A super aesthetic handwritten-style pharmacology revision note page for "Amphotericin B", top-view of a clean white lined notebook page. Neat, colorful, exam-oriented layout with the following organized sections: TOP: Large decorative title "Amphotericin B" in dark teal handwriting with a double underline and small mushroom/fungus doodle beside it. Subtitle in purple: "Polyene Antifungal | Drug of Choice for Severe Systemic Mycoses" SECTION 1 (coral/orange box heading): "DEFINITION & SOURCE" - Naturally occurring polyene antifungal antibiotic - Produced by Streptomyces nodosus (actinomycetes) - Amphoteric polyene macrolide (large lactone ring, 7 conjugated double bonds) - Available: Conventional (deoxycholate) + Lipid formulations SECTION 2 (blue heading with underline): "MECHANISM OF ACTION" Arrow flow diagram in handwriting style: AmB binds ERGOSTEROL (fungal membrane sterol) → Forms ION CHANNELS / PORES → K⁺ & electrolytes LEAK OUT → Osmotic disruption → CELL DEATH Second mechanism: Oxidative damage via free radicals Note box: "Binds cholesterol too (less avid) → TOXICITY in humans" SECTION 3 (green box heading): "ANTIFUNGAL SPECTRUM" Two columns: SENSITIVE: Candida albicans, Cryptococcus neoformans, Aspergillus spp., Mucormycetes, Histoplasma capsulatum, Blastomyces dermatitidis, Coccidioides immitis RESISTANT: Aspergillus terreus, Fusarium, Scedosporium, C. lusitaniae, C. auris Small note: "Resistance = ↓ ergosterol in membrane" Also used in: LEISHMANIASIS (protozoal) SECTION 4 (purple heading): "PHARMACOKINETICS" - Route: IV infusion (SLOW) — NOT absorbed orally or IM - Insoluble in water → formulated with sodium deoxycholate (conventional) OR lipid vehicles - Protein binding: Extensive - Distribution: Liver, spleen, kidney, bone marrow, lung - CSF penetration: POOR (yet effective in CNS fungal infections) - Excretion: Urine (slow, prolonged) — NOT affected by renal impairment dosing adjustment needed SECTION 5 (red/coral heading with warning symbol): "ADVERSE EFFECTS ⚠️" Drawn body diagram sketch on the right side with arrows pointing to: 🔴 INFUSION REACTIONS: Fever, chills, rigors (1-3 hrs after IV) — "shake & bake reaction" 🔴 NEPHROTOXICITY: ↓GFR, ↑Creatinine, K⁺ & Mg²⁺ wasting — most serious 🔴 HYPOKALAEMIA → risk with digoxin 🔴 NORMOCHROMIC NORMOCYTIC ANAEMIA (↓ EPO) 🔴 THROMBOPHLEBITIS at IV site 🔴 HYPOTENSION (shock-like) PREVENTION BOX (light yellow): • Premedicate: Antipyretics, antihistamines, corticosteroids • Sodium loading (normal saline) before infusion → ↓ nephrotoxicity • Add heparin → ↓ thrombophlebitis • Use LIPOSOMAL formulation → ↓ toxicity SECTION 6 (teal heading): "LIPID FORMULATIONS" Three options listed: 1. Liposomal AmB (L-AmB) — least toxic 2. AmB lipid complex (ABLC) 3. AmB colloidal dispersion (ABCD) Note: "↓ nephrotoxicity, ↓ infusion reactions, ↑ cost" SECTION 7 (orange box): "CLINICAL USES" • DOC: Invasive aspergillosis, mucormycosis, cryptococcal meningitis • Empirical antifungal in febrile neutropenia • Visceral leishmaniasis (liposomal form) • Combined with FLUCYTOSINE → Cryptococcal meningitis (SYNERGY) BOTTOM SECTION (pink/lavender star box): "⭐ LAST-MINUTE REVISION BOX" • Class: Polyene antifungal • MOA: Binds ergosterol → pore formation → cell lysis • Spectrum: Broad (not Aspergillus terreus, Fusarium) • Route: IV only (slow infusion) • Main toxicity: Nephrotoxicity + Infusion reactions • Resistance: ↓ ergosterol • Synergy: + Flucytosine (Crypto meningitis) • Lipid forms: Less toxic, more expensive MEMORY TRICK (sticky note doodle, yellow): "AmB = 'Ampho-TERRIBLE' — Terribly toxic but terribly effective! FRICK = Fever Rigors Infusion Chills K⁺↓ (adverse effects)" ONE-LINE SUMMARY (bottom, bold): "Gold standard for life-threatening systemic fungal infections — broad spectrum, IV only, nephrotoxic polyene." Use warm pastel colors, neat handwriting fonts, small fungal cell diagrams, colorful underlines, stars for key points, and an overall clean aesthetic study notes look.

