During Covid Panacea treatment of Mucormycosis.

Amphotericin B (AMB)

It is obtained from streptomyces nodosus.

#MOA:- The polyene antibiotic molecule is a macrocyclic ring, one side of which has several conjugated double bonds and highly lipophilic, while other side hydrophilic with many OH groups.All polyenes are insoluble in water and unstable in aqueous medium.

They have high affinity for ergosterol present in fungal cell membrane.They combine with it get inserted into membrane and several polyene molecules together Orient themselves in such way to form a 'micropore' The hydrophilic side forms interior of pore through which ions, amino acids and other water soluble substances move out. Micropore stabilized by membrane sterols which fill up spaces b/w Amphotericin B molecules on lipophilic side constituting outer surface of pore. Thus cell permeability is markedly increase.

Cholesterol present in host cell membrane, closely resembles ergosterol the polyene bind to cholesterol as well through with lesser affinity. Bacteria don't have sterols and are affected by polyenes.

AMB is also active on various species of Leishmania.

#Pharmacokinetics:- It can be given orally for intestinal Candidiasis without systemic toxicity. Administered I.V.as a suspension made with the help of deoxycholate (DOC). The terminal elimination is 15 days.

*Liposomal amphotericin B (L- AMB):- It has been produced to improve tolerability of I.V. infusion of AMB reduce toxicity and achieve targeted delivery. It consists of 10 % AMB incorporated in uniform size unilamellar liposomes made up of lecithin and other biodegradable phospholipid.

.It has lower nephrotoxicity.

.It causes minimal anaemia.

It produces milder acute reaction on I.V.infusion.