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Antifungal Agents01:15

Antifungal Agents

Amphotericin B is a broad-spectrum antifungal agent that exploits structural differences between fungal and mammalian cell membranes. Its amphipathic structure—featuring a hydrophobic polyene-lactone ring and a hydrophilic region containing mycosamine and carboxylic acid groups—enables selective binding to ergosterol, a sterol predominantly found in fungal plasma membranes. This selective interaction underlies the drug’s antifungal activity, although weak binding to cholesterol contributes to...
Extracorporeal Removal of Drugs: Hemoperfusion and Hemofiltration01:25

Extracorporeal Removal of Drugs: Hemoperfusion and Hemofiltration

Hemoperfusion and hemofiltration are critical techniques in medical treatments to eliminate accumulated drugs, metabolites, and electrolytes from the bloodstream. These methods are particularly vital in cases of accidental poisoning and drug overdose.Hemoperfusion involves passing blood through an adsorbent material to remove unwanted substances. The main adsorbents used in hemoperfusion include activated charcoal and Amberlite resins. Activated charcoal can adsorb both polar and nonpolar...
Enhanced Elimination of Poison01:26

Enhanced Elimination of Poison

Poison can be effectively removed from the gastrointestinal (GI) tract through various decontamination procedures.
Antidotes serve a crucial role in counteracting the effects of poison by inhibiting enzymes responsible for producing harmful drug metabolites. In some cases, these toxic metabolites can be neutralized by endogenous cosubstrates, which are maintained at specific concentrations to prevent interaction with cellular macromolecules and subsequent cell death.
Renal excretion is the...
Ion Exchange01:17

Ion Exchange

Ion exchange chromatography separates charged molecules from a solution by reversibly exchanging them with mobile, or 'active', ions associated with the oppositely charged stationary phase. This method can be used to separate ions, soften and deionize water, and purify solutions. The polymers comprising the ion-exchange column are high-molecular-weight and chemically stable polymers, crosslinked to be porous and essentially insoluble. They are also functionalized with either acidic or basic...
Extracorporeal Removal of Drugs: Peritoneal Dialysis and Hemodialysis01:30

Extracorporeal Removal of Drugs: Peritoneal Dialysis and Hemodialysis

Patients with end-stage renal disease (ESRD) or those experiencing drug overdose often require extracorporeal methods to eliminate accumulated drugs and metabolites. Hemoperfusion, hemofiltration, and dialysis are the primary techniques to rapidly remove harmful substances without disrupting the patient's fluid and electrolyte balance. For those with compromised renal function, dosage adjustments of concurrent medications may be necessary during extracorporeal drug removal.Dialysis is a process...
Drug Distribution: Plasma Protein Binding01:29

Drug Distribution: Plasma Protein Binding

Drugs predominantly attach to plasma proteins, with only a small percentage remaining unbound. The unbound portion can be calculated as one minus the bound fraction. Acidic drugs form large, inactive complexes by reversibly binding to plasma albumin, which prevents them from diffusing across biological barriers. These drug-protein complexes act as reservoirs for the drugs. As the concentration of unbound drugs decreases, these complexes quickly dissociate to release the free drug, maintaining...

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Updated: Jun 26, 2026

Formulation and Characterization of Bioactive Agent Containing Nanodisks
07:58

Formulation and Characterization of Bioactive Agent Containing Nanodisks

Published on: March 17, 2023

Amphotericin B removal by plasma exchange.

S Q Lew1

  • 1Division of Renal Diseases and Hypertension, Department of Medicine, George Washington University, Washington, DC, USA. sqlew@gwu.edu

Journal of Clinical Pharmacy and Therapeutics
|January 8, 2009
PubMed
Summary
This summary is machine-generated.

Plasma exchange removed 40% of amphotericin B in a patient with liver and renal failure. This finding adds to the understanding of amphotericin B pharmacokinetics during critical illness.

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Area of Science:

  • Pharmacokinetics
  • Critical Care Medicine
  • Nephrology

Background:

  • Amphotericin B is a critical antifungal agent.
  • Its use can be limited by toxicity and complex dosing.
  • High protein binding influences drug removal.

Observation:

  • A patient with concurrent liver and renal failure underwent plasma exchange.
  • Plasma exchange is a procedure that removes substances from blood plasma.
  • The procedure's impact on amphotericin B levels was assessed.

Findings:

  • Plasma exchange demonstrated a 40% reduction in amphotericin B levels.
  • This suggests significant removal of the drug during the procedure.
  • The patient's severe organ dysfunction likely contributed to these findings.

Implications:

  • Plasma exchange may necessitate adjustments in amphotericin B dosing in critically ill patients.
  • Understanding drug removal is crucial for optimizing antifungal therapy.
  • Further research is needed to confirm these pharmacokinetic alterations.