mkdir -p /home/daytona/workspace/amphotericin-notes && ls /home/daytona/workspac…

~/amphotericin-notes/amphotericin_b.html

<!DOCTYPE html>
<html lang="en">
<head>
<meta charset="UTF-8">
<meta name="viewport" content="width=device-width, initial-scale=1.0">
<title>Amphotericin B - Pharmacology Notes</title>
<style>
  @import url('https://fonts.googleapis.com/css2?family=Caveat:wght@400;500;600;700&family=Patrick+Hand&family=Indie+Flower&display=swap');

  * { margin: 0; padding: 0; box-sizing: border-box; }

  body {
    background: #f0ece3;
    font-family: 'Caveat', cursive;
    padding: 20px;
  }

  .page {
    background: #fffef7;
    width: 900px;
    margin: 0 auto;
    padding: 50px 55px 55px 75px;
    border-radius: 4px;
    box-shadow: 4px 4px 18px rgba(0,0,0,0.18), -1px -1px 5px rgba(0,0,0,0.07);
    position: relative;
    /* Lined paper effect */
    background-image:
      linear-gradient(transparent calc(100% - 1px), #c8dff0 1px),
      linear-gradient(90deg, #f5b8b8 40px, transparent 40px);
    background-size: 100% 36px, 100% 100%;
    min-height: 100vh;
  }

  /* Spiral binding holes */
  .page::before {
    content: '';
    position: absolute;
    left: 20px;
    top: 60px;
    bottom: 60px;
    width: 20px;
    background: repeating-linear-gradient(
      to bottom,
      transparent 0px,
      transparent 55px,
      #e0e0e0 55px,
      #e0e0e0 57px,
      transparent 57px,
      transparent 70px
    );
  }

  /* Title */
  .title-block {
    text-align: center;
    margin-bottom: 28px;
    padding-bottom: 10px;
  }

  .drug-name {
    font-size: 52px;
    font-weight: 700;
    color: #1a5f7a;
    font-family: 'Caveat', cursive;
    letter-spacing: 2px;
    text-shadow: 2px 2px 0 rgba(26,95,122,0.12);
    position: relative;
    display: inline-block;
  }

  .drug-name::after {
    content: '';
    display: block;
    height: 4px;
    background: linear-gradient(90deg, #1a5f7a, #57c5b6, #1a5f7a);
    border-radius: 3px;
    margin-top: 2px;
  }

  .drug-name::before {
    content: '';
    display: block;
    height: 2px;
    background: linear-gradient(90deg, transparent, #1a5f7a, transparent);
    border-radius: 2px;
    margin-bottom: 3px;
  }

  .subtitle {
    font-size: 20px;
    color: #7c3aed;
    font-family: 'Caveat', cursive;
    margin-top: 5px;
    letter-spacing: 0.5px;
  }

  .emoji-row {
    font-size: 18px;
    margin-top: 6px;
    color: #555;
  }

  /* Two-column layout */
  .two-col {
    display: grid;
    grid-template-columns: 1fr 1fr;
    gap: 18px;
    margin-bottom: 18px;
  }

