Abstract
Abstract
French
The pathogenesis, clinical manifestations, and management of adverse reactions of amphotericin B are presented. Various types of nephrotoxicity, thrombophlebitis, and anemia are described along with suggestions for their prevention and management. The management of generalized reactions such as fever, GI upset, headache, and myalgias is discussed, along with a commentary on allergic reactions. Complications associated with intrathecal administration and aerosolization of the drug are also described.
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