Fungal skin lesions bring significant discomfort to the patient. Moreover, such diseases are contagious. Therefore, when the first signs of a fungus appear, you should definitely contact a specialist. After passing medical tests and other examinations, the doctor is obliged to prescribe effective medicines to the patient.
Very often, various ointments and tablets are used to treat fungal diseases. However, most doctors argue that such a pathological condition is best treated with intravenous injections. After the injections, the drug will immediately begin to act on microorganisms that are particularly sensitive to it.
The most effective and effective means to eliminate fungal diseases include the drug "Amphotericin B". Instructions, release forms and reviews of this medicine will be presented below.
Shape, composition, description and packaging of the antibiotic
You can buy the drug in question in the following forms:
Lyophilisate "Amphotericin B". Reviews report that this formThe drug is a porous hygroscopic mass of yellow color without a pronounced odor. It is intended for the preparation of an infusion solution. The active component of this medication is amphotericin B. Substances such as monosubstituted sodium phosphate and deoxycholic acid are used as auxiliary components. This medication goes on sale in 10 ml bottles and cardboard packs
Ointment "Amphotericin B". The use of this agent is indicated as an additional drug in complex therapy. Antifungal ointment is used only externally. It has a yellow color and contains the active substance of the same name. As for the additional components, they use vaseline oil, medical vaseline and polysorbate 80. You can buy this medication in tubes of 30 or 15 g
Mechanism of action of an antifungal drug
What is Amphotericin B medication? Instructions for use (tablets with the same active substance are quite problematic to find) reports that this is a macrocyclic polyene antibiotic with antifungal activity. It is produced by Streptomyces nodosus, and also has a fungistatic and fungicidal effect (depending on the concentration of the drug in biological fluids and the sensitivity of the pathogen).
After a drug enters the bloodstream, it binds to sterols found in the cell membranes of a drug-sensitive fungus. As a result of thisimpact, their permeability is disturbed and intracellular components are excreted into the extracellular space.
Amphotericin B is active against many strains and moderately active against protozoan fungi.
It should also be noted that Fusarium spp. and Pseudallescheria boydii. In addition, this drug is ineffective against rickettsiae, bacteria and viruses.
Kinetic properties of the drug
Now you know what an antifungal drug like Amphotericin B is. The mechanism of action of this remedy has been described above.
After intravenous administration of the drug in a single dose, its effective concentration is immediately created in the blood, which persists throughout the day. This agent is 90 percent bound to plasma proteins.
The drug in question is distributed in the liver, lungs, kidneys, spleen, muscles, adrenal glands and other organs and tissues. Its concentration in pleural effusion, synovial and peritoneal fluids, as well as aqueous humor reaches 2/3 of the concentration in the blood.
Methods of metabolism of this drug are unknown. In urine and bile, about 98 percent of the drug is present as metabolites. It is excreted slowly through the kidneys. The initial half-life of the drug in adults is 24 hours, in children - 6-40 hours, and in newborns - 20-60 hours. The terminal half-life is 15 days.
Indicationsantibiotics
What diseases does Amphotericin B treat? It is prescribed for progressive, life-threatening fungal infections that have been caused by susceptible microorganisms:
- histoplasmosis, disseminated cryptococcosis, coccidioidomycosis;
- cryptococcal meningitis, paracoccidioidomycosis, chromomycosis;
- meningitis caused by other fungi, North American blastomycosis;
- disseminated and invasive aspergillosis, phycomycosis (zygomycosis);
- disseminated form of candidiasis, hyalohyphomycosis;
- mold mycosis, chronic mycetoma;
- disseminated sporotrichosis, abdominal infections (including peritonitis);
- endophthalmitis, endocarditis, fungal sepsis;
- visceral leishmaniasis, fungal infections of the urinary tract;
- American visceral leishmaniasis.
Contraindications for an antifungal agent
Let's consider what conditions prohibit the use of the drug "Amphotericin B" (pills from the fungus with the same name are not produced). According to the instructions, this remedy is contraindicated:
- for chronic renal failure;
- for hypersensitivity;
- during breastfeeding.
With caution, this medication is used for kidney disease (including glomerulonephritis), amyloidosis, liver cirrhosis, hepatitis, anemia, agranulocytosis, pregnancy and diabetes.