  .full-width {
    margin-bottom: 18px;
  }

  /* Section boxes */
  .section {
    border-radius: 10px;
    padding: 14px 16px;
    position: relative;
  }

  .section-heading {
    font-size: 20px;
    font-weight: 700;
    font-family: 'Caveat', cursive;
    margin-bottom: 8px;
    padding-bottom: 4px;
    display: flex;
    align-items: center;
    gap: 6px;
    border-bottom: 2px dashed rgba(0,0,0,0.15);
  }

  .section ul {
    list-style: none;
    padding: 0;
  }

  .section ul li {
    font-size: 17px;
    font-family: 'Caveat', cursive;
    padding: 2px 0 2px 20px;
    position: relative;
    line-height: 1.5;
  }

  .section ul li::before {
    content: '✦';
    position: absolute;
    left: 0;
    font-size: 11px;
    top: 5px;
    color: inherit;
    opacity: 0.7;
  }

  /* Color themes for sections */
  .blue-section { background: #e8f4fd; border-left: 5px solid #2980b9; }
  .blue-section .section-heading { color: #1a5276; }
  .blue-section ul li::before { color: #2980b9; }

  .green-section { background: #e9f7ef; border-left: 5px solid #27ae60; }
  .green-section .section-heading { color: #1e8449; }
  .green-section ul li::before { color: #27ae60; }

  .orange-section { background: #fef5e7; border-left: 5px solid #e67e22; }
  .orange-section .section-heading { color: #a04000; }
  .orange-section ul li::before { color: #e67e22; }

  .red-section { background: #fdedec; border-left: 5px solid #e74c3c; }
  .red-section .section-heading { color: #922b21; }
  .red-section ul li::before { color: #e74c3c; }

  .purple-section { background: #f5eef8; border-left: 5px solid #8e44ad; }
  .purple-section .section-heading { color: #6c3483; }
  .purple-section ul li::before { color: #8e44ad; }

  .teal-section { background: #e8f8f5; border-left: 5px solid #16a085; }
  .teal-section .section-heading { color: #0e6655; }
  .teal-section ul li::before { color: #16a085; }

  .pink-section { background: #fce4ec; border-left: 5px solid #e91e63; }
  .pink-section .section-heading { color: #880e4f; }
  .pink-section ul li::before { color: #e91e63; }

  .indigo-section { background: #e8eaf6; border-left: 5px solid #3f51b5; }
  .indigo-section .section-heading { color: #283593; }
  .indigo-section ul li::before { color: #3f51b5; }

  /* Mechanism flow */
  .flow-box {
    background: #e8f4fd;
    border-left: 5px solid #2980b9;
    border-radius: 10px;
    padding: 14px 16px;
    margin-bottom: 18px;
  }

  .flow-box .section-heading {
    font-size: 20px;
    font-weight: 700;
    color: #1a5276;
    margin-bottom: 10px;
    border-bottom: 2px dashed rgba(0,0,0,0.15);
    padding-bottom: 4px;
  }

  .flow-steps {
    display: flex;
    flex-wrap: wrap;
    align-items: center;
    gap: 6px;
    font-size: 16px;
    font-family: 'Caveat', cursive;
  }

  .flow-step {
    background: #fff;
    border: 2px solid #2980b9;
    border-radius: 8px;
    padding: 6px 12px;
    font-weight: 600;
    color: #1a5276;
  }

  .flow-arrow {
    font-size: 22px;
    color: #e67e22;
    font-weight: 700;
  }

  .flow-note {
    margin-top: 8px;
    font-size: 16px;
    color: #6c3483;
    font-style: italic;
    font-family: 'Caveat', cursive;
  }

