title: Amphotericin B-associated hypertension.
abstract: OBJECTIVE
  To report two cases of hypertension related to amphotericin B infusion.
  
  
  METHODS
  A 63-year-old woman with Candida albicans bacteremia and an 84-year-old man with Aspergillus fumigatus pneumonia developed hypertension within minutes of amphotericin B administration. Both patients' blood pressure returned to baseline soon after the infusion of amphotericin B was stopped. Neither patient was rechallenged.
  
  
  CONCLUSIONS
  A causal relationship may exist between the administration of amphotericin B and these hypertensive episodes. Blood pressure in both patients normalized without treatment on discontinuation of the infusion. The mechanism of amphotericin B-associated hypertension is unclear but could include vasoconstricting properties of the drug or the administration of intravenous NaCl 0.9% prior to amphotericin B infusion. We recommend that intravenous NaCl 0.9% be administered following amphotericin B infusion and that the infusion be stopped if hypertensive episodes arise.
  
  
  CONCLUSIONS
  Both acute hypertension and hypotension can occur in patients receiving amphotericin B for systemic fungal infections.
authors.affiliation: Department of Pharmacy, Veterans Administration Medical Center, Providence, RI, USA.
authors.forename: Y
authors.initials: Y
authors.lastname: Le
authors.forename: K Z
authors.initials: KZ
authors.lastname: Rana
authors.forename: M N
authors.initials: MN
authors.lastname: Dudley
mesh_terms: D000368:Aged; D000666:Amphotericin B / Q000009:adverse effects*; D000935:Antifungal Agents / Q000008:administration & dosage / Q000009:adverse effects*; D001228:Aspergillosis / Q000188:drug therapy*; D001232:Aspergillus fumigatus; D002177:Candidiasis / Q000188:drug therapy*; D002440:Cefoxitin / Q000008:administration & dosage; D002513:Cephamycins / Q000008:administration & dosage; D005260:Female; D006801:Humans; D006973:Hypertension / Q000139:chemically induced*; D017964:Itraconazole / Q000008:administration & dosage; D008297:Male; D011014:Pneumonia / Q000188:drug therapy; D012965:Sodium Chloride / Q000494:pharmacology
chemical_list: D000935:Antifungal Agents; D002513:Cephamycins; D017964:Itraconazole; D012965:Sodium Chloride; D002440:Cefoxitin; D000666:Amphotericin B