兩性黴素B
別名: Abelcet, AmBisome, Amphotec, Fungizone, Amphocil
藥物類別: Antifungal (Polyene Macrolide)
兩性黴素B 是一種強效的抗黴菌藥物，僅用於**嚴重、危及生命的黴菌感染**。 - **給藥方式：** 必須透過注射（通常為靜脈注射）給藥，這通常需要您的寵物住院或頻繁前往診所。 - **腎臟風險：** 此藥物對腎臟具有高度毒性。大多數寵物會經歷一定程度的腎臟壓力。我們將頻繁進行血液和尿液檢查，以密切監測腎臟功能。 - **副作用：** 請密切觀察寵物是否有嘔吐、食慾不振、極度嗜睡或發燒等生病跡象。如果出現這些情況，請立即聯繫您的獸醫師。 - **費用與承諾：** 治療費用可能很高，並且需要投入大量時間進行監測和給藥。
劑量必須由獸醫依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。
Veterinary professional? See the full dosing-by-species reference on VetSheet →
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)
- Leishmaniasis (AmBisome)
- Gastrointestinal pythiosis (ABLC; Abelcet)
- Systemic fungal infections and leishmaniosis
- Aspergillosis (raptors and psittacines)
- Aspergillosis (raptors and psittacines)
- Aspergillosis
- Macrorhabdiasis (Microrhabdus ornithogaster)
- Susceptible systemic fungal infections (Rapid-Infusion Technique)
- Cryptococcosis
- Cryptococcosis
- Cryptococcosis
- Cryptococcosis (ABLC; Abelcet)
- Histoplasmosis
- Histoplasmosis
- Blastomycosis
- Blastomycosis
- Systemic fungal infections (e.g., cryptococcosis)
- Cryptococcosis (when IV access is problematic)
- Fungal pneumonia
- Phycomycoses and pulmonary mycoses
- Intrauterine infusion
- Susceptible systemic fungal infections (Rabbits)
- Susceptible fungal respiratory infections
給藥方式
IVSCIntratrachealNebulizationIntrauterinePO (Birds only for specific GI infections)Topical
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.
- Nephrotoxic drugs: Concurrent use significantly increases the risk of severe nephrotoxicity.
常見問題
兩性黴素B用於寵物有什麼用途？
兩性黴素B 是一種強效的抗黴菌藥物，僅用於嚴重、危及生命的黴菌感染。 - 給藥方式： 必須透過注射（通常為靜脈注射）給藥，這通常需要您的寵物住院或頻繁前往診所。 - 腎臟風險： 此藥物對腎臟具有高度毒性。大多數寵物會經歷一定程度的腎臟壓力。我們將頻繁進行血液和尿液檢查，以密切監測腎臟功能。 - 副作用： 請密切觀察寵物是否有嘔吐、食慾不振、極度嗜睡或發燒等生病跡象。如果出現這些情況，請立即聯繫您的獸醫師。 - 費用與承諾： 治療費用可能很高，並且需要投入大量時間進行監測和給藥。
兩性黴素B對我的寵物安全嗎？
劑量必須由獸醫依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。