Name of the Procedure:

Common Name(s): Amphotericin B Injection
Technical/Medical Terms: Injection, amphotericin b liposome, 10 mg (J0289)

Summary

Amphotericin B Liposome Injection is a treatment where a medication is injected into a patient's vein to treat fungal infections. The medication is encapsulated in liposomes to reduce toxicity and enhance effectiveness.

Purpose

Conditions Addressed:

• Severe fungal infections such as cryptococcal meningitis in HIV patients, or systemic fungal infections in immunocompromised patients.

  Goals/Expected Outcomes:

• To eradicate fungal infections.
• To alleviate symptoms associated with these infections.
• To improve the patient's overall prognosis with minimal side effects.

Indications

• Persistent and severe fungal infections unresponsive to other treatments.
• Patients diagnosed with conditions like cryptococcosis, histoplasmosis, or aspergillosis.
• Patients with compromised immune systems (e.g., HIV/AIDS, chemotherapy patients).

Preparation

Pre-procedure Instructions:

• Patients may need to fast for a few hours before the procedure.

• Inform your healthcare provider about all the medications you are taking as some may need to be paused.

  Diagnostic Tests/Assessments:

• Blood tests to check kidney and liver function.
• Fungal cultures or biopsies to identify the specific fungal infection.

Procedure Description

1. Preparation: The healthcare provider prepares the Amphotericin B liposome solution.

2. Administration:

   • The area where the intravenous (IV) line will be inserted is cleaned.
   • An IV line is inserted into a vein, usually in the arm.
   • The medication is slowly injected via IV over a specified period.

   Tools/Equipment Used:

   • IV line, syringes, Amphotericin B liposome solution, infusion pump.

Anesthesia or Sedation:

• Typically, no anesthesia or sedation is required.

  Duration

  The injection typically takes about 1 to 2 hours to administer.

Setting

Location:

• Hospital inpatient wards, outpatient clinics, or specialized infusion centers.

Personnel

• Physicians (e.g., infectious disease specialists)
• Nurses
• Pharmacists (for preparing the medication)

Risks and Complications

Common Risks:

• Infusion-related reactions such as fever, chills, or headache.

• Kidney function impairment.

  Rare Risks:

• Severe allergic reactions.
• Anemia or electrolyte imbalances.

Management of Complications:

• Monitoring kidney function and adjusting doses.
• Managing infusion reactions with medications such as antipyretics or antihistamines.

Benefits

Expected Benefits:

• Effective eradication of fungal infections.
• Symptomatic relief, often noticeable within a few days to weeks depending on the infection.

Recovery

Post-procedure Care:

• Monitor for any delayed allergic reactions or side effects.

• Regular blood tests to check kidney function and drug levels.

  Recovery Time:

• Varies depending on the severity of the infection but often includes ongoing treatments over several weeks.

Restrictions/Follow-Ups:

• Avoid other nephrotoxic medications.
• Regular follow-up visits to the healthcare provider for monitoring.

Alternatives

Other Treatment Options:

• Other antifungal medications such as fluconazole or itraconazole.

  Pros and Cons of Alternatives:

• Alternatives may have different side effect profiles or efficacy rates. Amphotericin B is often chosen when other treatments are not effective.

Patient Experience

During the Procedure:

• A sensation of coolness or mild discomfort at the IV site.
• Possible transient symptoms like chills or fever during the infusion.

After the Procedure:

• Tiredness or mild flu-like symptoms can occur but are typically managed and temporary.

  Pain Management:

• Pre-medications (like acetaminophen) may be given to manage infusion-related symptoms.
• Hydration and electrolyte management to reduce kidney-related side effects.