  /* Highlight text */
  .hl-yellow { background: #fff176; padding: 0 3px; border-radius: 3px; }
  .hl-green { background: #c8e6c9; padding: 0 3px; border-radius: 3px; }
  .hl-pink { background: #f8bbd0; padding: 0 3px; border-radius: 3px; }
  .hl-blue { background: #b3e5fc; padding: 0 3px; border-radius: 3px; }
  .hl-orange { background: #ffe0b2; padding: 0 3px; border-radius: 3px; }
  .hl-purple { background: #e1bee7; padding: 0 3px; border-radius: 3px; }

  strong { font-weight: 700; }

  /* Spectrum table-style */
  .spectrum-grid {
    display: grid;
    grid-template-columns: 1fr 1fr;
    gap: 10px;
    margin-top: 6px;
  }

  .spec-card {
    border-radius: 8px;
    padding: 8px 10px;
    font-size: 15.5px;
    font-family: 'Caveat', cursive;
  }

  .spec-sensitive {
    background: #e8f5e9;
    border: 2px solid #66bb6a;
  }

  .spec-sensitive .spec-title {
    color: #2e7d32;
    font-size: 16px;
    font-weight: 700;
    margin-bottom: 4px;
    display: flex;
    align-items: center;
    gap: 4px;
  }

  .spec-resistant {
    background: #ffebee;
    border: 2px solid #ef5350;
  }

  .spec-resistant .spec-title {
    color: #c62828;
    font-size: 16px;
    font-weight: 700;
    margin-bottom: 4px;
    display: flex;
    align-items: center;
    gap: 4px;
  }

  /* Adverse effects grid */
  .ae-grid {
    display: grid;
    grid-template-columns: 1fr 1fr;
    gap: 8px;
    margin-top: 8px;
  }

  .ae-card {
    background: #fff;
    border-radius: 8px;
    padding: 8px 10px;
    border: 1.5px solid #e74c3c;
    font-size: 16px;
    font-family: 'Caveat', cursive;
  }

  .ae-card .ae-title {
    font-weight: 700;
    color: #c0392b;
    font-size: 16.5px;
    margin-bottom: 2px;
  }

  /* Prevention box */
  .prevention-box {
    background: #fffde7;
    border: 2px dashed #f9a825;
    border-radius: 10px;
    padding: 10px 14px;
    margin-top: 10px;
    font-size: 16px;
    font-family: 'Caveat', cursive;
  }

  .prevention-box .prev-title {
    font-weight: 700;
    color: #e65100;
    font-size: 17px;
    margin-bottom: 5px;
  }

  /* Lipid formulations table */
  .lipid-table {
    width: 100%;
    border-collapse: collapse;
    font-family: 'Caveat', cursive;
    font-size: 16px;
    margin-top: 8px;
  }

  .lipid-table th {
    background: #16a085;
    color: white;
    padding: 6px 10px;
    text-align: left;
    font-weight: 600;
  }

  .lipid-table td {
    padding: 5px 10px;
    border-bottom: 1px solid #b2dfdb;
    color: #1a3a30;
  }

  .lipid-table tr:nth-child(even) { background: #e0f2f1; }
  .lipid-table tr:nth-child(odd) { background: #f1fffe; }

  /* Memory trick */
  .memory-box {
    background: linear-gradient(135deg, #fff9c4, #fff3e0);
    border: 3px solid #f9a825;
    border-radius: 12px;
    padding: 16px 20px;
    margin-bottom: 18px;
    position: relative;
    box-shadow: 3px 3px 10px rgba(249,168,37,0.2);
  }

  .memory-box::before {
    content: '📌';
    position: absolute;
    top: -12px;
    left: 20px;
    font-size: 24px;
  }

  .memory-title {
    font-size: 20px;
    font-weight: 700;
    color: #e65100;
    font-family: 'Caveat', cursive;
    margin-bottom: 6px;
  }

  .memory-text {
    font-size: 18px;
    font-family: 'Caveat', cursive;
    color: #4a148c;
    font-weight: 600;
  }

