Thrombophlebitis amphotericin

Amphotericin B is the only polyene antibiotic given parenterally. When the intravenous route is contemplated, amphotericin B is dispersed fresh, as discussed, and infused slowly. Amphotericin B should not be administered rapidly because this causes cardiac toxicity. Heparin (1000 units) is often added to the infusion suspension to avert the risk of thrombophlebitis. Amphotericin B can also precipitate normocytic or normochromic anemia, leukopenia, and thrombocytopenia. 

Amphotericin B is the mainstay of treatment of patients with severe endemic fungal infections. The conventional deoxycholate formulation of the drug can be associated with substantial infusion-related adverse effects (e.g., chills, fever, nausea, rigors, and in rare cases hypotension, flushing, respiratory difficulty, and arrhythmias). Pre-medication with low doses of hydrocortisone, acetaminophen, nonsteroidal anti-inflammatory agents, and meperidine is common to reduce acute infusion-related reactions. Venous irritation associated with the drug can also lead to thrombophlebitis, hence central venous catheters are the preferred route of administration in patients receiving more than a week of therapy. 

Normochromic normocytic anemia is the most common hematological side effect of amphotericin B administration thrombocytopenia and leukopenia are much less common. Infusion of the drug into a peripheral vein usually causes phlebitis or thrombophlebitis. Nausea, vomiting, and anorexia are a persistent problem for some patients. 

Tile usefulness of amphotericin B is limited by a high prevalence of adverse reactions. Nearly 80% of patient-treated with amphotericin B develop nephrotoxicity. Fever headache, anorexia, gastrointestinal distress, malaise, and muscle and joint pain arc common. Pain at the site of injection and thrombophlebitis are frequent complications of intravenous administration. The drug must never be administered intramuscularly. The hemolytic activity of amphotericin B may be a consequence of its ability to Icadi cholesterol from erythrocyte cell membranes. 

The clinical usefulness of amphotericin B in the treatment of systemic mycoses is limited by its toxicity profile. Acute adverse reactions during and in the immediate postinfusion period include nausea, vomiting, headache, fever and chills. Thrombophlebitis at the infusion site is also a... 

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