Wednesday, November 6, 2019
Amphotericin B Essays - Antifungals, RTT, Rare Diseases, Free Essays
Amphotericin B Essays - Antifungals, RTT, Rare Diseases, Free Essays AmB kills yeast via ion channel-mediated membrane permeabilization. This channel model has been extended to also rationalize the unique lack of resistance to AmB as well as its dose-limiting toxicity. This perceived understanding has stimulated extensive research toward the goals of developing new channel-forming compounds as putative resistance-refractory antimicrobial agents and/or less toxic derivatives of AmB that more selectively form channels in fungal cells versus human cells. This drug should be used primarily for treatment of patients with progressive and potentially life-threatening fungal infections; it should not be used to treat noninvasive forms of fungal disease such as oral thrush, vaginal candidiasis, and esophageal candidiasis in patients with normal neutrophil counts. Expected Pharmacological Action AmphotericinB deoxycholate is an antifungal agent that acts on fungal cell membranes to cause cell death. Depending on concentration, these agents can be fungistatic (slows growth on the fungus) or fungicidal (destroys the fungus). Therapeutic Uses Antifungals are the treatment of choice for systemic fungal infection (Candidiasis, Aspergillosis, Cryptococcosis, Mucormycosis) and nonopportunistic mycoses, (Blastomycosis, Histoplasmosis, Coccidioidomycosis). Some antifungal treat superficial fungal infections: dermatophytic infections (tinea pedis [ringworm of the foot], tinea cruris [ringworm of the groin]); candida infections of the skin and mucous membranes; and fungal infections of the nails (Onychomycosis). Adverse effectsNursing Intervention infusion reactions (fever, chills, rigors, and headache) 1 to 3 hr after initiation pretreat with diphenhydramine (benadryl) and acetaminophen. meperidine (demerol), dantrolene, or hydrocortisone may be given for rigors. thrombophlebitisobserve infusion sites for signs of erythema, swelling, and pain. rotate injection sites. administer in a large vein and administer heparin before infusing amphotericin b. nephrotoxicityobtain baseline kidney function (bun and creatinine) and do weekly kidney function tests. monitor i&o. infuse 1 l of saline on the day of amphotericin b infusion. hypokalemia monitor electrolyte levels, especially potassium. administer potassium supplements accordingly. bone marrow suppressionobtain baseline CBC and hematocrit, and monitor weekly.