  .memory-sub {
    font-size: 16px;
    font-family: 'Caveat', cursive;
    color: #5d4037;
    margin-top: 5px;
  }

  /* Last minute revision box */
  .revision-box {
    background: linear-gradient(135deg, #e8eaf6, #fce4ec);
    border: 3px solid #3f51b5;
    border-radius: 12px;
    padding: 16px 20px;
    box-shadow: 4px 4px 14px rgba(63,81,181,0.15);
  }

  .revision-title {
    font-size: 24px;
    font-weight: 700;
    color: #1a237e;
    font-family: 'Caveat', cursive;
    margin-bottom: 10px;
    text-align: center;
    border-bottom: 3px double #3f51b5;
    padding-bottom: 6px;
  }

  .rev-grid {
    display: grid;
    grid-template-columns: 1fr 1fr;
    gap: 8px;
  }

  .rev-item {
    font-size: 17px;
    font-family: 'Caveat', cursive;
    color: #283593;
    padding: 3px 0;
    display: flex;
    gap: 6px;
  }

  .rev-label {
    font-weight: 700;
    color: #880e4f;
    min-width: 120px;
  }

  /* One-line summary */
  .summary-line {
    text-align: center;
    font-size: 18px;
    font-family: 'Caveat', cursive;
    color: #1a5f7a;
    font-weight: 600;
    margin-top: 14px;
    padding: 8px 16px;
    background: #e0f7fa;
    border-radius: 20px;
    border: 2px solid #00acc1;
  }

  /* Divider */
  .divider {
    height: 2px;
    background: linear-gradient(90deg, transparent, #c0c0c0, transparent);
    margin: 20px 0;
  }

  .tag {
    display: inline-block;
    background: #1a5f7a;
    color: white;
    border-radius: 12px;
    padding: 2px 10px;
    font-size: 13px;
    font-family: 'Caveat', cursive;
    margin-left: 6px;
    vertical-align: middle;
  }

  .tag-doc { background: #e53935; }
  .tag-key { background: #7b1fa2; }
</style>
</head>
<body>
<div class="page">

  <!-- TITLE -->
  <div class="title-block">
    <div class="drug-name">🍄 Amphotericin B</div>
    <div class="subtitle">✦ Polyene Antifungal ✦ Drug of Choice for Severe Systemic Mycoses ✦</div>
    <div class="emoji-row">Class: Antifungal &nbsp;|&nbsp; Type: Polyene Macrolide &nbsp;|&nbsp; Route: IV only</div>
  </div>

  <!-- ROW 1: Definition + Source -->
  <div class="two-col">
    <div class="section blue-section">
      <div class="section-heading">📖 Definition &amp; Source</div>
      <ul>
        <li>Naturally occurring <span class="hl-yellow"><strong>polyene antifungal</strong></span> antibiotic</li>
        <li>Produced by <span class="hl-green"><strong>Streptomyces nodosus</strong></span> (actinomycetes)</li>
        <li>Amphoteric <span class="hl-blue"><strong>polyene macrolide</strong></span> — large lactone ring with 7 conjugated double bonds</li>
        <li>Insoluble in water → needs special formulation</li>
        <li>Amphotericin A exists but NOT in clinical use</li>
      </ul>
    </div>

    <div class="section orange-section">
      <div class="section-heading">💊 Formulations</div>
      <ul>
        <li><span class="hl-orange"><strong>Conventional:</strong></span> AmB + sodium deoxycholate (colloidal suspension)</li>
        <li><span class="hl-green"><strong>L-AmB</strong></span> — Liposomal AmB (least toxic, highest cost)</li>
        <li><span class="hl-blue"><strong>ABLC</strong></span> — AmB Lipid Complex (ribbon-like)</li>
        <li><span class="hl-purple"><strong>ABCD</strong></span> — AmB Colloidal Dispersion (disc-like)</li>
        <li>Lipid forms → <span class="hl-pink">↓ nephrotoxicity &amp; infusion reactions</span></li>
      </ul>
    </div>
  </div>

