Pharmacology Antifungal #5

Question

A client has been on amphotericin B for a septic fungal infection. Which would indicate a serious side effect of this medication?

Answers

  1. White blood cell count of 10,000
    • Rationale:

      This answer is not correct because a white blood cell count of 10,000 is the upper end of normal since the normal ranges are 4,500 to 11,000. A WBC count of 10,000 is excellent considering the client is septic. A serious side effect of amphotericin B is nephrotoxicity.

  2. Urinary output of 210 mL in 8 hours
    • Rationale:

      This answer is correct because amphotericin B is a potent antifungal with a serious side effect of nephrotoxicity. Indications of kidney damage and failure associated with nephrotoxicity include urinary output of <30 mL/hour of urine output, creatinine of >1.3mg/dL and BUN of > 20 mg/dL.

  3. Mild diarrhea x 3 over the past 3 days
    • Rationale:

      This answer is not correct because diarrhea is a common side effect of amphotericin B. Furthermore, mild diarrhea three times in 3 days is not considered concerning. A serious side effect of amphotericin B is nephrotoxicity. Indications of kidney damage and failure associated with nephrotoxicity include urinary output of <30 mL/hour of urine output, creatinine of >1.3mg/dL and BUN of > 20 mg/dL.

  4. Loss of appetite and flushing of the skin
    • Rationale:

      This answer is not correct because loss of appetite and flushing of the skin is considered common, non-serious side effects. A serious side effect of amphotericin B is nephrotoxicity. Indications of kidney damage and failure associated with nephrotoxicity include urinary output of <30 mL/hour of urine output, creatinine of >1.3mg/dL and BUN of > 20 mg/dL.

Overview

Amphotericin B is a potent antifungal used to treat serious fungal infections. The antifungal has a serious side effect of nephrotoxicity, which is reflected in decreased urinary output.

Explanation

Learning Outcomes

Amphotericin B is a potent antifungal with a serious side effect of nephrotoxicity. Indications of kidney damage and failure associated with nephrotoxicity include urinary output of <30 mL/hour of urine output, creatinine of >1.3mg/dL and BUN of > 20 mg/dL. Due to the increased toxicity potential, amphotericin B is used to only treat serious fungal infections, such as when a client is septic.

Test Taking Tip

Understanding basic labs that reflect damage to certain body systems will help when trying to answer nursing questions. For example, understanding that AST/ALT reflect liver function and BUN/creatinine reflect kidney function.

Video Rationale