Fungal skin lesions bring significantdiscomfort to the patient. Moreover, such diseases are contagious. Therefore, when the first signs of fungus appear, you should always contact a specialist. After the delivery of medical tests and other examinations, the doctor must appoint effective medications to the patient.
Very often for the treatment of fungal diseasesuse a variety of ointments and tablets. However, most doctors claim that such a pathological condition is better treated with intravenous injections. After injections, the drug will immediately begin to affect the microorganisms, which show special sensitivity to it.
The most effective and effective means for eliminating fungal diseases include the drug "Amphotericin B". The instructions, the release forms and reviews about this medicine will be presented below.
Form, composition, description and packaging of antibiotic
You can buy the drug in the following forms:
- Lyophilisate "Amphotericin B". Reviews report that this form of drugmeans is a porous hygroscopic mass of yellow color without a pronounced odor. It is intended for the preparation of an infusion solution. The active component of this drug is amphotericin B. As auxiliary constituents, substances such as monosodium phosphate and deoxycholic acid are used. On sale, this medication comes in 10 ml vials and packs of cardboard.
- Ointment "Amphotericin B". The use of this agent is shown asan additional drug for complex therapy. Antifungal ointment is used only externally. It has a yellow color and contains the same active substance. As for additional components, they use vaseline oil, medical Vaseline and polysorbate 80. They can be purchased in tubes of 30 or 15 g.
The mechanism of action of the antifungal drug
What is the drug "Amphotericin B"? Instructions for use (tablets with the same active substance found quite problematic) reports that it is a macrocyclic polyene antibiotic with antifungal activity. It is produced by Streptomyces nodosus, and also has a fungistatic and fungicidal effect (depends on the concentration of the drug in biological fluids and the sensitivity of the pathogen).
After getting the medicine into the bloodstream, hebinds to sterols that are in the cell membranes of the fungus, sensitive to the drug. As a result of such an impact, their permeability is disrupted and the intracellular components are withdrawn to the extracellular space.
The drug "Amphotericin B" is active against many strains and moderately active against the simplest fungi.
Also it should be noted that Fusarium spp. and Pseudallescheria boydii. In addition, this drug is ineffective against rickettsia, bacteria and viruses.
Kinetic properties of the drug
Now you know what constitutes an antifungal drug, such as "Amphotericin B". The mechanism of action of this agent was described above.
After intravenous administration of the drug ina single dose in the blood immediately creates its effective concentration, which persists throughout the day. With plasma proteins, this drug binds to 90 percent.
The drug is divided intoliver, lungs, kidneys, spleen, muscles, adrenal glands and in other organs and tissues. Its concentration in pleural effusion, synovial and peritoneal fluids, as well as watery moisture reaches 2/3 of the concentration in the blood.
The ways of metabolism of this agent are unknown. In urine and bile, about 98 percent of the drug is present in the form of metabolites. It is withdrawn slowly, through the kidneys. The initial half-life of the drug in adults is 24 hours, children - 6-40 hours, and in newborns - 20-60 hours. The final half-life is 15 days.
Indications of antibiotic
What diseases does the drug Amphotericin B treat? It is prescribed for progressive, life-threatening fungal infections that have been caused by sensitive microorganisms:
- histoplasmosis, disseminated cryptococcosis, coccidioidosis;
- Cryptococcal meningitis, paracoccidioidosis, chromomycosis;
- meningitis caused by other fungi, North American blastomycosis;
- disseminated and invasive aspergillosis, fikomycosis (zygomycosis);
- disseminated form of candidiasis, hyalogomycosis;
- mold mycosis, chronic mycetoma;
- disseminated sporotrichosis, infections of the abdominal cavity (including peritonitis);
- endophthalmitis, endocarditis, fungal sepsis;
- visceral leishmaniasis, fungal infections of the urinary tract;
- American skin-visceral leishmaniasis.
Contraindications antifungal agents
Let's consider, what conditions forbid to apply a preparation «Amfotericin In» (tablets from a fungus with the similar name are not made). According to the instruction, this remedy is contraindicated:
- with chronic renal failure;
- with hypersensitivity;
- in the period of breastfeeding.
With caution this medication is used for kidney diseases (including glomerulonephritis), amyloidosis, liver cirrhosis, hepatitis, anemia, agranulocytosis, pregnancy and diabetes.
