Description

• Notify Pharmacy early in the day to arrange the manufacture of single-use syringes. These will take several hours to prepare.
• If urgent (discuss with Neonatologist) after hours contact the On-Call Pharmacist through the Duty Manager
• Amphotericin at 0.1 mg/mL (1 mg/10mL) is 256 mOsm/kg and pH 5.7

• Dose of drug is charted in mg/dose on prescription chart.

Administration

Slow IV Infusion

1. Pre-prepared syringes from Pharmacy: The supplied syringe is ready to prime through the extension tubing. Do NOT filter through a 0.22micron filter. The solution in the syringes will have been filtered by Pharmacy in the preparation process.
2. Preferably administer via a central line. Can be administered peripherally but may cause pain at infusion site with thrombophlebitis.
3. Administer first dose over 4 hours. For first 30 minutes observe baby closely for adverse reactions. Monitor ECG and B.P. If no adverse reactions observed continue remainder of first dose over remaining 3.5 hours and monitor for adverse reactions.
4. Second and subsequent doses, administer over 2 hours if tolerated.
5. Incompatible with lipid, sodium chloride, amikacin, dopamine, gentamicin, meropenem, benzylpenicillin.
6. Compatible with glucose 5 % and 10%. Do NOT mix with any other drug, IV solution, blood or blood products. A separate cannula is usually inserted for administration of amphotericin.
7. Flush cannula with glucose 5% before and after administration of amphotericin.
8. Protect from light during administration. Wrap tubing in tinfoil and cover syringe.

Nursing Considerations

1. Ensure patient is adequately hydrated before and during therapy.
2. Obtain baseline FBC, serum electrolytes, renal and liver function tests. Repeat these measurements regularly during therapy
3. Monitor and document vital signs including blood pressure and fluid balance.
4. Assess IV site carefully before and during infusion of amphotericin.
5. Observe for signs of adverse effects.

Storage

• Syringes are single use only.

References