Home Drug Guide Anidulafungin

Drug Guide

Generic Name

Anidulafungin

Brand Names Eraxis

Classification

Therapeutic: Antifungal agent

Pharmacological: Echinocandin

FDA Approved Indications

  • Treatment of candidemia and other forms of invasive candidiasis

Mechanism of Action

Inhibits β-1,3-D-glucan synthase enzyme, leading to impairment of fungal cell wall synthesis and resulting in cell death.

Dosage and Administration

Adult: 200 mg loading dose on day 1, followed by 100 mg once daily; dose adjustments not typically necessary.

Pediatric: Not established; safety and efficacy have not been fully determined.

Geriatric: No specific dose adjustment recommended, but monitor renal and hepatic function.

Renal Impairment: No dose adjustment needed.

Hepatic Impairment: No dose adjustment needed.

Pharmacokinetics

Absorption: Not applicable (administered intravenously).

Distribution: Widely distributed in body tissues and fluids.

Metabolism: Metabolized minimally; primarily excreted unchanged.

Excretion: Primarily via feces, minimal renal excretion.

Half Life: ≈24 hours.

Contraindications

  • Hypersensitivity to anidulafungin or other echinocandins.

Precautions

  • Use with caution in patients with hepatic impairment. Monitoring liver enzymes is recommended.
  • Ensure renal function is monitored, especially if combined with nephrotoxic drugs.

Adverse Reactions - Common

  • Headache (Less common)
  • Nausea (Less common)
  • Vomiting (Less common)
  • Histamine-mediated infusion reactions (flushing, rash, hypotension) (Less common)

Adverse Reactions - Serious

  • Hepatotoxicity (elevations in liver enzymes) (Rare)
  • Anaphylaxis (Rare)

Drug-Drug Interactions

  • Potential increased risk of bleeding with anticoagulants.
  • Caution with other nephrotoxic or hepatotoxic drugs.

Drug-Food Interactions

N/A

Drug-Herb Interactions

N/A

Nursing Implications

Assessment: Monitor for signs of allergic reactions, infusion-related reactions, liver function tests, renal function.

Diagnoses:

  • Risk for infection related to invasive fungal infection.

Implementation: Administer IV infusion over 90 minutes, monitor infusion site.

Evaluation: Assess clinical response and adverse effects.

Patient/Family Teaching

  • Report any allergic reactions immediately.
  • Inform about possible side effects and the importance of adhering to dosing schedule.
  • Keep follow-up appointments for lab testing.

Special Considerations

Black Box Warnings:

  • No black box warnings for anidulafungin.

Genetic Factors: Limited data on pharmacogenomics.

Lab Test Interference: May cause transient elevations in liver enzymes, monitor liver function tests regularly.

Overdose Management

Signs/Symptoms: Potential for infusion reactions, liver toxicity.

Treatment: Supportive care; no specific antidote. Discontinue drug and provide symptomatic treatment as needed.

Storage and Handling

Storage: Store at room temperature, 20°C to 25°C (68°F to 77°F).

Stability: Stable for the duration specified in the package insert, typically stored protected from light.

🛡️ 5 Critical Medication Safety Tips for Nurses

1

Triple-Check High-Risk Medications

Always have another nurse verify insulin, heparin, warfarin, and chemotherapy drugs. These "high-alert" medications cause the most serious errors. Check concentration, dose calculation, and pump settings twice.

2

Know Look-Alike, Sound-Alike Drugs

Common mix-ups: hydromorphone/morphine, Celebrex/Celexa, Zyprexa/Zyrtec. Always use BOTH generic and brand names, read labels twice, and use barcode scanning when available. One wrong letter can be fatal.

3

Assess Before AND After Giving Meds

Check vitals before cardiac meds, pain levels before analgesics, and blood glucose before insulin. Always reassess within 30 minutes to evaluate effectiveness and watch for adverse reactions.

4

Watch for Drug Interactions

Common dangerous combinations: warfarin + aspirin (bleeding), ACE inhibitors + potassium (hyperkalemia), digoxin + diuretics (toxicity). Always check drug interactions before administering new medications.

5

Educate Your Patients

Teach patients medication names, purposes, major side effects, and what to report. Informed patients catch errors and improve compliance. Always encourage questions - an educated patient is a safer patient.

⚡ Remember: When in doubt, don't give it out! It's always safer to double-check than regret later.

⚠️ Medical Disclaimer

This drug guide is for educational purposes only and is NOT intended for clinical use. Always consult current prescribing information, healthcare providers, and institutional protocols before administering any medication. Do not use this information for patient care decisions.