotericin B Nephrotoxicity Characteristic electrolyte abnormalities include wasting of potassium and magnesium secondary to increased permeability of the cell membranes. The back-leak of hydrogen ions in the collecting duct leads to distal renal tubular acidosis (dRTA).

Why is amphotericin B so toxic to humans?

Mechanism of toxicity Amphotericin B molecules can form pores in the host membrane as well as the fungal membrane. This impairment in membrane barrier function can have lethal effects. Ergosterol, the fungal sterol, is more sensitive to amphotericin B than cholesterol, the common mammalian sterol.