Administration and clearance of amphotericin B during high-efficiency or high-efficiency/high-flux dialysis

Gussak, Hiie M.; Rahman, Saad; Bastani, Bahar

doi:10.1053/ajkd.2001.24545

Cited by 7 publications

(4 citation statements)

References 1 publication

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“…The drug is not removed by haemodialysis with conventional or high-flux dialysis membranes 30. As the cardiac toxicity signs become evident, after the suspension of amphotericin administration the approach consists of supportive therapy directed at correcting electrolyte abnormalities, anaemia and dialytic support for renal failure.…”

Section: Discussionmentioning

confidence: 99%

Atrioventricular block related to liposomal amphotericin B

et al. 2014

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Atrioventricular block can occur in normal children, young adults or athletes. It is also associated with underlying heart disease or occurs as a drug adverse effect. Amphotericin B is used in the treatment of invasive fungal infections. Cardiac toxicity is a rare adverse reaction. We report the case of a 9-month girl, admitted in the paediatric intensive care unit with cytomegalovirus pneumonitis. During hospitalisation the patient developed a systemic fungic infection and was medicated with liposomal amphotericin B. On the third day of treatment she began repeated episodes of bradycardia with spontaneous reversion. The investigation revealed a second-degree atrioventricular block. We excluded the misplacement of the central catheter, myocarditis or structural cardiomyopathy and suspended amphotericin. After 8 days, the bradycardia episodes ceased what was consistent with the drug's half-life. Amphotericin cardiotoxic mechanism is still unclear. It may be related with alteration of myocardial membrane depolarisation.

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Section: Discussionmentioning

confidence: 99%

Atrioventricular block related to liposomal amphotericin B

et al. 2014

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“…A case report de-scribed the use of continuous veno-venous hemodiafiltration (CVVHDF) for patients with end-stage renal disease receiving therapeutic dosing of amphotericin B and the drug was found to be poorly dialyzable. 8 In general, plasmapheresis and exchange transfusion are used to eliminate xenobiotics that are too large to be removed by hemodialysis and that have a high rate of protein binding. Plasmapheresis is effective for removing many drugs, including some immunosuppressants, chemotherapeutic agents, cardiovascular agents, antiinfective agents, and antiepileptics.…”

Section: Discussionmentioning

confidence: 99%

“…The treatment for amphotericin B toxicity is unclear, as there are no rescue or reversal agents, and it is not amendable to hemodialysis because of its physical characteristics. 8 We describe survival after an amphotericin B overdose due to a medication error. Amphotericin B deoxycholate was administered instead of liposomal amphotericin B.…”

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confidence: 99%

Survival after Amphotericin B Overdose Treated with Plasmapheresis

et al. 2013

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“…The drug is not removed by hemodialysis with either conventional or high-flux dialysis membranes. 23 In dog studies, administration of hydrocortisone in conjunction with amphotericin B infusion raised the LD 50 and attenuated the electrocardiographic changes noted with high doses, although this has not been demonstrated in humans. 11 In our patient, the medication error was discovered late in her course and after the arrhythmias had resolved.…”

Section: Discussionmentioning

confidence: 99%