Home Drug Guide Caspofungin Acetate

Drug Guide

Generic Name

Caspofungin Acetate

Brand Names Cancidas

Classification

Therapeutic: Antifungal agent

Pharmacological: Echinocandin, Cell wall synthesis inhibitor

FDA Approved Indications

  • Invasive candidiasis (including candidemia)
  • Invasive aspergillosis (as salvage therapy or when other agents are unsuitable)

Mechanism of Action

Inhibits synthesis of β-1,3-D-glucan, an essential component of the fungal cell wall, leading to cell lysis and death.

Dosage and Administration

Adult: 70 mg IV loading dose on day 1, then 50 mg IV daily; doses may be increased to 70 mg if certain conditions are present.

Pediatric: Not approved for pediatric use under 3 months; for children 3 months and older, dosing depends on weight.

Geriatric: No adjustment necessary; monitor closely as with other patients.

Renal Impairment: No dose adjustment needed.

Hepatic Impairment: No adjustment needed, but use with caution and monitor liver function.

Pharmacokinetics

Absorption: Not absorbed orally; administered IV.

Distribution: Widely distributed in body tissues and fluids.

Metabolism: Minimal metabolism; primarily eliminated unchanged.

Excretion: Excreted mainly in feces via biliary excretion.

Half Life: 9-11 hours in adults.

Contraindications

  • Hypersensitivity to caspofungin or other echinocandins.

Precautions

  • Liver function impairment; monitor liver enzymes regularly.
  • Use cautiously in patients with pre-existing hepatic disease.

Adverse Reactions - Common

  • Histaminic reactions (rash, pruritus, erythema) (Less common)
  • Elevated liver enzymes (Common)
  • Headache, nausea, flushing (Common)

Adverse Reactions - Serious

  • Anaphylaxis (Rare)
  • Liver failure (Rare)

Drug-Drug Interactions

  • Cyclosporine (may increase caspofungin levels)
  • Rifampin (may decrease caspofungin levels)

Drug-Food Interactions

N/A

Drug-Herb Interactions

N/A

Nursing Implications

Assessment: Monitor liver function tests before and during therapy, assess for adverse reactions.

Diagnoses:

  • Risk for infection related to immunosuppression
  • Impaired liver function

Implementation: Administer IV infusion over 1 hour; monitor for infusion reactions.

Evaluation: Assess for resolution of fungal infection and monitor liver enzymes regularly.

Patient/Family Teaching

  • Report any signs of allergic reactions immediately.
  • Inform about possible side effects like headache, flushing, or rash.
  • Emphasize the importance of completing the full course of therapy.

Special Considerations

Black Box Warnings:

  • None currently

Genetic Factors: No known genetic factors affecting response.

Lab Test Interference: May elevate liver enzymes, which should be interpreted carefully.

Overdose Management

Signs/Symptoms: Nausea, vomiting, hypotension, flushing.

Treatment: Supportive care, monitor vital signs, and provide symptomatic relief.

Storage and Handling

Storage: Store vials at 2-8°C (36-46°F), protected from light.

Stability: Stable until the expiration date when stored properly.

🛡️ 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.