| DRUG | SUPPLIED | DOSE | COMMENTS |
|---|---|---|---|
| AMPHOTERICIN B deoxycholate (Paeds) (Conventional, Fungizone) Mechanism of action: Polyene antifungal Ref: 5,6, 44, 302, 609 Last update: 2022-06-08 |
Injection: 50 mg/vial | 1-1.5 mg/kg/dose IV Q24H Bladder Irrigation: 15-50 mg/24 hr diluted to 0.05 mg/mL in SWI as a continuous irrigation over 24 hr or 5-15 mg in 100 mL SWI at 100-300 mL/day for irrigation TID-QID for 2-5 daysVia Inhalation for Cystic Fibrosis: 2-10 mg nebulized BID. Further dilute with sterile water for nebulization (not compatible with sodium chloride) |
Infuse first dose over 6 hours and closely monitor for anaphylactic/adverse reactions. May result in nephrotoxicity. Monitor renal, fluid and electrolyte (K+, Mg2+) status closely. Avoid concomitant use with other nephrotoxic drugs. Infusion related reactions (fever, chills, nausea and vomiting) are common. Acetaminophen and/or diphenhydramine 30 minutes prior and 4 hours after infusion may alleviate febrile reactions. Meperidine may be useful for chills. Hydrocortisone 1 mg per mg of amphotericin (Maximum: 25 mg) added to infusion bag may help prevent immediate adverse reactions. After 1 week of therapy, adequate serum concentrations can usually be maintained by administering double the daily dose (maximum 1.5 mg/kg) every second day. Injectable form may be nebulized. Reconstitute with 10 mL of sterile water = 5 mg/mL solution Stable for 7 days refrigerated. Protect from light *Incompatible with sodium chloride*. Refer to nursing guidelines “Aerosol therapy using mask and nebulizer” on SHOP. Standard Prescription: amphotericin B __mg IV Q__H (__mg/kg/24 hr) amphotericin B __mg nebulized__(frequency) amphotericin B __mg diluted in __mL SWI instilled into bladder over__hours or Q__H |