Amphotericin B
別名: Abelcet, AmBisome, Amphotec, Fungizone, Amphocil
Amphotericin B is a powerful antifungal medication used only for **serious, life-threatening fungal infections**. - **Administration:** It must be given by injection (usually IV), which often requires your pet to be hospitalized or make frequent visits to the clinic. - **Kidney Risks:** This drug is highly toxic to the kidneys. Most pets will experience some degree of kidney stress. We will perform frequent blood and urine tests to monitor kidney function closely. - **Side Effects:** Watch for signs of illness such as vomiting, loss of appetite, extreme lethargy, or fever. Contact your veterinarian immediately if these occur. - **Cost & Commitment:** Treatment can be expensive and requires a significant time commitment for monitoring and administration.
劑量必須由獸醫按你寵物的個別情況決定。切勿在沒有獸醫指導下給予人類藥物或其他寵物的處方藥。
用途
- Susceptible systemic fungal infections (Llama)
- Susceptible systemic fungal infections (Rapid-Infusion Technique)
- Susceptible systemic fungal infections (Slow IV Infusion Technique)
- Systemic fungal infections (Dehydrated/compromised)
- Systemic mycoses (Lipid-based: AmBisome, Amphocil, Abelcet)
- Systemic mycoses (ABLC; Abelcet)
- Blastomycosis
- Blastomycosis
- Blastomycosis (severe cases, using Abelcet)
- Cryptococcosis
- Histoplasmosis
- Histoplasmosis
- Leishmaniasis (Liposomal form)
給藥方式
可能的副作用
- Nephrotoxicity (very common, dose-dependent)
- Anorexia and vomiting
- Hypokalemia and hypomagnesemia
- Distal renal tubular acidosis
- Phlebitis at injection site
- Cardiac arrhythmias
- Non-regenerative anemia
- Fever (can be mitigated with NSAIDs or low-dose steroids)
- Tachycardia, tachypnea, lethargy, restlessness (horses)
- Calcinosis cutis (dogs)
注意事項與禁忌
- Patients with known hypersensitivity to amphotericin B (unless the infection is life-threatening and no alternatives exist)
- > **Black Box Warning Equivalent:** Amphotericin B is highly nephrotoxic. Renal function must be aggressively monitored during therapy. - Use with extreme caution in patients with pre-existing renal disease. - Cats are more sensitive to nephrotoxic effects; reduced dosages are often recommended. - Ensure adequate hydration prior to administration. Sodium loading (e.g., normal saline administration before and after dosing) may help avert renal insufficiency by preventing tubuloglomerular feedback-induced vasoconstriction. - Pregnancy: Weigh risks vs. benefits. FDA Category B (human); Papich Class A (veterinary).
藥物相互作用
- Corticosteroids: May exacerbate the potassium-losing effects of amphotericin B.
- Digoxin: Amphotericin B-induced hypokalemia may exacerbate digoxin toxicity.
- Flucytosine: In vitro synergy against Cryptococcus and Candida, but may also increase flucytosine toxicity.
- Nephrotoxic Drugs (Aminoglycosides, Polymyxin B, Cisplatin, Cyclosporine, etc.): Additive renal toxicity; avoid concurrent or sequential use if possible.
- Potassium-Depleting Drugs (Thiazide or Loop Diuretics): Increased risk of severe hypokalemia.
- Saline Solutions or Preservative-containing Solutions: Reconstituting amphotericin B deoxycholate with these solutions may cause precipitation.
- Skeletal Muscle Relaxants (Tubocurarine): Amphotericin B-induced hypokalemia may enhance curariform effects.
- Fluorouracil: Amphotericin may increase the toxic effects of fluorouracil.
- Doxorubicin: Amphotericin may increase the toxic effects of doxorubicin.
- Methotrexate: Amphotericin may increase the toxic effects of methotrexate.
常見問題
Amphotericin B用於寵物有甚麼用途？
Amphotericin B is a powerful antifungal medication used only for **serious, life-threatening fungal infections**. - **Administration:** It must be given by injection (usually IV), which often requires your pet to be hospitalized or make frequent visits to the clinic. - **Kidney Risks:** This drug is highly toxic to the kidneys. Most pets will experience some degree of kidney stress. We will perform frequent blood and urine tests to monitor kidney function closely. - **Side Effects:** Watch for signs of illness such as vomiting, loss of appetite, extreme lethargy, or fever. Contact your veterinarian immediately if these occur. - **Cost & Commitment:** Treatment can be expensive and requires a significant time commitment for monitoring and administration.
Amphotericin B對我的寵物安全嗎？
劑量必須由獸醫按你寵物的個別情況決定。切勿在沒有獸醫指導下給予人類藥物或其他寵物的處方藥。
本文僅供一般健康教育，不能取代專業獸醫意見。如寵物身體不適，請諮詢獸醫。