Amphotericin B-induced shivering in patients with cancer: a nursing approach

Shivering is a common and distressful reaction associated with administration of amphotericin B, a systemic antifungal agent. Shivering occurs as a result of the drug's intrinsic pyrogenicity, and thus resembles febrile shivering. This heat loss phenomenon has metabolic as well as psychologic costs. The intervention approach to amphotericin B-induced shivering includes reporting the phenomenon, restoring lost heat, modifying the rate of heat loss, altering the physiologic determination of heat loss, and giving drugs to suppress shivering. Specific suggestions for interventions are discussed. Supportive care of the patient with cancer who is receiving this drug is briefly mentioned as it relates to thermoregulatory principles. Possible areas of future inquiry into shivering suppression are mentioned.