  <!-- MECHANISM OF ACTION — FLOW -->
  <div class="flow-box">
    <div class="section-heading">⚙️ Mechanism of Action</div>
    <div class="flow-steps">
      <div class="flow-step">AmB enters blood</div>
      <div class="flow-arrow">→</div>
      <div class="flow-step">Binds <span class="hl-yellow">Ergosterol</span> in fungal membrane</div>
      <div class="flow-arrow">→</div>
      <div class="flow-step">Forms ION PORES / CHANNELS</div>
      <div class="flow-arrow">→</div>
      <div class="flow-step">K⁺, Mg²⁺ &amp; molecules leak out</div>
      <div class="flow-arrow">→</div>
      <div class="flow-step" style="background:#e8f5e9; border-color:#27ae60; color:#1b5e20">Osmotic disruption → CELL DEATH 💀</div>
    </div>
    <div class="flow-note">
      🔴 Also binds <strong>cholesterol</strong> (mammalian membranes) → less avid → explains <strong>human toxicity</strong><br>
      🟡 2nd mechanism: Oxidative cascade → free radicals → rapid fungicidal activity<br>
      🟢 At low levels: <strong>Immunostimulatory effect</strong>
    </div>
  </div>

  <!-- SPECTRUM -->
  <div class="section green-section full-width">
    <div class="section-heading">🎯 Antifungal Spectrum <span class="tag">BROAD</span></div>
    <div class="spectrum-grid">
      <div class="spec-card spec-sensitive">
        <div class="spec-title">✅ SENSITIVE</div>
        • <strong>Candida albicans</strong><br>
        • <strong>Cryptococcus neoformans</strong><br>
        • <strong>Aspergillus spp.</strong> (most)<br>
        • <strong>Mucormycetes</strong> (Mucor, Rhizopus)<br>
        • <strong>Histoplasma capsulatum</strong><br>
        • <strong>Blastomyces dermatitidis</strong><br>
        • <strong>Coccidioides immitis</strong><br>
        • <strong>Paracoccidioides brasiliensis</strong><br>
        • Sporothrix schenckii
      </div>
      <div class="spec-card spec-resistant">
        <div class="spec-title">❌ RESISTANT</div>
        • <span class="hl-pink"><strong>Aspergillus terreus</strong></span><br>
        • <strong>Fusarium spp.</strong><br>
        • <strong>Scedosporium spp.</strong><br>
        • <strong>Lomentospora prolificans</strong><br>
        • <strong>Trichosporon spp.</strong><br>
        • <em>C. lusitaniae, C. auris, C. guilliermondii</em><br>
        <br>
        <strong>Resistance mechanism:</strong> <span class="hl-yellow">↓ Ergosterol in membrane</span>
      </div>
    </div>
    <div style="margin-top: 8px; font-size:16px; font-family:'Caveat', cursive; color:#1e8449;">
      🌟 Also used in: <span class="hl-green"><strong>Visceral Leishmaniasis</strong></span> (protozoal!) — liposomal form preferred
    </div>
  </div>

  <!-- PHARMACOKINETICS -->
  <div class="section purple-section full-width">
    <div class="section-heading">🔬 Pharmacokinetics</div>
    <div class="two-col" style="margin-bottom:0">
      <ul>
        <li><strong>Route:</strong> <span class="hl-pink">IV infusion ONLY</span> (SLOW, over 2–6h)</li>
        <li>NOT absorbed orally or IM</li>
        <li><strong>Protein binding:</strong> Extensive (&gt;90%)</li>
        <li><strong>Distribution:</strong> Liver, spleen, kidney, bone marrow, lung</li>
      </ul>
      <ul>
        <li><strong>CSF penetration:</strong> <span class="hl-orange">POOR</span> — yet effective in CNS mycoses!</li>
        <li>Poor penetration: Vitreous humor, peritoneal, synovial fluid</li>
        <li><strong>Excretion:</strong> Urine (slow, prolonged) &amp; bile</li>
        <li>Long terminal half-life (~15 days)</li>
      </ul>
    </div>
  </div>

