两性霉素B不同制剂的药学特性和临床应用  

Pharmaceutical properties and clinical applications of different formulations of Amphotericin B

作　　者：孔旭东[1] 王晓星[1] 陈玥 刘晓[1] KONG Xu-dong;WANG Xiao-xing;CHEN Yue;LIU Xiao(Department of Pharmacy,China-Japan Friendship Hospital,Beijing 100029,China)

机构地区：[1]中日友好医院药学部,北京100029

出　　处：《临床药物治疗杂志》2022年第7期7-12,共6页Clinical Medication Journal

摘　　要：两性霉素B是广谱强效抗真菌药物,但其传统的脱氧胆酸盐制剂往往因毒副作用大而不能足量使用,影响了其治疗效果。相比传统制剂,两性霉素B脂质制剂的安全性大为改善,使足量使用成为可能,从而有效提升了疗效。同时,两性霉素B各类制剂的基本结构和理化特性有着很大的不同,其体内过程、抗真菌作用也有较大差异,因此彼此间的药物代谢动力学参数并不能简单对比。临床实践中,应在充分了解各个制剂的药理学特性的基础上,结合患者具体情况,在权衡疗效、经济性、可及性等方面的因素后,选择适宜的治疗方案。Amphotericin B is a broad-spectrum potent antifungal agent,but the conventional deoxycholate formulation is often used in inadequate doses due to its toxicities,which affects its clinical efficacy.Compared with the conventional formulation,the safety profiles of lipid formulations of amphotericin B substantially improved,making it possible to use adequate doses and thus effectively improving efficacy.Meanwhile,one formulation of amphotericin B is very different from another in structure and physicochemical properties as well as in vivo process and antifungal effect.Therefore,their pharmacokinetic parameters cannot be simply compared.In clinical practice,treatment regimens should be selected based on a thorough understanding of the pharmacological properties of each formulation,balancing efficacy,economy,and accessibility and taking into considerations of patient’s specific situations.

关 键 词：两性霉素B 药物代谢动力学 抗真菌药物 侵袭性真菌病 

分 类 号：R978.5[医药卫生—药品]