Amphotericin B causes deficiency of?
Amphotericin B (AMB): The polyenes have high affinity for ergosterol present in fungal cell membrane: combine with it, get inseed into the membrane and several polyene molecules together orient themselves in such a way as to form a &;micropore&;. The hydrophilic side forms the interior of the pore through which ions, amino acids and other watersoluble substances move out. The micropore is stabilized by membrane sterols which fill up the spaces between the AMB molecules on the lipophilic side-constituting the outer surface of the pore. Thus, cell permeability is markedly increased. Adverse effects: The toxicity of AMB is high. 1)acute reaction This occurs with each infusion and consists of chills, fever, aches and pain all over,nausea, vomiting and dyspnoea lasting for 2-5 hour, probably due to release of cytokines (IL, TNF). When these are severe--the dose is increased gradually.Injection of hydrocoisone 0.6 mg/kg with the infusion may reduce the intensity of reaction. Thrombophlebitis of the injected vein can occur. 2)Long term toxicity: Nephrotoxicity is the most impoant. It occurs fairly uniformly and is dose related. manifestations are--azotemia, reduced gfr,acidosis, hypokalaemia and inability to concentrate urine.It reverses slowly and often incompletely after stoppage of therapy. ESSENTIALS OF MEDICAL PHARMACOLOGY K.D.TRIPATHI SIXTH EDITION PAGE NO:758,759
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