Vomiting amphotericin

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. 

These bind sterols in the cell membrane causing leakage and, hence, cell death. Amphotericin B is the most important member of this group and is active against almost all medically important fungi. However, its limitations are mandatory parenteral administration and toxic reactions that include headache, vomiting, anaemia. 

Adverse effects associated with oral administration of nystatin include mild nausea, diarrhea, and occasional vomiting. Topical application is nonirritating, and allergic contact hypersensitivity is exceedingly uncommon. Topical amphotericin is well tolerated and only occasionally locally irritating. Hypersensitivity is rare. The drug may cause a temporary yellow staining of the skin, especially when the cream vehicle is used. 

Nystatin [nye STAT in] is a polyene antibiotic its structure, chemistry, mode of action, and resistance resemble those of amphotericin B. Its use is restricted to topical treatment of Candida infections because of its systemic toxicity. The drug is negligibly absorbed from the gastrointestinal tract, and it is never used par-enterally. It is administered as an oral agent ( swish and swallow ) for the treatment of oral candidiasis. Excretion in the feces is nearly quantitative. Adverse effects are rare because of its lack of absorption, but occasionally nausea and vomiting occur. 

Amphotericin and itraconazole have been compared in a multicenter, open, randomized study in 277 adults with cancer and neutropenia (54). Itraconazole oral solution (100 mg bd, n — 144) was compared with a combination of amphotericin capsules and nystatin oral suspension n — 133). Adverse events were reported in about 45% of patients in each group. The most frequent were vomiting (14 versus 12 patients), diarrhea (12 versus 9 patients), nausea (5 versus 12 patients), and rash (2 versus 13 patients). There were no differences in liver function... 

Anorexia, nausea, and vomiting are common effects of parenteral administration of amphotericin. Gastrointestinal complaints are markedly less common with liposomal amphotericin than with ABCD(5). 

Miltefosine has been compared with the most effective standard treatment, amphotericin, in a randomized, open comparison in India, in which 299 patients, aged 12 years or over, received oral miltefosine (50 or 100 mg) and 99 patients received intravenous amphotericin deoxycho-late (1 mg/kg every other day to a total of 15 injections) (4). Vomiting and diarrhea were more common with miltefosine. However, the effects were mild in almost all cases, and only 3-4% of patients needed antiemetic drugs in both groups. One patient who took miltefosine withdrew because of gastrointestinal intolerance and one developed Stevens-Johnson syndrome. 

Amphotericin B 100 mg/mL suspension - RC 1-5 mL swish and swallow 4-5 times Oral Nausea, vomiting, diarrhea with... 

H. pylori is a major etiological factor in gastroduodenal disorders such as chronic gastritis, peptic ulcer, and gastric cancer. Therefore, the treatment and prevention of these diseases would be facilitated by its eradication. At present, triple therapies that comprise two antibiotics (clarithromycin and amphotericin B) and a proton pump inhibitor are used to eradicate H. pylori. However, strains that are resistant to antibiotics have appeared. In addition, antibiotic treatment is associated with serious side effects such as nausea, vomiting, and diarrhea. Therefore, the discovery of novel antibacterial agents that are highly effective and safe is badly needed for the treatment of H. pylori infection. 

Imidazoles arc wide-spectnim antifungal drugs to which resistance rarely develops. Except for ketoconazolc. the imidazoles are poorly absorbed orally. Clotrimazole, econii/ule and miconazole are widely used lopic-aliy in the Ireatment of dennaiophyle and Candida alhicam infections. Miconazole is used intravenously in systemic infections in patients who cannot tolerate amphotericin. It may cause nausea and vomiting, faintness and anaphylaxis. Ketoconazole is well absorbed orally, and has been used in Ihe crealment of local and systemic mycoses. Enthusiasm for ketoconazole has declined because it may cause hepatic necrosis and adrenal suppression. 

Renal tubular acidosis can occur during amphotericin B therapy [439,440]. Renal tubular acidosis and hykalemia can be easily corrected with oral potassium therapy [436,439,441]. Hydrocortisone and heparin are sometimes used in conjunction with polyene therapy to reduce toxic side effects [442]. The immediate reactions to intravenous amphotericin B therapy (nausea, vomiting and fever) can be controlled to some extent by usually antihistamines and hydrocortisone [443,444] but reports that some of the symptoms of nephrotoxicity may be overcome by mannitol supplementation [445] have been disputed [446]. 

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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