Amphotericin B Deoxycholate(Fungizone)

Question 1

therapeutic class

Answer 1

antifungal systemic type

Question 2

pharmacologic class

Answer 2

polyene

Question 3

pregnancy category

Answer 3

B

Question 4

mechanism of action

Answer 4

binds to ergosterol in fungal cell membrane

Question 5

indications

Answer 5

severe systemic mycoses

prophylactic antifungal therpay

Question 6

contraindications

Answer 6

BUN exceeds 40 mg/dL

serum creatinine above 3 mg/dL

Question 7

precautions

Answer 7

hypotension, hypokalemia, and shock if the medication is administered too rapidly

Question 8

drug interactions

Answer 8

caution w/ other ototoxic and nephrotoxic drugs; corticosteroids, skeletal muscle relaxants and thiazole may potentiate hypokalemia; drug-induced hypokalemia can increase risk of digoxin toxicity; antifungal class of azoles

Question 9

adverse effects

Answer 9

acute fever, chills, vomiting, anorexia, headache, phlebitis, potassium deficiency, electrolyte imbalance

Question 10

serious adverse effects

Answer 10

CARDIAC ARREST, OTOXICITY, NEPHROTOXICITY, hepatotoxicity, anaphylaxis, blood abnormalities, dysrhythmias

Question 11

responsibilities

Answer 11

premedicate w/ antipyretics, antihistamines, antiemetics, and corticosteroids; reduce or discontinue drug if BUN >40 mg/dL or creatinine >3 mg/dL; monitor for improved renal function before resuming; monitor cardiovascular and respiratory stats during initial IV; check vital signs every 30 mins for at least 4 hrs after test dose

Question 12

more reponsibilities

Answer 12

record I&O and weight; report any change in appearance of urine; observe injection site for inflammation or thrombosis; assess for ototoxicity and report hearing loss or tinnitus, vertigo, or unsteady gait; assess for erythema, administer IV slowly over 2 to 6 hrs

Question 13

teaching

Answer 13

notify if no improvement in 1 to 2 wks; immediately report worsening symptoms; no breast-feeding; wash towels or clothing coming in contact with affected area; report change in amount or color of urine, bleeding or bruising, yellowing of eyes or skin, palpitations or chest pain; report loss of hearing, dizziness or ringing

Question 14

General Antifungal mechanism of Actions all types

Answer 14

inhibition of nucleic acid synthesis
disruption of membrane integrity
disruption of microtubule formation
inhibition of glucan synthesis
inhibition of ergosterol synthesis