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From GT:
Amphotericin B (sometimes referred to as "amphoterrible" because of its toxicity) is a potent nephrotoxin. Toxicity is first signaled by a rise in serum magnesium and calcium. The azole anti-fungals are inhibitors cholesterol synthesis, and thus decrease steroid hormone synthesis. However, the patient is unlikely to be receiving both amphotericin and an azole, and even if he were, the dangers of amphotericin B are much greater than those of the azoles. Pulmonary function would be monitored in patients on bleomycin or amiodarone, which can both cause pulmonary fibrosis. Lactic acidosis is a common complication of biguanides such as metformin, a class of medications for type II diabetics that decrease insulin resistance. Ototoxicity is a common complication of treatment with aminoglycoside antibiotics.
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I had always thought amphotericin B toxicity results in a decrease in these electrolytes, particularly given the nephrotoxicity.
From PubMed:
The fact that side effects of AmB resemble those of serious magnesium deficiency, and that AmB inactivates magnesium by binding it to cell membranes, thereby removing it from the availalble body pool (infra vide), suggests that replacing the magnesium might protect against
AmB toxicity.
Can also be found at: http://www.mgwater.com/seelig_amphotericin_b_binding.pdf
---
Any thoughts here?
Cheers,
Amphotericin B (sometimes referred to as "amphoterrible" because of its toxicity) is a potent nephrotoxin. Toxicity is first signaled by a rise in serum magnesium and calcium. The azole anti-fungals are inhibitors cholesterol synthesis, and thus decrease steroid hormone synthesis. However, the patient is unlikely to be receiving both amphotericin and an azole, and even if he were, the dangers of amphotericin B are much greater than those of the azoles. Pulmonary function would be monitored in patients on bleomycin or amiodarone, which can both cause pulmonary fibrosis. Lactic acidosis is a common complication of biguanides such as metformin, a class of medications for type II diabetics that decrease insulin resistance. Ototoxicity is a common complication of treatment with aminoglycoside antibiotics.
---
I had always thought amphotericin B toxicity results in a decrease in these electrolytes, particularly given the nephrotoxicity.
From PubMed:
The fact that side effects of AmB resemble those of serious magnesium deficiency, and that AmB inactivates magnesium by binding it to cell membranes, thereby removing it from the availalble body pool (infra vide), suggests that replacing the magnesium might protect against
AmB toxicity.
Can also be found at: http://www.mgwater.com/seelig_amphotericin_b_binding.pdf
---
Any thoughts here?
Cheers,