  <!-- ADVERSE EFFECTS -->
  <div class="section red-section full-width">
    <div class="section-heading">⚠️ Adverse Effects (Low Therapeutic Index!)</div>
    <div class="ae-grid">
      <div class="ae-card">
        <div class="ae-title">🔥 Infusion Reactions</div>
        Fever, chills, rigors, headache 1–3 hrs after IV<br>
        <em>"Shake &amp; Bake" reaction</em><br>
        Subsides with repeated doses
      </div>
      <div class="ae-card">
        <div class="ae-title">🫘 Nephrotoxicity (Most Serious)</div>
        ↓ GFR, ↑ Serum creatinine<br>
        K⁺ &amp; Mg²⁺ wasting (tubular damage)<br>
        Usually reversible; residual damage at high doses
      </div>
      <div class="ae-card">
        <div class="ae-title">🩸 Anaemia</div>
        Normochromic, normocytic<br>
        Due to ↓ Erythropoietin (EPO) production<br>
        Bone marrow suppression (rare)
      </div>
      <div class="ae-card">
        <div class="ae-title">⚡ Electrolyte Disturbances</div>
        <span class="hl-pink"><strong>Hypokalaemia</strong></span> → risk with <strong>Digoxin</strong>!<br>
        <strong>Hypomagnesaemia</strong><br>
        Requires K⁺ &amp; Mg²⁺ supplementation
      </div>
      <div class="ae-card">
        <div class="ae-title">💉 Thrombophlebitis</div>
        At IV infusion site<br>
        Add heparin to infusion to reduce
      </div>
      <div class="ae-card">
        <div class="ae-title">💔 Hypotension</div>
        Shock-like fall in BP<br>
        Accompanied by hypokalemia<br>
        Monitor closely during infusion
      </div>
    </div>
    <div class="prevention-box">
      <div class="prev-title">🛡️ Prevention of Adverse Effects</div>
      • Pre-medicate: <strong>Antipyretics</strong> (paracetamol) + <strong>antihistamines</strong> + <strong>corticosteroids</strong><br>
      • <strong>Sodium loading</strong> (0.9% NaCl infusion before AmB) → ↓ nephrotoxicity<br>
      • Add <strong>heparin</strong> to infusion → ↓ thrombophlebitis<br>
      • Use <strong>liposomal formulation</strong> → ↓ toxicity overall &nbsp; • Monitor renal function, K⁺, Mg²⁺ regularly
    </div>
  </div>

  <!-- CLINICAL USES + SYNERGY -->
  <div class="two-col">
    <div class="section teal-section">
      <div class="section-heading">🏥 Clinical Uses <span class="tag tag-doc">DOC</span></div>
      <ul>
        <li><span class="hl-yellow">DOC:</span> <strong>Mucormycosis</strong></li>
        <li><span class="hl-yellow">DOC:</span> Severe/disseminated <strong>Cryptococcosis</strong></li>
        <li><span class="hl-yellow">DOC:</span> Severe <strong>Histoplasmosis</strong></li>
        <li>Invasive <strong>Aspergillosis</strong></li>
        <li>Invasive <strong>Candidiasis</strong></li>
        <li>Empirical antifungal in <strong>febrile neutropenia</strong></li>
        <li><strong>Blastomycosis, Coccidioidomycosis</strong></li>
        <li>Visceral <strong>Leishmaniasis</strong> (L-AmB)</li>
      </ul>
    </div>

