Description of the medicine: Amphotericin B (Amphotericinum B)
AMPHOTERICIN B (Amphotericinum B).
Antibiotic produced by Strepomyces nodosus actinomycete.
Synonyms: Amfostat, Amphotericin B, Fungilin, Fundizone, Saramycetin, Vencidin, etc.
Belongs to the group of polyene antibiotics.
The powder is yellow or yellow-orange. Practically insoluble in water and alcohol. Hygroscopic. Sensitive to light and heat. Easily inactivated in acidic and alkaline environments.
Contains not less than 750 PIECES in 1 mg; 1 unit corresponds to the activity of 1 μg of chemically pure amphotericin B.
The drug is effective against many pathogenic fungi, pathogens of various diseases. A characteristic feature of amphotericin B compared with other modern antifungal drugs is its effectiveness in deep and systemic mycoses. It is effective in a number of fungal diseases that cannot be treated with other antifungal agents: blastomycosis, cryptococcosis, coccidioidosis, histoplasmosis, mold mycoses, etc., as well as in chronic and granulomatous disseminated forms of candidiasis.
Apply the drug intravenously, inhalation and topically (in the form of an ointment). When introduced into the gastrointestinal tract, it is practically not absorbed. With intravenous administration, the drug is effective, but toxic and should be used only according to the indications with the exact observance of the dosage. Despite the high toxicity and the risk of side effects, amphotericin B is used in some cases due to its high efficiency.
For intravenous infusions, the drug is available in the form of a special dosage form - amphotericin B for intravenous administration (Amphotericinum B prgo injectione intravenosa) in bottles containing 50,000 units (0.0694 g) of amphotericin B (in combination with sodium deoxycholate and phosphate buffer).
The dosage form for infections (amorphous powder or yellow porous mass) is dissolved in a 5% glucose solution and in water with the formation of a colloidal system.
A solution for intravenous administration is prepared immediately before use. The contents of the vial (50,000 IU of amphotericin B) are dissolved in 10 ml of sterile water for injection (puncture the cork with a sterile needle and syringe), the solution from the vial is filled into a syringe and poured into a vial containing 450 ml of sterile 5% glucose solution. Enter the drip method for 4 to 6 hours. The solution during its preparation and administration should not be exposed to bright light.
The dose of amphotericin B is set for each patient individually at the rate of 250 PIECES / kg (this solution contains 122 PIECES in 1 ml).
Prior to the introduction of the drug at this dose, 100 U / kg are preliminarily administered (to determine individual tolerance). In the future, with good tolerance, the absence of side effects and, if necessary, the dose can be increased to 1000 PIECES / kg.
The drug is administered every other day or 2 times a week (danger of cumulation), in some cases 1 to 2 times a week.
The duration of treatment depends on the severity and localization of the process, the duration of the disease, etc.