Bind to ergosterol in the fungal cell membrane → formation of pores in the fungal membrane → disruption of electrolyte balance → cell lysis → cell death
It binds cholesterol to a degree, which explains a large number of its adverse effects.
Amphotericin B
Adverse effects
Nephrotoxicity: Lipid-based formulations of the drug and IV hydration reduce nephrotoxicity.
IV phlebitis
Impaired renal tubule permeability → hypokalemia and hypomagnesemia (restoring K+ and Mg2+ while administering the drug can counter this effect)
Fever, chills (amphotericin B is sometimes referred to as “shake and bake”)
Bone marrow suppression, anemia
Arrhythmias
Nystatin
Routes of administration (too toxic for intravenous use)