Amphotericine B

Class

Polene

Dose

0.7-10 mg/kg od (depends on indication)

Mechanism

Cidal

MoA

Binds ergosterol in membranes and forms pores in fungus

Leakage → cell death

Time v Conc

Concentration

Spectrum

Covers

Doesnt

Almsot all candida

Cryptococcal meningitis

*2nd line for candida bc echinocandins (caspo) are just as effective and less toxic

Except Candida lustanae +
Protozoa

Indications

Severe fungal infections

PK

A

IV

D

Enormous Vd

Highly lipophilic 

M

Liver & Renal

E

Only 3% excreted unchanged in urine. 

 

40% still in urine after 7 days

AE

  • Nephrotoxic
  • Hepatotoxic
  • Electrolyte disturbances
  • Blood dyscrasias
  • Seizures

Resistance

Monitoring

Cease in renal failure