What should I monitor during amphotericin B?
What should I monitor during amphotericin B?
Patients on outpatient amphotericin B must be monitored 2-3 times weekly because of its high incidence of adverse effects. The parameters that need to be monitored include CBC count with differentials; electrolyte evaluations; and serum magnesium, BUN, and serum creatinine levels.
What adverse effects are associated with amphotericin B?
Common side effects may include:
- nausea, vomiting, stomach pain, diarrhea;
- upset stomach, loss of appetite;
- muscle or joint pain;
- headache, ringing in your ears;
- pain, bruising, or swelling where the medicine was injected;
- weight loss; or.
- flushing (warmth, redness, or tingly feeling).
How do you reduce the toxicity of amphotericin B?
The incidence and severity of nephrotoxicity can be reduced by providing 500–1000 mL bolus of normal saline before and after amphotericin B infusion. The rate of nephrotoxicity, fevers, chills, and rigors are proportional to the dose and infusion rate.
What electrolyte imbalance does amphotericin B cause?
Amphotericin B-induced nephrotoxicity is manifested as azotaemia, renal tubular acidosis, impaired renal concentrating ability and electrolyte abnormalities like hypokalaemia and sodium and magnesium wasting. All these abnormalities occur to varying degrees in almost all patients receiving the drug.
Why is amphotericin high risk?
Amphotericin exhibits infusion-related toxicity, which accounts for its extended administration times. Infuse slowly over 3 hours; rapid infusion can cause cardiotoxicity.
How do you inject amphotericin B?
How to use Amphotericin B Vial. This medication is usually given by injection into a vein as directed by your doctor, usually given once a day or every other day. It should be injected slowly over 2 to 6 hours. Your doctor may give you a smaller dose first to test your response to the medication.
Which of the following is the most serious adverse effect of amphotericin B?
Acute reactions including fever, shaking chills, hypotension, anorexia, nausea, vomiting, headache, and tachypnea are common 1 to 3 hours after starting an intravenous infusion. These reactions are usually more severe with the first few doses of amphotericin B and usually diminish with subsequent doses.
Does amphotericin cause hyperkalemia?
A lipid formulation of amphotericin B is commercially available, and no reports of hyperkalemia are associated with its administration.
How is an amphotericin B infusion reaction treated?
In clinical practice, infusion-related reactions associated with amphotericin B therapy may be blunted by slowing the infusion rate but often require premedication with acetaminophen (10 to 15 mg/kg), hydrocortisone (0.5 to 1.0 mg/kg), or meperidine (0.2 to 0.5 mg/kg).
Is amphotericin compatible with normal saline?
– The Amphotericin B should NEVER be mixed with Normal Saline or Half Normal Saline as it will precipitate. The line that is used for Amphotericin-B should not be used for administering any other drugs.
How do you reduce amphotericin nephrotoxicity?
These strategies include sodium supplementation, low-dose dopamine, slower infusion rates, the administration of AmB in lipid emulsions, and in lipid formulations. The results of these trials showed that the lipid formulations of AmB significantly reduce nephrotoxicity.
Can amphotericin cause hypokalemia?
Hypokalemia and potassium depletion are frequent complications of amphotericin B therapy. Both ischemic and gentamicin-induced renal failure is potentiated by potassium depletion; it is, therefore, possible that amphotericin B nephrotoxicity is similarly influenced.
