By S M Yentis; Nicholas Hirsch; James K Ip; G B Smith
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Extra resources for Anaesthesia and intensive care A-Z : an encyclopaedia of principles and practice
Highly protein-bound, it penetrates tissues poorly. Administered orally as a treatment for intestinal candidiasis, or iv for systemic fungal infections. Amphotericin is available encapsulated in liposomes or as a complex with sodium cholesteryl sulphate, both of which reduce its toxicity. ● Dosage: 1–5 mg/kg/day iv, depending on the formulation. ● Side effects: renal and hepatic impairment, nausea and vomiting, electrolyte disturbance, especially hypokalaemia, arrhythmias, blood dyscrasias, convulsions, peripheral neuropathy, visual and hearing disturbances.
Half-life is 3–6 h. Not available in the UK. g. GIT upset, thrombocytopenia). Amylase. Group of enzymes secreted by salivary glands and the pancreas. 7; consequently it is inactivated by gastric acid. In the small intestine, both salivary and pancreatic α-amylase act on ingested polysaccharides. Plasma amylase measurements may be useful for the diagnosis of numerous conditions, particularly acute pancreatitis. About 35–40% of total plasma amylase activity is contributed by the pancreatic isoenzyme.
Not absorbed from the GIT; must be given parenterally. Excretion is via the kidney and delayed in renal impairment. Side effects include ototoxicity (especially with concurrent furosemide therapy) and nephrotoxicity. In pregnancy, they may cross the placenta and cause fetal ototoxicity. They may also impair neuromuscular function and therefore avoidance has been suggested in myasthenia gravis. Monitoring of plasma levels should ideally be performed in all cases but is especially important in the elderly, children, those with renal impairment, the obese, and if high dosage or prolonged treatment is used.
Anaesthesia and intensive care A-Z : an encyclopaedia of principles and practice by S M Yentis; Nicholas Hirsch; James K Ip; G B Smith