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document
Amphotericin B in children with malignant disease : a comparison of the toxicities and pharmacokinetics of amphotericin B administered in dextrose versus lipid emulsion . In a prospective , randomized clinical trial , the toxicity of 1 mg of amphotericin B ( AmB ) per kg of body weight per day infused in 5 % dextrose was compared with that of AmB infused in lipid emulsion in children with malignant disease . In an analysis of 82 children who received a full course of 6 days or more of AmB ( 117 courses ) , it was shown that there were significant increases in plasma urea and creatinine concentrations and in potassium requirement after 6 days of therapy with both AmB infused in dextrose and AmB infused in lipid emulsion , with there being no difference between the two methods of AmB administration . An intent-to-treat comparison of the numbers of courses affected by acute toxicity ( fever , rigors ) and chronic toxicity ( nephrotoxicity ) also indicated that there was no significant difference between AmB infused in dextrose ( 78 courses ) and AmB infused in lipid emulsion ( 84 courses ) . The pharmacokinetics of AmB were investigated in 20 children who received AmB in dextrose and 15 children who received AmB in lipid emulsion . Blood samples were collected up to 24 h after administration of the first dose , and the concentration of AmB in plasma was analyzed by a high-performance liquid chromatography assay . The clearance ( CL ) of AmB in dextrose ( 0.039 +/- 0.016 liter . h-1 . kg-1 ) was significantly lower ( P < 0.005 ) than the CL of AmB in lipid emulsion ( 0.062 +/- 0 . 024 liter . h-1 . kg-1 ) . The steady-state volume of distribution for AmB in dextrose ( 0.83 +/- 0.33 liter . kg-1 ) was also significantly lower ( P < 0.005 ) than that for AmB in lipid emulsion ( 1.47 +/- 0.77 liter . kg-1 ) . Although AmB in lipid emulsion is apparently cleared faster and distributes more widely than AmB in dextrose , this study did not reveal any significant advantage with respect to safety and tolerance in the administration of AmB in lipid emulsion compared to its administration in dextrose in children with malignant disease .
1016
Intervention_Pharmacological
Amphotericin B
1017
Intervention_Pharmacological
amphotericin B administered in dextrose
1018
Intervention_Pharmacological
lipid emulsion
1019
Intervention_Pharmacological
amphotericin B ( AmB )
1020
Intervention_Pharmacological
dextrose
1021
Intervention_Pharmacological
AmB infused in lipid emulsion
1022
Intervention_Pharmacological
AmB
1023
Intervention_Pharmacological
AmB
1024
Intervention_Pharmacological
dextrose
1025
Intervention_Pharmacological
AmB
1026
Intervention_Pharmacological
lipid emulsion
1027
Intervention_Pharmacological
AmB
1028
Intervention_Pharmacological
AmB
1029
Intervention_Pharmacological
dextrose
1030
Intervention_Pharmacological
AmB infused in lipid emulsion
1031
Intervention_Pharmacological
AmB
1032
Intervention_Pharmacological
AmB
1033
Intervention_Pharmacological
dextrose
1034
Intervention_Pharmacological
AmB in lipid emulsion
1035
Intervention_Pharmacological
AmB
1036
Intervention_Pharmacological
AmB in dextrose
1037
Intervention_Pharmacological
AmB in lipid emulsion
1038
Intervention_Pharmacological
AmB in lipid emulsion
1039
Intervention_Pharmacological
AmB in lipid emulsion
1040
Intervention_Pharmacological
AmB in dextrose
1041
Intervention_Pharmacological
AmB
1042
Intervention_Pharmacological
dextrose
1043
Outcome_Physical
pharmacokinetics of AmB
1044
Outcome_Physical
concentration of AmB in plasma
1045
Outcome_Physical
clearance ( CL ) of AmB in dextrose
1046
Outcome_Physical
steady-state volume of distribution for AmB
1047
Outcome_Physical
AmB in lipid emulsion
1048
Outcome_Physical
AmB in dextrose
1049
Outcome_Other
safety and tolerance
1050
Participant_Age
children
1051
Participant_Condition
malignant disease :
1052
Participant_Age
children
1053
Participant_Condition
malignant disease
1054
Participant_Sample-size
82
1055
Participant_Age
children
1056
Participant_Condition
malignant disease