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Explain Nephrotoxicity
Nephrotoxicity is the major dose-limiting toxicity of amphotericin B deoxycholate; sodium loading with normal saline may prevent or ameliorate it and is generally recommended for patients who can tolerate a fluid load. The nephrotoxicity of amphotericin B may add to the nephrotoxicity of other drugs including cyclosporine (Sandimmune, Neoral), tacrolimus (Prograf) and aminoglycoside antibiotics like gentamicin (Garamycin, and others). Hypo- kalemia and hypomagnesemia are common and are usually due to a mild renal tubular acidosis. Weight loss, malaise, anemia, thrombocytopenia and mild leukopenia can happen. Cardiac toxicity and myopathy have been reported.
The stepped steel shaft illustrated in Figure is subjected to a torque (T) at the free end and a torque (2T) in the opposite direction at the junction of the two sizes.
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