Management of Amphotericin Administration

Description

• Yellow fluffy powder for reconstitution. Is insoluble in water alone and is solubilised by the addition of sodium desoxycholate.
• Pre-prepared syringes of Amphotericin may be available through Pharmacy- contact the Clinical Pharmacist or, if After Hours contact the On-Call Pharmacist through the Duty Manager.
• Amphotericin is a colloidal "solution" (too large to filter through a 0.2 micron filter). Reconstituted drug is clear, pale yellow. (Is not a true solution). pH in water 6-8. Turbidity occurs in solutions < pH 6- Do not use.

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

Infusion is also charted on fluid chart giving

• dose in mg/dose.
• rate in ml/hour.

Administration

Slow IV Infusion over 2-6 Hours

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.

Note: This medication will never be made up within the NICU. An on-call pharmacist is available to prepare amphotericin as required.

2. Is incompatible with most drugs and all IV solutions except D5W, D10W. Compatible with heparin 2U/ml.
3. Do NOT mix with any other drug, IV solution, blood or blood products. A separate cannula is usually inserted for administration of amphotericin.
4. Flush cannula with D5W before and after administration of amphotericin.
5. Protect from light during administration. Wrap tubing in tinfoil and cover syringe.

Nursing Considerations

1. Assess IV site carefully before and during infusion of amphotericin.
2. Observe for signs of adverse effects.
3. Monitor and document vital signs including blood pressure.
4. Monitor fluid balance.
5. Observe for signs of renal, hepatic and haematological dysfunction.

Storage

• Do not store reconstituted solution.

References