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Amphotericin B

Fungilin, Fungizone, Abelcet, AmBisome, Fungisome  , Amphocil, Amphotec is a polyene antifungal drug, used intravenously for systemic fungal infections. It was originally extracted from Streptomyces nodosus, a filamentous bacterium, in 1955 at the Squibb Institute for Medical Research from cultures of an undescribed streptomycete isolated from the soil collected in the Orinoco River region of Venezuela [sic].

 Antifungal

Oral preparations of amphotericin B are used to treat thrush; these are ‘virtually’ nontoxic, in contrast to typical intravenous therapy (IV) doses.
One of the main intravenous uses is in treating various systemic fungal infections (e.g. in critically ill, comorbidly infected or immunocompromised patients), including cryptococcal meningitis.
It is usually sold in a concentrated solution, either on its own or in combination with the antibiotics penicillin and streptomycin.

Antiprotozoan

Another IV use is as a’ drug of last resort’ in otherwise untreatable parasitic protozoan infections such as visceral leishmaniasis and primary amoebic meningoencephalitis.

Mechanism of action

Quote “As with other polyene antifungals, amphotericin B associates with ergosterol, the main component of fungal cell membranes, forming a transmembrane channel that leads to monovalent ion (K+, Na+, H+ and Cl−) leakage, which is the primary effect leading to fungal cell death. Recently, however, researchers found evidence that pore formation is not necessarily linked to cell death (i.e. Angewandte Chemie Int. Ed. Engl. 2004). The actual mechanism of action may be more complex and multifaceted.”  So they don’t know.

“Amphotericin B molecules can form pores in the host membrane as well as the fungal membrane. This impairment in membrane barrier function can have lethal effects”

Side effects

Amphotericin B is well-known for its severe and potentially lethal side effects. Very often, a serious acute reaction after the infusion (1 to 3 hours later) is noted, consisting of high fever, shaking chills, hypotension, anorexia, nausea, vomiting, headache, dyspnea and tachypnea, drowsiness, and generalized weakness. …. This response necessitates a critical (and diagnostically difficult) professional determination as to whether the onset of high fever is a symptom of a fast-progressing disease, or merely the induced effect of the drug.

Intravenously administered amphotericin B has also been associated with multiple organ damage in ‘therapeutic doses’ [sic].

• Nephrotoxicity (kidney damage) is a frequently reported side effect, and can be severe and/or irreversible.

• Electrolyte imbalances (e.g. hypokalemia and hypomagnesemia) may also result.

• Liver damage - In the liver, increased liver enzymes and hepatotoxicity (up to and including fulminant liver failure) are common.

• Blood system - In the circulatory system, several forms of anemia and other blood dyscrasias (leukopenia, thrombopenia),

• Heart failure -  serious cardiac arrhythmias (including ventricular fibrillation), and even frank cardiac failure have been reported.

• Skin reactions, including serious forms, are also possible.

On Apr, 1, 2016: 4,958 people reported to have side effects when taking Amphotericin b. Among them, 28 people (0.56%) have Hallucination.

Time on Amphotericin b when people have Hallucination  :