Amphotericin B

Amphotericin B

Drug monograph · NCLEX study reference
Therapeutic class	Antifungal
Pharmacologic class	Polyene
Onset / peak / duration	IV infusion; lipid formulations reduce toxicity.
Half-life / level	Long; no routine level.
Routes	IV
High-alert (ISMP)	No
Black box warning	None
Antidote / reversal	Supportive care; replace electrolytes.
Pregnancy / lactation	Use if clearly needed.

Nursing pharmacology study reference (NCLEX-style monograph). Numeric values are standard teaching ranges for study and must be verified against current manufacturer labeling before clinical use. This is educational content, not prescribing guidance.

Amphotericin B — Antifungal; Polyene.

Identification

• Therapeutic class: Antifungal.
• Pharmacologic class: Polyene.

Pharmacology

• Mechanism of action: Binds fungal membrane ergosterol to create pores (fungicidal); reserved for serious systemic mycoses.
• Onset / peak / duration: IV infusion; lipid formulations reduce toxicity.
• Half-life / therapeutic level: Long; no routine level.

Clinical use

• Indications: Severe systemic fungal infections.
• Usual dose, route, frequency: IV by formulation and weight.
• Maximum dose / adjustments: Use lipid formulations to reduce nephrotoxicity; premedicate for infusion reactions.

Safety

• Contraindications: Hypersensitivity.
• Black box warning: None (the conventional form has a strong nephrotoxicity caution).
• Interactions: Nephrotoxic drugs, corticosteroids and diuretics (potassium loss), digoxin (hypokalemia toxicity).
• Pregnancy / lactation: Use if clearly needed.
• High-alert: No.

Adverse effects

• Common side effects: Fever, chills, rigors during infusion (often called shake and bake), nausea.
• Serious effects to report: Nephrotoxicity, hypokalemia and hypomagnesemia, severe infusion reaction.
• Antidote / reversal: Supportive care; replace electrolytes.

Nursing process

• Assessment before administration: Renal function, electrolytes, baseline vitals.
• Interventions during therapy: Premedicate (acetaminophen, diphenhydramine, sometimes hydrocortisone); hydrate; monitor electrolytes; verify the correct formulation.
• Monitor: Renal function, potassium and magnesium, infusion reactions.
• Evaluation / expected outcome: Resolution of systemic fungal infection.

Patient teaching

• Patient teaching: Infusion reactions are common and managed with premedication.
• Notify provider if: Decreased urination, severe chills, muscle weakness.
• Administration tips: Confirm formulation (conventional versus lipid); premedicate and hydrate.