    <div class="section indigo-section">
      <div class="section-heading">🔗 Key Drug Interactions &amp; Synergy</div>
      <ul>
        <li><span class="hl-green"><strong>+ Flucytosine (5-FC)</strong></span> → SYNERGY<br>
          Used in <em>Cryptococcal meningitis</em><br>
          AmB damages membrane → more 5-FC enters</li>
        <li><span class="hl-orange"><strong>+ Azoles</strong></span> → In vitro synergy (mechanism unclear); generally AVOID combining (azoles reduce ergosterol → reduce AmB target)</li>
        <li><span class="hl-pink"><strong>+ Aminoglycosides / Cyclosporine / Vancomycin</strong></span> → ↑↑ Nephrotoxicity</li>
        <li><span class="hl-purple"><strong>+ Digoxin</strong></span> → Hypokalaemia → Digoxin toxicity!</li>
      </ul>
    </div>
  </div>

  <!-- MEMORY TRICK -->
  <div class="memory-box">
    <div class="memory-title">🧠 Memory Tricks</div>
    <div class="memory-text">
      "Ampho-<u>TERRIBLE</u>" — Terribly toxic, but terribly effective! 🔥
    </div>
    <div class="memory-sub">
      <strong>FRICK</strong> = <u>F</u>ever, <u>R</u>igors, <u>I</u>nfusion reaction, <u>C</u>hills, <u>K</u>⁺↓ (Adverse effects mnemonic)<br>
      <strong>S. nodosus → "Nod-OSUS"</strong> = The fungus nodded off (killed by AmB)<br>
      AmB + Ergosterol = Like a <strong>key in a lock</strong> → punches HOLES in the fungal door!
    </div>
  </div>

  <!-- LAST MINUTE REVISION BOX -->
  <div class="revision-box">
    <div class="revision-title">⭐ Last-Minute Revision Box ⭐</div>
    <div class="rev-grid">
      <div class="rev-item"><span class="rev-label">Class:</span> Polyene antifungal</div>
      <div class="rev-item"><span class="rev-label">Source:</span> Streptomyces nodosus</div>
      <div class="rev-item"><span class="rev-label">MOA:</span> Binds ergosterol → pores → cell lysis</div>
      <div class="rev-item"><span class="rev-label">Spectrum:</span> Broad (fungicidal)</div>
      <div class="rev-item"><span class="rev-label">Route:</span> IV only (slow infusion)</div>
      <div class="rev-item"><span class="rev-label">CSF:</span> Poor penetration</div>
      <div class="rev-item"><span class="rev-label">Main ADR:</span> Nephrotoxicity + Infusion rxn</div>
      <div class="rev-item"><span class="rev-label">Anaemia:</span> Normochromic normocytic</div>
      <div class="rev-item"><span class="rev-label">Resistance:</span> ↓ Ergosterol in membrane</div>
      <div class="rev-item"><span class="rev-label">Synergy:</span> + Flucytosine (Crypto. mening.)</div>
      <div class="rev-item"><span class="rev-label">Lipid form:</span> ↓ toxic, ↑ cost</div>
      <div class="rev-item"><span class="rev-label">Avoid with:</span> Aminoglycosides (↑ nephrotox)</div>
      <div class="rev-item"><span class="rev-label">DOC:</span> Mucormycosis, Leishmaniasis</div>
      <div class="rev-item"><span class="rev-label">Prevent ADR:</span> Na loading + premedicate</div>
    </div>
    <div class="summary-line">
      💡 One-liner: "Gold standard IV antifungal — broad spectrum, binds ergosterol, fungicidal, but nephrotoxic &amp; infusion reactions limit use."
    </div>
  </div>

</div>
</body>
</html>

cd /home/daytona/workspace/amphotericin-notes && python3 -c " import subprocess,…

which wkhtmltopdf chromium-browser google-chrome chromium puppeteer 2>/dev/null;…

cd /home/daytona/workspace/amphotericin-notes && /usr/bin/chromium --headless --…

cd /home/daytona/workspace/amphotericin-notes && /usr/bin/chromium --headless --…