Lyophilizate "Amphotericin B":instructions for use
For the preparation of an intravenous solution, the drug is used with an initial concentration of 5 mg / ml. Using a sterile syringe, 10 ml of water for injection is introduced into the vial with the medication. Then its contents are shaken until a transparent colloidal liquid is formed.
Intravenously, the drug is administered for half an hour under the control of blood pressure, body temperature and pulse of the patient. With good tolerance of the drug, its recommended daily dosage is 0.25-0.3 mg per kg of body weight (depending on the severity of the disease).
In diseases of the heart and blood vessels, hypersensitivity and insufficient kidney function, treatment begins with small doses (5-10 mg), which are gradually increased by 5-10 mg per day and adjusted to 0.5-0.7 mg per kg.
With sporotrichosis, the course dose of the drug is 2.5 g, and the duration of therapy is at least 9 months.
For aspergillosis, the dosage of this remedy is 3.6 g, and the duration of treatment is at least 11 months.
Children are given 0.25 mg per kg of body weight per day at the very beginning of therapy, and then gradually increase to the maximum dose (1 mg per kg).
Amphotericin B ointment: instructions for use
Pills under the same trade name are not sold in pharmacies. Therefore, to replace this medicine, you should consult a doctor.
If it is necessary to use Amphotericin B ointment, apply it in a thin layer to the affected areas twice a day. The treatment course depends on the availableindications:
- with candidiasis of skin folds - about 1-3 weeks;
- for diaper rash in children - approximately 7-14 days;
- with paronychia and lesions of the interdigital spaces - 2-4 weeks.
Side effects
Amphotericin B may cause the following side effects:
- headaches, seizures, peripheral neuropathy, transient vertigo, encephalopathy;
- appetite loss, vomiting, dyspepsia, nausea, gastralgia, diarrhea, hepatotoxicity, acute liver failure, jaundice, hepatitis, melena, hemorrhagic gastroenteritis;
- normochromic normocytic anemia, leukopenia, coagulation disorder, thrombocytopenia, agranulocytosis, hemolytic anemia, eosinophilia, leukocytosis;
- visual impairment, hearing loss, diplopia, tinnitus;
- tachypnea, shortness of breath, pulmonary edema, arrhythmia and allergic pneumonitis;
- lower or higher blood pressure, itching, ECG changes, cardiac arrest, shock, heart failure;
- anaphylactoid reactions, sneezing, nephrogenic diabetes insipidus, bronchospasm, nephrocalcinosis, rash, exfoliative dermatitis, toxic epidermal necrolysis
- renal dysfunction, hypokalemia, hypostenuria, renal tubular acidosis, Stevens-Johnson syndrome, acute renal failure, oliguria, anuria;
- thrombophlebitis and burn at the injection site;
- fever, myalgia, weight loss, arthralgia, general weakness.
Overdose cases
Whenadministration of large doses of the drug, the patient may experience respiratory and cardiac arrest. Therefore, in the course of therapy, one should strictly adhere to the dosages recommended by the doctor. It is also necessary to monitor the work of respiratory and cardiac activity, kidney and liver function, the picture of peripheral blood, as well as the content of electrolytes in it.
Compatibility with other medicines
The drug "Amphotericin B" may increase or decrease the effect of other drugs, as well as increase their toxicity. In this regard, this medication is prescribed with caution in complex therapy.
When prescribing the mentioned remedy, the patient should be sure to inform his doctor about taking other drugs. Otherwise, the use of "Amphotericin B" (intravenous) can adversely affect the he alth and general well-being of a person.
Special Recommendations
- Amphotericin B should only be used to treat life-threatening and progressive fungal infections.
- With prolonged use, the likelihood of developing toxic effects increases.
- If anemia occurs, the use of the drug should be discontinued.
Reviews
Now you know how Amphotericin B works. A suspension with this name is not sold in pharmacies. Therefore, for oral administration, you should choose another medication with a similar effect.
According to most patients, the remedy in question effectively copes withassigned task. It perfectly treats fungal skin lesions, eliminating the physical and psychological discomfort of the patient.
The main disadvantage of this drug is the presence of a large number of side effects. During treatment with this remedy, adverse reactions can occur from any organs and systems. Therefore, it should be used only for special indications.
