Hypokalaemia amphotericin

DIGOXIN AMPHOTERICIN Risk of digoxin t by toxicity due to hypokalaemia Amphotericin may cause hypokalaemia Monitor potassium levels closely. Monitor digoxin levels watch for digoxin toxicity... 

LOOP DIURETICS ANTI FUNG ALS -AMPHOTERICIN Risk of hypokalaemia Additive effect Monitor potassium closely... 

Bearden DT, Muncey LA. The effect of amiloride on amphotericin B-induced hypokalaemia. J Antimicrob Chemother 2001 48(1) 109-11. 

Smith SR, Galloway MJ, Reilly JT, Davies JM. Amiloride prevents amphotericin B related hypokalaemia in neutropenic patients. J Clin Pathol 1988 41 494-7. 

Amphotericin B can induce hypokalaemia resulting in muscle weakness, which might be expected to enhance the effects of neuromuscular blockers, but there appear to be no reports in the literature confirming that a clinically significant interaction actually occurs. 

The combined use of drugs that can cause hypokalaemia (e.g. amphotericin B, corticosteroids, thiazide and ioop diuretics, and stimuiant iaxatives) and drugs that proiong the QT intervai (e.g. ciass la and ciass in antiarrhythmics see Tabie 9.2 , (above)) shouid be well monitored because hypokalaemia increases the risk of torsade de pointes arrhythmias. There appear to be only a few reports of this interaction, for example, see Beta blockers + Potassium-depleting drugs , p.8S2. ... 

Observational studies A prospective study investigated the effectiveness and safety of liposomal amphotericin B (L-AmB) therapy in critically ill paediatric patients Altogether, 23 critically ill patients were included (nine females, mean age 26.4 months, range, 5-39 months) and they received L-AmB for a median of 10 days (range, 3-28 days). Two cases of hepatotoxicity and one case of nephrotoxicity leading to discontinuation of therapy were recorded. Seven cases of mild reversible hypokalaemia and five cases of hyponatremia were also reported. 

S. Shigemi, K. Matsumoto, K. Iwaka, K. Yaji, Y. Shimodozono, N. Morikawa, Y. Takeda and K. Yamada, Safety analysis of liposomal amphotericin B in adult patients anaemia, thrombocytopenia, nephrotoxicity, hepatotoxicity and hypokalaemia, Int. J. Antimicrob. Agents, 2011, 38, 417 20. 

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