Which of the following antibiotics is known to cause photosensitivity?

Choice A reason: Using an infusion pump ensures precise delivery of amphotericin B, which requires controlled infusion rates to minimize toxicity. Amphotericin B’s nephrotoxic and infusion-related reactions (e.g., fever, chills) necessitate accurate dosing, as rapid administration increases adverse effects, making pumps essential for safe administration.

Choice B reason: Discontinuing amphotericin B for tingling and numbness is appropriate, as these may indicate neurotoxicity or severe infusion reactions. Stopping the infusion prevents further exposure, allowing assessment of potential electrolyte imbalances or neurological damage, ensuring patient safety during this high-risk antifungal therapy.

Choice C reason: Reducing the IV rate for adverse effects like fever or chills may be appropriate, but tingling and numbness require immediate discontinuation, as they suggest serious toxicity. Rate reduction is insufficient for neurological symptoms, which demand urgent evaluation to prevent irreversible harm, making this action less prioritized.

Choice D reason: Rapid IV infusion of amphotericin B is inappropriate, as it increases the risk of nephrotoxicity and infusion reactions. Slow, controlled infusion over several hours minimizes toxicity, as amphotericin B’s binding to ergosterol causes systemic effects that worsen with faster administration, making this incorrect.

Choice E reason: Monitoring the IV site for phlebitis and infiltration is essential, as amphotericin B is irritating to veins. Phlebitis or extravasation can cause tissue damage, and regular site checks ensure proper drug delivery and prevent complications, supporting safe administration of this potent antifungal.

Choice A reason: Intravenous heparin has an immediate onset, as it rapidly enhances antithrombin activity, inhibiting thrombin and factor Xa, preventing clot formation. This quick action makes it ideal for acute conditions like pulmonary embolism, providing instant anticoagulation, with effects measurable by aPTT within minutes of administration.

Choice B reason: A 5- to 10-minute onset is too slow for IV heparin, which acts immediately upon entering the bloodstream. Subcutaneous heparin has a delayed onset (20-60 minutes), but IV delivery ensures rapid anticoagulant effects, making this timeframe incorrect for IV administration.

Choice C reason: A 20-minute onset is inaccurate for IV heparin. Its immediate binding to antithrombin provides instant anticoagulation, unlike oral anticoagulants like warfarin, which take days. The 20-minute timeframe may apply to subcutaneous heparin, not IV, which acts within seconds to minutes.

Choice D reason: A 1-hour onset is incorrect for IV heparin, which provides immediate anticoagulation by enhancing antithrombin’s inhibition of clotting factors. This rapid action is critical for acute thrombotic conditions. A 1-hour delay applies to drugs with slower absorption, not IV heparin’s direct action.