Caspofungin (Cancidas) Antifungal Drug Overview PDF

Overview of the Drug Class **Prototype: caspofungin (Cancidas) ** - **Category:** Echinocandin Antifungal Agent  - **Primary Function**: Caspofungin is a narrow-spectrum IV antifungal agent limited to aspergillus and candida species.  - **Unique Features**: These drugs are the newest c...

Overview of the Drug Class **Prototype: caspofungin (Cancidas) ** - **Category:** Echinocandin Antifungal Agent  - **Primary Function**: Caspofungin is a narrow-spectrum IV antifungal agent limited to aspergillus and candida species.  - **Unique Features**: These drugs are the newest class of antifungal agents. In contrast to amphotericin B and the Azoles, which disrupt the fungal cell membrane, the echinocandins disrupt the fungal cell wall. Caspofungin is better tolerated than amphotericin b with similar efficacy.  Mechanism of Action Caspofungin inhibits the biosynthesis of beta-1,3-d-glucan, an essential fungal cell wall component.    **Image Title: Mechanism of antifungal drugs** - Cell wall - Cell membrane - DNA - Proteins - Echinocandins, triterpenoids - Azoles, polyenes, allylamines - 5-fluorocytosine - Sordarins Indications and Therapeutic Uses - **Systemic Fungal Infections**: Caspofungin is approved for IV therapy of invasive aspergillosis in clients unresponsive or intolerant to amphotericin b or itraconazole or systemic candida infections, including candidemia and candida-related peritonitis, pleural space infections, and intraabdominal abscesses. Side Effects and Adverse Reactions **Side Effect** **Description** ------------------------------ --------------------------------------------------------------------------------------------------------------- Histamine-Mediated Reactions Effects include rash, facial flush, pruritis, anaphylaxis, or a sense of warmth related to histamine release. Injection Site Reactions Phlebitis at the injection site. Common Reactions Fever, headache, rash, nausea, or vomiting. Precautions and Contraindications **Precautions ** - Caspofungin is classified as an FDA Pregnancy risk Category C agent as it is embryotoxic in rats and rabbits. Avoid use in pregnancy unless the potential benefits outweigh the risks.  - Reduce dosage in clients with moderate hepatic impairment.  **Contraindications** - Avoid in clients with severe hepatic impairment.  Drug Interactions - Drugs that induce CYP450 enzymes (like **\[efavirenz, nelfinavir, rifampin, carbamazepine, dexamethasone, and phenytoin\]**) may decrease caspofungin levels.  - Simultaneous caspofungin use with **\[tacrolimus\]** can decrease its plasma levels.  - Concomitant use of caspofungin with **\[cyclosporine\]** increases the risk for hepatic injury.  Dosing, Administration, & Client Teaching **Dosing** - Dosing varies based on the condition, severity, and client response.  - Check drug dosing guidelines for individualized dosing.  - Caspofungin is not absorbed from the GI tract and must be given intravenously.  - Available in powder for saline reconstitution in 50mg and 70 mg.  - Treatment should include a 70 mg loading dose followed by daily maintenance dosing of 50 mg. Treatment duration depends on the disease\'s severity and the client\'s response.  - Capsofungin should be infused slowly over 1 hour.  **Administration** - IV administration slowly over one hour.  **Client Teaching** - Advise clients who are pregnant or considering pregnancy of the risks and benefits of using this drug.  - Educate clients to monitor for side effects and report to providers.  Labs to Monitor **Liver Function Tests (LFTS)** - Liver function tests should be done at initiation and during use to monitor for hepatic dysfunction.  **Serum Drug Levels** - If this drug is used concomitantly with tacrolimus, plasma levels of tacrolimus should be monitored.