Lyophilisate "Amphotericin B": instructions for use
For the preparation of an intravenous solution, the preparationis used with an initial concentration of 5 mg / ml. Using a sterile syringe, 10 ml of water for injections is introduced into the vial with the medicament. Further, its contents are shaken until a clear, colloidal liquid forms.
Intravenously, the drug is administered for half an hourunder the control of blood pressure, body temperature and pulse of the patient. If the drug is well tolerated, its recommended daily dosage is 0.25-0.3 mg per kg of body weight (depending on the severity of the disease).
In diseases of the heart and blood vessels, increasedsensitivity and insufficient work of the kidneys, treatment starts with small doses (5-10 mg), which gradually increase by 5-10 mg per day and adjusted to 0.5-0.7 mg per kg.
With sporotrichosis, the course dose of the drug is 2.5 g, and the duration of therapy is at least 9 months.
In aspergillosis, the dosage of this remedy is 3.6 g, and the duration of treatment is at least 11 months.
Children at the beginning of therapy are given 0.25 mg per kg of body weight per day, and then gradually increased to the maximum dose (1 mg per kg).
Ointment "Amphotericin B": instructions for use
Tablets under the same name in pharmacies are not sold. Therefore, to replace this medication you should consult a doctor.
If you need to use the ointment "Amphotericin B", apply a thin layer to the affected areas twice a day. The treatment course depends on the available indications:
- with candidiasis skin folds - about 1-3 weeks;
- with diaper rash in children - about 7-14 days;
- at paronychia and lesions of interdigital spaces - 2-4 weeks.
The drug "Amphotericin B" can cause the following side effects:
- headaches, convulsions, peripheral neuropathy, transient vertego, encephalopathy;
- loss of appetite, vomiting, dyspepsia, nausea, gastralgia, diarrhea, hepatotoxicity, acute hepatic insufficiency, jaundice, hepatitis, melena, hemorrhagic gastroenteritis;
- normochromic normocytic anemia, leukopenia, clotting disorder, thrombocytopenia, agranulocytosis, hemolytic anemia, eosinophilia, leukocytosis;
- impaired vision, loss of hearing, diplopia, tinnitus;
- tachypnea, dyspnea, pulmonary edema, arrhythmia and allergic pneumonitis;
- decrease or increase in blood pressure, itching, changes in ECG indicators, cardiac arrest, shock, heart failure;
- anaphylactoid reactions, sneezing, nephrogenic diabetes insipidus, bronchospasm, nephrocalcinosis, rash, exfoliative dermatitis, toxic epidermal necrolysis
- renal dysfunction, hypokalemia, hypostenuria, renal tubular acidosis, Stevens-Johnson syndrome, acute renal failure, oliguria, anuria;
- thrombophlebitis and burn at the injection site;
- fever, myalgia, weight loss, arthralgia, general weakness.
Cases of overdose
When administering large doses of medication in a patientcan stop breathing and heart. Therefore, during the therapy should strictly adhere to the recommended dosage. It is also necessary to monitor the work of respiratory and cardiac activity, kidney and liver function, the picture of peripheral blood, as well as the content of electrolytes in it.
Compatibility with other medicines
The drug "Amphotericin B" canstrengthen or weaken the effect of other drugs, as well as increase their toxicity. In this regard, this medication with caution is prescribed in complex therapy.
When the said agent is administered to a patientIt is necessary to inform your doctor about other medications. Otherwise, the use of "Amphotericin B" (intravenous) may be detrimental to the health and overall well-being of the person.
- The drug "Amphotericin B" should be used only to treat life-threatening and progressive fungal infections.
- With prolonged use, the likelihood of developing toxic effects increases.
- When anemia occurs, use of the drug should be discontinued.
Now you know how the drug worksAmphotericin B. Suspension with this name in pharmacies is not for sale. Therefore, for oral administration, you should choose another medication with a similar effect.
According to most patients, themeans effectively copes with the task. It perfectly treats fungal skin lesions, eliminating the patient's physical and psychological discomfort.
The main drawback of this drug ispresence of a large number of side effects. In the course of treatment with this drug, unwanted reactions can be manifested by any organs and systems. Therefore, it should be used only on special indications.