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Ambisome(安必素)安必松的适应症、用药注意事项及禁忌

发布时间:2024-01-18 17:14:54 阅读:1049 来源:问药网
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安必素

安必素 生产厂家:迈兰(Mylan)制药有限公司 功能主治:一线抗真菌药物,治疗深部真菌感染有效率高 用法用量:用法用量  静脉用药:开始静脉滴注时先试以1~5mg或按体重一次0.02~0.1mg/kg给药,以后根据患者耐受情况每日或隔日增加5mg,当增至一次 0.6~0.7mg/kg时即可暂停增加剂量,此为一般治疗量。  成人最高一日剂量不超过1mg/kg,每日或隔1~2日给药1次,累积总量 1.5~3.0g,疗程1~3个月,也可长至6个月,视病情及疾病种类而定。  对敏感真菌感染宜采用较小剂量,即成人一次20~30mg,疗程仍宜长。  鞘内给药:首次0.05~0.1mg,以后渐增至每次0.5mg,最大量一次不超过1mg,每周给药2~3次,总量15mg左右。  鞘内给药时宜与小剂量地塞米松或琥珀酸氢化可的松同时给与,并需用脑脊液反复稀释药液,边稀释边缓慢注入以减少不良反应。  局部用药:气溶吸入时成人每次5~10mg,用灭菌注射用水溶解成0.2%~0.3%溶液应用;超声雾化吸入时本品浓度为0.01%~0.02%,每日吸入2~3次,每次吸入5~10ml;持续膀胱冲洗时每日以两性霉素B 5mg加入1000ml灭菌注射用水中,按每小时注入40ml速度进行冲洗,共用5~10日。  静脉滴注或鞘内给药时,均先以灭菌注射用水10ml配制本品50mg,或5ml配制25mg,然后用5%葡萄糖注射液稀释(不可用氯化钠注射液,因可产生沉淀),滴注液的药物浓度不超过10mg/100ml,避光缓慢静滴,每次滴注时间需6小时以上,稀释用葡萄糖注射液的pH值应在4.2以上。  鞘内注射时可取5mg/ml浓度的药液1ml,加5%葡萄糖注射液19ml稀释,使最终浓度成250μg/ml。  注射时取所需药液量以脑脊液5~30ml反复稀释,并缓慢注入。  鞘内注射液的药物浓度不可高于25mg/100ml,pH值应在4.2以上。
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Ambisome(安必素)安必松的适应症、用药注意事项及禁忌,Ambisome(AmBisome)适用于患有深部真菌感染的患者;因肾损伤或药物毒性而不能使用有效剂量的两性霉素B的患者,或已经接受过治疗无效的患者均可使用。Ambisome(AmBisome)的注意事项:1.如果发生严重的变态反应或过敏/类过敏反应,应立即中止输注。2.在服用含两性霉素B的产品期间,可能会发生其他与输液有关的严重反应。3.如果临床上出现肾功能显著下降或其他参数恶化,则应考虑减少剂量,中断治疗或中止治疗。4.在白细胞输注期间或之后不久,服用两性霉素B会可能出现急性肺毒性。5.对于糖尿病患者而言,每个小瓶中的AmBisome均含约900mg蔗糖。治疗糖尿病患者时应考虑到这一点。

Ambisome (安必松) is a medication commonly used for the treatment of fungal infections. It is an antifungal medication that contains the active ingredient amphotericin B. Ambisome is specifically designed to be a lipid-based formulation of amphotericin B, which helps enhance its efficacy and reduce toxicity. In this article, we will explore the indications for Ambisome, important considerations for its use, and contraindications.

1. Indications for Ambisome

Ambisome is primarily used for the treatment of serious, invasive fungal infections caused by various fungi, including:

Cryptococcal meningitis: Ambisome is considered the treatment of choice for cryptococcal meningitis, a potentially life-threatening infection of the brain and spinal cord caused by the fungus Cryptococcus neoformans.

Invasive aspergillosis: This is a severe infection caused by the fungus Aspergillus, which commonly affects individuals with weakened immune systems, such as those undergoing chemotherapy or organ transplantation.

Disseminated candidiasis: Ambisome can be used to treat invasive candidiasis, a systemic infection caused by the yeast Candida that can affect various organs in the body.

Visceral leishmaniasis: Ambisome is also indicated for the treatment of visceral leishmaniasis, a parasitic infection caused by Leishmania species, which primarily affects the liver, spleen, and bone marrow.

2. Important considerations for Ambisome use

When using Ambisome, several important considerations should be kept in mind:

Dosage and administration: Ambisome is administered intravenously (IV) and the dosage is determined by the patient's weight, type of infection, and severity of the condition. It is typically given once daily.

Precautions for administration: Ambisome should be administered by healthcare professionals in a controlled clinical setting, as it may cause infusion-related reactions. Patients may experience fever, chills, headache, or abnormal blood pressure during or after the infusion.

Kidney function monitoring: Ambisome can be associated with kidney toxicity. Regular monitoring of kidney function, including blood tests to assess creatinine levels, is essential during treatment.

Other potential side effects: Ambisome may cause other adverse effects, including anemia, low potassium levels, liver dysfunction, and allergic reactions. Any unusual symptoms should be promptly reported to the healthcare provider.

3. Contraindications of Ambisome

While Ambisome is effective in treating fungal infections, it may not be suitable for everyone. The following conditions are considered contraindications for the use of Ambisome:

Hypersensitivity: Ambisome should not be used in individuals who have a known hypersensitivity or allergy to amphotericin B or any of the lipid components of the formulation.

Significant kidney impairment: Ambisome is primarily eliminated through the kidneys. Therefore, it is contraindicated in patients with severe kidney dysfunction or a history of significant nephrotoxicity associated with amphotericin B.

Pregnancy and breastfeeding: The use of Ambisome during pregnancy or breastfeeding should be carefully evaluated by the healthcare provider, weighing the potential risks and benefits.

In conclusion, Ambisome is a lipid-based formulation of amphotericin B used for the treatment of serious fungal infections. It is effective against cryptococcal meningitis, invasive aspergillosis, disseminated candidiasis, and visceral leishmaniasis. However, its administration requires close monitoring and precautions due to potential side effects and contraindications. It is crucial to consult with a healthcare professional for proper assessment and guidance regarding the use of Ambisome.