Bradycardia after rapid intravenous infusion of amphotericin B

Soler, J. Gordito; Ibañez, L; Zuazu, J; Julià, Antoni

doi:10.1016/0140-6736(93)90173-e

Cited by 8 publications

(3 citation statements)

References 9 publications

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“…70 Amphotericin B was also reported to cause bradycardia. 71 The more recent liposomal formulations of amphotericin B have improved the overall tolerability of the drug, but the potential for electrolyte unbalance and QT prolongation remains. 72,73 QT prolongations associated with the use of azole antifungals were believed to occur by inhibition of the hepatic metabolism of other QT-prolonging drugs; [70][71][72][73][74][75][76][77] however, a direct effect was also observed.…”

Section: Anti-infective Drugsmentioning

confidence: 99%

“…71 The more recent liposomal formulations of amphotericin B have improved the overall tolerability of the drug, but the potential for electrolyte unbalance and QT prolongation remains. 72,73 QT prolongations associated with the use of azole antifungals were believed to occur by inhibition of the hepatic metabolism of other QT-prolonging drugs; [70][71][72][73][74][75][76][77] however, a direct effect was also observed. 78 Pentamidine is a second-line drug structurally similar to procainamide used for the treatment and prophylaxis of Pneumocystis carinii pneumonia.…”

Section: Anti-infective Drugsmentioning

confidence: 99%

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Drugs and Cardiotoxicity in HIV and AIDS

Fantoni

Autore

Borgo

2001

Annals of the New York Academy of Sciences

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A BSTRACT : The advent of potent antiretroviral drugs in recent years has had an impressive impact on mortality and disease progression in HIV-infected patients, so that issues related to long-term effects of drugs are of growing importance. Hyperlipidemia, hyperglycemia, and lipodystrophy are increasingly described adverse effects of highly active antiretroviral therapy (HAART), in particular when protease inhibitors are used. Hyperlipidemia is strikingly associated with the use of most available protease inhibitors, with an estimated prevalence of up to 50%. Because of the short observation period and the small number of cardiovascular events, epidemiological evidence for an increased risk of coronary heart disease in HIV-infected patients treated with HAART is not adequate at present; however, it is likely that shortly more data will accumulate to quantify this risk. Before starting HAART and during treatment it is reasonable to evaluate all patients for traditional coronary risk factors, including lipid profile. Among the drugs that are currently used in HIV + patients, antibacterials, antifungals, psychotropic drugs and anti-histamines have been associated with QT prolongation or torsade de pointe, a lifethreatening ventricular arrhythmia. Among the risk factors that may precipitate an asymptomatic electrocardiographic abnormality into a dangerous arrhythmia is the concomitant use of drugs that share the CYP3A metabolic pathway. Since most protease inhibitors are potent inhibitors of CYP3A, clinicians should be aware of this potentially dangerous effect of HAART. Anthracyclines are potent cytotoxic antibiotics that have been widely used for the treatment of HIV-related neoplasms. Their cardiotoxicity is well known, ranging from benign and reversible arrhythmias to progressive severe cardiomyopathy. The increased survival and quality of life of HIV + patients emphasize the importance of a high awareness of adverse drug-related cardiac effects. K EYWORDS : cardiotoxicity; antiretrovirals; HAART; dyslipidemia; cardiomyopathy Cardiac involvement in HIV disease is estimated to be approximately 6-7 %. 1 A proportion of cardiac morbidity may be ascribed to the toxic effect of drugs used for the treatment of HIV + patients. The pharmacological treatment of AIDS and HIV-related diseases includes the use of antiretroviral and other anti-infective or anti-neoplastic drugs. Moreover, patients with HIV infection are at higher risk for conditions such as psychiatric diseases or allergic diseases that require additional drug treatments. Until recently the prognosis for people with the acquired immunodeficiency

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Section: Anti-infective Drugsmentioning

confidence: 99%

Section: Anti-infective Drugsmentioning

confidence: 99%

Drugs and Cardiotoxicity in HIV and AIDS

Fantoni

Autore

Borgo

2001

Annals of the New York Academy of Sciences

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“…Ventricular arrhythmias and bradycardia have been reported not only in acute overdose but even with correct dosage with slow rates of drug infusion. [16,17] Previous studies showed the drug itself could be cardiotoxic and these complications were reported even in patients with a normal concentration of potassium and magnesium. [18] The drug could be embryotoxic if administered during pregnancy.…”

Section: How To Initiate Treatment?mentioning

confidence: 99%

Challenges and Pitfalls in the Management of Rhino-Orbital Mucormycosis in Ophthalmology: A Highlighted Problem in the COVID-19 Era

Pakdel

Zand

Sharifi

et al. 2022

JOVR

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Secondary infections in hospitalized and ill patients with coronavirus disease 2019 (COVID-19) are common. One of these life-threatening infectious diseases is rhino-orbital mucormycosis, which made an outbreak recently. This outbreak was mainly caused by the administration of high-dose corticosteroids in patients with COVID-19, especially those with diabetes mellitus. The increased incidence of rhino-orbital mucormycosis in the COVID-19 era presents different challenges for healthcare providers including ophthalmologists who are directly involved in disease management. We summarized the main challenges and recommendations for ophthalmologists on the management of rhino-orbital mucormycosis.

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Hyperkalemia Associated with Rapid Infusion of Conventional and Lipid Complex Formulations of Amphotericin B

Barcia

1998

Pharmacotherapy

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A child developed hyperkalemia and cardiac arrest with infusion of an amphotericin B lipid complex 5.0 mg/kg over 1 hour. Another child, with chronic renal failure, developed hyperkalemia after infusion of conventional amphotericin B deoxycholate 1.0 mg/kg over 2 hours. Rapid infusion of the agent causes hyperkalemia in dogs and humans that is exacerbated in the setting of renal failure. A lipid formulation of amphotericin B is commercially available, and no reports of hyperkalemia are associated with its administration.

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Bradycardia after rapid intravenous infusion of amphotericin B

Cited by 8 publications

References 9 publications

Drugs and Cardiotoxicity in HIV and AIDS

Drugs and Cardiotoxicity in HIV and AIDS

Challenges and Pitfalls in the Management of Rhino-Orbital Mucormycosis in Ophthalmology: A Highlighted Problem in the COVID-19 Era

Hyperkalemia Associated with Rapid Infusion of Conventional and Lipid Complex Formulations of Amphotericin B

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