In AMFOTERITSIN (Amphotericinum B).

     Antibiotics, produtsiruemy aktinomitsetom Strepomyces nodosus.

     Synonyms : Amfostat, Amphotericin B, Fungilin, Fundizone, Saramycetin, Vencidin and others.

     Refers to a group polienovyh antibiotics.

     Powder yellow or yellow-orange. Almost nerastvorim in water and alcohol. Gigroskopichen. Sensitive to light and high temperatures. Easily inaktiviruetsya in acidic and alkaline media.

     Contains at least 750 ED 1 mg; 1 ED activity with 1 µ g of chemically pure amphotericin B V.

     The drug is effective against many pathogenic fungi cause disease. A characteristic of amphotericin B, compared to other modern-containing drugs is effective in the deep and systemic mycosis. It is effective in some fungal diseases are not curable - containing other means : blastomikoze, cryptococcosis, koktsidioidoze, histoplasmosis, mould mycosis etc., as well as for chronic and granulematoznyh forms disseminated candidiasis.

     Applied medication intravenously, inhalation and local (in the form of masi). With the gastrointestinal he barely absorbed. With intravenous drug is effective, but toxic, and should be used only in strict compliance with dosage. Despite the high toxicity and the risk of side effects, amphotericin B applied in some cases because of its high efficiency.

     For intravenous drug infusions produced as a special form of drug-amphotericin B intravenous (B Amphotericinum WGEdu injectione intravenosa) in vials containing 50000 ED (0.0694 grams), amphotericin B (in conjunction with dezoksiholatom sodium phosphate buffer).

     Pharmaceutical form for infections (amorphous powder or porous mass of yellow) dissolved in 5% glucose solution and in the water, education colloidal systems.

     Solution intravenous introductions prepared immediately before use. The contents of a bottle (ED amphotericin B 50000 B) dissolved in 10 ml of sterile water for injection (cork sterile needle punctured with a syringe) solution from a bottle gaining syringe and mouth in a bottle containing 450 ml of sterile 5% glucose solution. Enter drip method over 4 to 6 hours Solution in its preparation and implementation should not be subjected to a bright light.

     Dose amphotericin B in the set individually for each patient at the rate of 250 ED / kg (this solution contains 122 ED in 1 ml).

     Prior to the introduction of the preparation of this type of pre-dose 100 ED / kg (for individual endurance). In the future, good endurance, no side effects and, if necessary, dose can be increased to 1000 ED / kg.

     Enter product in a day or two times a week (cumulative risk), in some cases, 1 to 2 times a week.

     The length of treatment depends on the severity and localization process, the duration of illness, etc. Treatment is usually continued 4 - 8 weeks. Too early termination of treatment can lead to recidivism. The total dose of a drug treatment for adults is 1500000 2000000 - ED.

     To apply freshly infusion solutions. Unencumbered storage solution is not. In the case of turbidity, or a solution to the sludge application is not suitable. The solvent should be used only glucose attached to the drug.

     Children designate in the following doses (ED / kg) :

     Age 1-5 6 th-10 th -15 11 16 th-20 th years infusion injection injection injection

  January-March 1975 - 150100 - 250150 - 350175-400-7100 4-200150 - 300175 - 400200-500 8-12125 - 250175 - 350200 - 450225-600 13-18150 - 300200 - 400225 - 500250-700

     Every five days of making a break for two days. After 20 injections made 7 - 10-day break. The course of treatment repeat at intervals of 1 month.

     When poor Portability and exchange daily dose amphotericin B in reducing and increasing the breaks between infusion.

     Inhalation amphotericin B applied in cases of mycosis superior localization in the lungs and upper respiratory tract, as well as the impossibility of intravenous drugs.

     Inhalation Solution to prepare just before use an estimated 50,000 ED (the contents of a bottle) in 10 mL of sterile water for injection. Inhalation spend 1 to 2 times a day; Inhalation 15-length 20 minutes; One inhalation using ED 50000 (adult). Using inhalers, working only on the breath, a single dose to reduce ED 25000 (5 ml). The course of treatment 10 to 14 days. If necessary, designate a refresher course after 7 - 10-day break. Unencumbered solution for inhalation can be used within 24 hours of storage in the refrigerator.

     Ointments amphotericin B V (V contains 1 g 30000 ED) adversely affected by a thin layer of skin sites 1-2 times a day. The course of treatment for at least 10 days.

     When intravenous amphotericin B in the application regarding the frequency of side effects : nausea, vomiting, diarrhea, fever, the reaction temperature, headache, breach of the blood electrolyte changes electrocardiograms. If necessary, designate fever (musk), antihistamines drugs, vitamins set in, ascorbic acid, etc.

     The most serious complications are nefrotoksichesky effect and gipokaliemiya. Some patients develop anemia. Perhaps flebitov appearance at the injection.

     Treatment of amphotericin B are to be conducted under close medical supervision. There is a need to monitor the overall condition of the patient, his body weight, blood studied systematically, urine, to determine funktsinonalnoe state of the kidneys and liver. If side effects following injection of virulence, it is necessary to take a break for treatment to reduce the dose increase breaks between infusion. In the case of the anemia drug cancel, appointed ferrous.

     In inhalation solution in the amphotericin B may MEDOSIL sore throat, cough, runny nose, increased body temperature. Inhalation better transferred to a solution with the addition of 10 - 15 drops of glycerin. Patients with a proclivity to bronhiolospazmam you to appoint Bronchiodialator funds.

     The drug is contraindicated in cases of kidney, liver, blood system, diabetes and in the case of individual intolerances.

     Method of issuance : powder in hermetically ukuporennyh 50,000 bottles of ED in two versions : a) for the intravenous application from a bottle with the solvent (5% glucose), b) for inhalation without solvent; Ointment in the tubes.

     Storage : List B. In dry, the dark place at a temperature of up to + 4 + 6; Ointment, with a temperature not exceeding + 4 C.

     Ointments amphotericin B V (Unguentum Amphotericini B 30000 ED in 1, 0). Ointments for a yellow liquid in tubes of 15 and 30 g. Includes 30000 ED in 1 year

     Applied to fungal diseases skin and mucous membranes. Apply a thin layer of 1 to 2 times (up to 4 times) a day. The course of treatment for 10 days.

     Storage : at a temperature not exceeding + 4 C.

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