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Transient asystole associated with amphotericin B infusion
Drug Intelligence & Clinical Pharmacy
|July 1, 1983
Summary
This case report details a patient experiencing cardiac events during Amphotericin B infusions, suggesting a potential, though unproven, link. Further investigation is needed to understand this rare Amphotericin B side effect.
Area of Science:
- Cardiology
- Infectious Diseases
- Pharmacology
Background:
- Amphotericin B is a critical systemic antifungal medication.
- Clinical evidence linking Amphotericin B to cardiac toxicity is historically absent.
- Candida septicemia and renal failure are serious conditions often requiring aggressive treatment.
Observation:
- A 76-year-old patient with severe illness experienced transient asystole and cardiovascular collapse.
- These episodes occurred during Amphotericin B infusions.
- The patient had elevated serum potassium and digoxin, and low serum calcium during the events.
Findings:
- A temporal association between Amphotericin B infusion and asystole was observed.
- The association was supported by a rechallenge in the patient.
- Postmortem examination showed fungal vegetations on the aortic valve but no other gross cardiac pathology.
Implications:
- This case highlights a potential, rare adverse effect of Amphotericin B.
- Clinicians should be aware of the possibility of cardiac events during Amphotericin B therapy.
- Further research is warranted to elucidate the mechanism and incidence of this potential Amphotericin B-induced cardiac toxicity.