Description of the medicine: Amphotericin B (Amphotericinum B)
AMPHOTERICINE B (Amphotericinum B).
Antibiotic, produced by actinomycete Strepomyces nodosus.
Synonyms: Amfostat, Amphotericin B, Fungilin, Fundizone, Saramycetin, Vencidin and others.
Refers to a group of polyene antibiotics.
Powder of yellow or yellow-orange color. Almost nerastvorim in water and alcohol. Hygroscopic. Sensitive to light and high temperature. Easily inactivated in acidic and alkaline environments.
Contains not less than 750 units per 1 mg; 1 ED 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 in comparison with other modern antifungal drugs is its effectiveness in deep and systemic mycoses. It is effective in a number of fungal diseases that can not be treated with other antifungal agents: blastomycosis, cryptococcosis, coccidioidosis, histoplasmosis, mold mycoses, etc., as well as chronic and granulomatous disseminated forms of candidiasis.
Apply the drug intravenously, inhalation and topically (as an ointment). When injected into the gastrointestinal tract, it is practically not absorbed. With intravenous administration, the drug is effective, but toxic and should only be used according to the indications with accurate dosage. Despite the high toxicity and risk of side effects, amphotericin B is used in a number of cases due to its high efficacy.
For intravenous infusions, the drug is available as a special dosage form - amphotericin B for intravenous administration (Amphotericinum B rgo injectione intravenosa) in vials containing 50,000 U (0.0694 g) amphotericin B (in combination with sodium deoxycholate and phosphate buffer).
The medicinal form for infections (amorphous powder or porous mass of yellow color) dissolves in a 5% solution of glucose and in water with the formation of a colloidal system.
The solution for intravenous administrations is prepared immediately before use. The contents of the vial (50,000 units of amphotericin B) are dissolved in 10 ml of sterile water for injection (puncture the plug with a sterile needle with a syringe), the solution from the vial is drawn into a syringe and poured into a vial containing 450 ml of sterile 5% glucose solution. Introduce by drop method for 4 - 6 hours. The solution during its preparation and administration should not be exposed to the action of bright light.
The dose of amphotericin B is set for each patient individually at the rate of 250 U / kg (this solution contains 122 U in 1 ml).
Prior to the introduction of the drug at this dose, 100 U / kg is administered in advance (to determine individual tolerability). In the future, with good tolerability, no side effects and if necessary, the dose can be increased to 1000 units / kg.
Enter the drug every other day or twice 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.