Amphotericin B is an important drug in ENT practice. Therefore, it is oft repeated in DNB and MS theory exams. We have uploaded 3 images which cover all sub-topics under this drug. We have included a few excerpts from the images in this blog post. Readers please note that – AmB refers to Amphotericin B.
Please check the image gallery for a concise note on Amphotericin B with all necessary details to fetch you a full 10/10 marks!
INTRODUCTION and mechanism of action
It is a polyene antifungal. It is regarded as the gold standard of antifungals. The drug is obtained from Streptomyces nodosus.
It forms a micropore in the cell membrane of fungus thereby increasing the permeability. As a result the fungus dies. The same mechanism causes its systemic toxicity as well.
antifungal spectrum and adverse effects
The spectrum includes candida, histoplasma, cryptococcus, blastomycoses and a few more fungi. The adverse effects include nephrotoxicity, anemia and CNS toxicity.
lipid formulations and their advantages
The three formulations available are AmB lipid complex, AmB colloidal dispersion and Liposomal AmB. Above all, the lipid formulations have milder systemic toxicity and nephro-toxicity. They give higher doses and have special benefit in immunocompromised individuals.
HOW TO ADMINISTER LIPOSOMAL AMPHOTERICIN B?
The last image tells you how to administer Lip AmB. We follow this technique in our set-up. Firstly, take 5 mg of the drug and mix in 20 mL of 5% dextrose and infuse I.V. over 20 minutes. Check for any rashes, reactions, breathing difficulties, etc. Secondly, take 45 mg of the drug and mix in 500 mL of 5% dextrose and infuse over 4 hours. Like before, check for any adverse reactions. Observe till the next day and if the patient is fine then give the drug as follows. Mix 150-200 mg of the drug in 500 mL 5% dextrose and infuse over 4 hours once daily. We give a total of 2-3 g to the patient over 15 days times. Please note that the above is the adult dosage.
some brand names
Fungizone, Ambisome
references and more details
To read more on the topic you may please refer to the following.
- Conventional Amphotericin B by Medscape
- WebMD
- Scot Brown Otorhinolaryngology 8th edition
- Cummings 6th edition
- K. D. Tripathi’s Pharmacology
- Read more on Topics of Nose by World ENT Care Academics
Other related topics asked in exams
- Mucormycosis
- Fungal sinusitis
- Invasive fungal sinusitis
- Aspergillosis
- Fungal ball
- Allergic Fungal Rhino-Sinusitis
- Bent and Kuhn classification