As doenças tratadas com anfotericina B e suas consequências medicamentosa

Abstract

Introduction: Amphotericin B (AmB) is a nephrotoxic drug with a high incidence of kidney damage. Objectives: The aim of this study was to evaluate adverse effects compared to different amphotericin B formulations. Methods: The data from this study consists of an integrative literature review using PubMed, Google Scholar and other search engines. To search for articles, the following descriptors and their combinations were used in Portuguese, English and Spanish: “Pharmacological treatment”, “complications”, “kidney injury” and “metabolism”. Results: Amphotericin B deoxycholate (d-AMB) had more adverse effects and more possibilities to evolve into ICU care, hemodialysis and death than lipid formulations, however, studies have been conducted in an attempt to circumvent the high prices of Liposomal amphotericin (LAMB) and lipid complex amphotericin (ABLC) with good results using the strategy of switching from d-AmB to ABLC when the kidney injury reached AKIN stage 2 or 3, pre and post medication with saline 0 .9%, N-acetylcysteine, post-medication with 10% sodium chloride, and pre-treatment with diosmin and hesperidin, without implying a significant increase in the final costs of treatment with AmB. Conclusion: Adopting measures to prevent progression to acute kidney injury may be the best cost-effective strategy.