Cardiopulmonary Toxicity after Liposomal Amphotericin B Infusion (1991)

Brief Reports15 April 1991Cardiopulmonary Toxicity after Liposomal Amphotericin B InfusionStewart J. Levine, MD, Thomas J. Walsh, MD, Anthony Martinez, MD, Peter Q. Eichacker, MD, Gabriel Lopez-Berestein, MD, Charles Natanson, MDStewart J. Levine, MD, Thomas J. Walsh, MD, Anthony Martinez, MD, Peter Q. Eichacker, MD, Gabriel Lopez-Berestein, MD, Charles Natanson, MDAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-114-8-664 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptLiposomal and lipid-complex drug delivery systems are being developed to enhance the therapeutic activity, decrease the toxicity, and provide site-specific delivery of high doses of amphotericin B (1-3). Incorporation within liposomes is thought to produce lipid-stabilized, ribbon-like amphotericin B aggregates that may decrease toxicity by allowing selective transfer of the drug directly to ergosterol-containing fungal cell membranes (4). Toxic reactions associated with liposomal amphotericin B (L-AmpB) therapy in humans have included fever, chills, nausea, and electrolyte disturbances (5-7). This report supplements the known toxicities by describing reversible abnormalities in pulmonary gas exchange and cardiopulmonary hemodynamics in a patient receiving high-dose...References1. WiebeDeGregorio VM. Liposome-encapsulated amphotericin B: a promising new treatment for disseminated fungal infections. Rev Infect Dis. 1988;10:1097-101. CrossrefMedlineGoogle Scholar2. Sarosi G. Nosocomial amphotericin B: current status [Editorial]. Arch Intern Med. 1989;149:2402-3. CrossrefMedlineGoogle Scholar3. Lopez-Berestein G. Liposomal amphotericin B in the treatment of fungal infections. Ann Intern Med. 1986;105:130-1. LinkGoogle Scholar4. JanoffBoniPopescu ALM. Unusual lipid structures selectively reduce the toxicity of amphotericin B. Proc Natl Acad Sci USA. 1988;85:6122-6. CrossrefMedlineGoogle Scholar5. Lopez-BeresteinFainsteinHopfer GVR. Liposomal amphotericin B for the treatment of systemic fungal infections in patients with cancer: a preliminary study. J Infect Dis. 1985;151:704-10. CrossrefMedlineGoogle Scholar6. Lopez-BeresteinBodeyFrankelMehta GGLK. Treatment of hepatosplenic candidiasis with liposomal-amphotericin B. J Clin Oncol. 1987;5:310-7. CrossrefMedlineGoogle Scholar7. Lopez-BeresteinBodeyFainstein GGV. Treatment of systemic fungal infections with liposomal amphotericin B. Arch Intern Med. 1989;149:2533-6. CrossrefMedlineGoogle Scholar8. MiyamotoSchultzHeathMitchellAlbertineStaub KETMKN. Pulmonary intravascular macrophages and hemodynamic effects of liposomes in sheep. J Appl Physiol. 1988;64:1143-52. CrossrefMedlineGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: From the National Institutes of Health, Bethesda, Maryland; and the University of Texas M. D. Anderson Cancer Center, Houston, Texas. For current author addresses, see end of text. 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