Safety analysis of liposomal amphotericin B in adult patients: anaemia, thrombocytopenia, nephrotoxicity, hepatotoxicity and hypokalaemia
| Autor: | Katsushi Yamada, Yasuo Takeda, Keiko Yaji, Kazuaki Matsumoto, Yoshihiro Shimodozono, Akari Shigemi, Kazuro Ikawa, Norifumi Morikawa |
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| Rok vydání: | 2011 |
| Předmět: |
Male
Microbiology (medical) Antifungal Agents Bilirubin Hypokalemia Pharmacology Nephrotoxicity chemistry.chemical_compound Amphotericin B hemic and lymphatic diseases medicine Humans Pharmacology (medical) Alanine aminotransferase Aged Adult patients business.industry Anemia General Medicine Middle Aged Thrombocytopenia Safety profile Red blood cell Infectious Diseases medicine.anatomical_structure chemistry Female Kidney Diseases Liposomal amphotericin Chemical and Drug Induced Liver Injury business medicine.drug |
| Zdroj: | International Journal of Antimicrobial Agents. 38:417-420 |
| ISSN: | 0924-8579 |
| Popis: | Liposomal amphotericin B (L-AmB), which was developed to reduce side effects, has been shown to have a better safety profile than both the deoxycholate and lipid complex forms of amphotericin B; however, the frequency of major side effects is still unclear. Thus, the aim of the present study was to assess retrospectively the frequency of L-AmB-induced anaemia, thrombocytopenia, nephrotoxicity, hepatotoxicity and hypokalaemia as well as the relationship between daily dose of L-AmB and these side effects. A low red blood cell (RBC) count (post-/pre-treatment) and anaemia were observed in 7 and 10 of 21 adult patients, respectively. Thrombocytopenia was observed in 11 of 19 adult patients. Doses of L-AmB that are estimated to cause side effects of a low RBC count, anaemia and thrombocytopenia with 50% probability are 4.0, 3.3 and 3.0mg/kg/day, respectively. Nephrotoxicity was observed in 6 of 22 patients. Variations of total bilirubin, γ-glutamyl transpeptidase, aspartate aminotransferase and alanine aminotransferase used as indices of hepatotoxicity were observed in 6, 7, 8 and 8 of 22 patients, respectively. Hypokalaemia was observed in 4 of 9 patients; however, nephrotoxicity, hepatotoxicity and hypokalaemia were not caused in a dose-dependent manner. In conclusion, the present analyses showed that L-AmB dose-dependently induced anaemia and thrombocytopenia in adult patients. It is important to pay attention to causing anaemia and thrombocytopenia when patients are receiving L-AmB at doses of >3.3mg/kg/day and >3.0mg/kg/day, respectively. |
| Databáze: | OpenAIRE |
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