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Amphotericin B
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-only with systemic fungal infections that are progressive and potentially fatal ie: life threatening!!!
-infusion reactions and renal damage occur in all patients in varying degrees -the patient should be under close supervision, preferably in hospital -infusion reactions, nephrotoxicity: monitor and record intake and output; kidney fxn tested q 3-4 days-infuse with 1 L saline on day to reduce; check potassium levels and serum creatinine often-not above 3.5 mg/dL-above 4 g dose is residual impairment likely; hematocrits to determine RBC status -hypokalemia, hematologic effects -infusion rxns-fever, chills, rigors, nausea, headache; mild with dihenhydramine and acetaminophen; aspirin-but might increase kidney damage; IV meperidine or dantrolene for rigors; hydrocortisone-glucocorticoid-decrease fever and chills if others fail -phlebitis-change sites often, pretreat with heparin, give amphotericin through a large central vein |
