Comprehensive Nursing Pharmacology Q 157
When administering amphotericin B, which of the following must be used?
A. A brown bag to protect the infusion from the light
B. A diluent of 5% dextrose with no preservatives
C. A diluent of normal saline with alcohol
D. A micron filter of above 1 micron
Correct Answer: B. A diluent of 5% dextrose with no preservatives
Amphotericin B must be mixed with a solution with no preservatives. Amphotericin B is amphoteric (can act as both an acid and a base) and virtually water-insoluble. It is not absorbable via oral or intramuscular administration.
Option A: The solution is sensitive to light but does not require the infusion to be covered. Amphotericin B acts by binding to ergosterol in the cell membrane of most fungi. After binding with ergosterol, it causes the formation of ion channels leading to loss of protons and monovalent cations, which results in depolarization and concentration-dependent cell killing.
Option C: Amphotericin B, which is more commonly administered in a liposomal formulation and exhibits increased tolerability and a reduced toxicity profile. These lipid formulations permit a higher daily dose, provide better delivery to organs within the reticuloendothelial system such as the lungs, liver, and spleen, have similar efficacy when compared to conventional amphotericin B, and are less nephrotoxic.
Option D: A micron filter should not be used; if unavoidable, it must be less than 1 ?. Additionally, amphotericin B also produces oxidative damage to the cells with the formation of free radicals and subsequently increased membrane permeability. Additionally, amphotericin B has a stimulatory effect on phagocytic cells, which assists in fungal infection clearance.