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Questions and Answers
What is the primary mechanism of action of echinocandins?
What is the primary mechanism of action of echinocandins?
What is the primary route of administration for echinocandins?
What is the primary route of administration for echinocandins?
Which of the following is a rare but potential adverse effect of echinocandins?
Which of the following is a rare but potential adverse effect of echinocandins?
What is the primary mechanism of resistance to echinocandins?
What is the primary mechanism of resistance to echinocandins?
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Which of the following is a potential drug interaction with echinocandins?
Which of the following is a potential drug interaction with echinocandins?
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What is the primary site of metabolism for echinocandins?
What is the primary site of metabolism for echinocandins?
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Which of the following is an indication for echinocandin therapy?
Which of the following is an indication for echinocandin therapy?
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What is the class of antifungal medications that echinocandins belong to?
What is the class of antifungal medications that echinocandins belong to?
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Study Notes
Echinocandins
Overview
- A class of antifungal medications that inhibit the synthesis of beta-1,3-glucan, a key component of the fungal cell wall
- Used to treat invasive aspergillosis, candidemia, and other fungal infections
Mechanism of Action
- Inhibit the enzyme glucan synthase, which is necessary for the synthesis of beta-1,3-glucan
- Disrupt the integrity of the fungal cell wall, leading to cell death
Examples of Echinocandins
- Caspofungin
- Micafungin
- Anidulafungin
- Rezafungin (experimental)
Pharmacokinetics
- Administered intravenously
- Distributed widely throughout the body, including the CNS
- Undergo hepatic metabolism, with minimal renal excretion
Adverse Effects
- Common: infusion reactions, nausea, vomiting, diarrhea, headache
- Less common: elevations in liver enzymes, hypokalemia, rash
- Rare: anaphylaxis, Stevens-Johnson syndrome
Drug Interactions
- May interact with cyclosporine, tacrolimus, and sirolimus, increasing the risk of liver toxicity
- May interact with warfarin, increasing the risk of bleeding
Resistance
- Fungal resistance to echinocandins is rare, but emerging
- Mechanisms of resistance include mutations in the FKS1 gene, which encodes the glucan synthase subunit
Indications
- Invasive aspergillosis
- Candidemia
- Invasive candidiasis
- Esophageal candidiasis
- Empirical therapy for febrile neutropenia
Echinocandins
- A class of antifungal medications that inhibit the synthesis of beta-1,3-glucan, a key component of the fungal cell wall
- Used to treat invasive aspergillosis, candidemia, and other fungal infections
Mechanism of Action
- Inhibit the enzyme glucan synthase, necessary for the synthesis of beta-1,3-glucan
- Disrupt the integrity of the fungal cell wall, leading to cell death
Examples
- Caspofungin
- Micafungin
- Anidulafungin
- Rezafungin (experimental)
Pharmacokinetics
- Administered intravenously
- Distributed widely throughout the body, including the CNS
- Undergo hepatic metabolism, with minimal renal excretion
Adverse Effects
- Infusion reactions
- Nausea, vomiting, diarrhea, headache
- Elevations in liver enzymes
- Hypokalemia
- Rash
- Anaphylaxis
- Stevens-Johnson syndrome (rare)
Drug Interactions
- Increase risk of liver toxicity with cyclosporine, tacrolimus, and sirolimus
- Increase risk of bleeding with warfarin
Resistance
- Fungal resistance to echinocandins is rare, but emerging
- Mechanisms of resistance include mutations in the FKS1 gene, which encodes the glucan synthase subunit
Indications
- Invasive aspergillosis
- Candidemia
- Invasive candidiasis
- Esophageal candidiasis
- Empirical therapy for febrile neutropenia
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Description
Learn about Echinocandins, a class of antifungal medications that inhibit the synthesis of beta-1,3-glucan, used to treat invasive aspergillosis and candidemia.
