Amphotericin B Case Summary

1. Provide the rationale for why Ms, Unger is prescribed amphotericin B.

Patient is prescribed amphotericin due to her potentially fatal fungal infection. This will bind to fungal cell membrane, allowing leakage of cellular contents.

2. What contraindications or precautions would eliminate the use of amphotericin B for Ms. Unger?

Hypersensitivity; Lactation: Potential for distribution into breast milk and toxicity in infant; discontinue nursing. Use Cautiously in: Renal impairment or electrolyte abnormalities; Patients receiving concurrent leukocyte transfusions

3. What other drugs could be considered for the treatment of Ms. Unger’s infection?

Newer medication voriconazole (Vfend) is now preferred because it appears to be more effective and

Several weeks to months of therapy may be required to prevent relapse. Amphotericin B should be administered intravenously under close clinical observation by medically trained personnel. It should be reserved for treatment of patients with progressive, potentially life-threatening fungal infections due to susceptible organisms. Rapid intravenous infusion has been associated with hypotension, hypokalemia, arrhythmias, and shock and should, therefore, be avoided.

7. Which of the findings from the nursing assessment demonstrate possible adverse effects from amphotericin B?

If respiratory distress occurs, discontinue infusion immediately; anaphylaxis may occur. Monitor patient closely during test dose and the first 1–2 hr of each dose for fever, chills, headache, anorexia, nausea, or vomiting. Renal function should be monitored frequently during Amphotericin B therapy.

8. What nursing actions are indicated to maximize therapeutic effects?

Monitor vital signs every 15 min during test dose and every 30 min for 2–4 hr after administration. Monitor intake and output and weigh daily. Adequate hydration (2000–3000 mL/day).

9. What nursing actions are indicated to minimize adverse