Caspofungin renal dosing book

Adult drugs analgesics antihypertensive and cardiovascular agents antimicrobial agents miscellaneous agents sedatives, hypnotics, and other drugs used in. Monitor intake and output and daily weight to assess hydration status and renal function. Duration of treatment should be based on the patients clinical response. Maintenance doses are determined for digoxin by renal function. Renal dosage adjustment guidelines for antimicrobials. No adjustment for renal dysfunction, monitor serum creatinine and electrolytes. This report investigated safety and dosing recommendations of intravenous caspofungin in hepatic insufficiency.

The renal drug handbook the st georges hospital, adult critical. This book is distributed under the terms of the creative commons attribution 4. In the singledose study, 8 patients each with mild and moderate hepatic. Book dosing guidelines for children dosing guidelines for adults. Acp books, here is the classic pocket guide to drugdosing for patients with impaired renal functionin a revised and updated new edition. Cancidas caspofungin acetate is an antifungal antibiotic used to treat fungal infections that involve the stomach, lungs, esophagus, or other internal body areas. Renal drug handbook 3rd edition general intensive care unit. Caspofungin side effects, dosage, interactions drugs. Adult antimicrobial dosing, nondialysis infectious. Caspofungin solution, reconstituted recon soln side effects by likelihood and severity common side effects if experienced, these tend to have a severe expression.

The pharmacists will automatically adjust the doses of any of the antimicrobials included in the protocol according to the estimated creatinine clearance generally using the cockroftgault equation for patients. Dglucan synthase and thereby disturbing the integrity of the fungal cell wall. Caspofungin is contraindicated in patients with hypersensitivity to any component of this product. A single 70mg loading dose should be administered on day 1, followed by 50 mg daily. Assessforsignsofsuperinfectionfever,upperrespiratoryinfection,vaginalitch.

Foscarnet1 please see lexicomp or micromedex for renal dosing table. Carbamazepine, carbidopa, carboplatin, carmustine, carteolol, carvedilol, caspofungin, cefaclor, cefadroxil, cefamandole, cefazolin, cefdinir, cefditoren. No adjustment is needed with renal insufficiency or dialysis. A pharmacokinetic study conducted in 39 children 2 to 17 years of age evaluated caspofungin dosing based on both weight 1 mgkgday and body surface area 50 or 70 mgm 2 day. The maximum loading dose and the daily maintenance dose should not exceed 70 mg, regardless of the patients calculated dose. Although renal function can be assessed by a number of tests and procedures, e. Echinocandins represent the newest class of antifungal agents. Give 500ml normal saline before and after ambisome administration if able to tolerate. The empiricalmolecular formula is c 56 h 70 n 9 nao 23 s and the formula weight is 1292.

To estimate the costeffectiveness of three echinocandins anidulafungin, caspofungin, and micafungin and generic fluconazole in the treatment of nonneutropenic adult patients with. For rapid effect, a larger initial loadingdigitalizing dose should be given in several divided doses over 1224 hr. Caspofungin is a valuable new antifungal agent with a novel mechanism of. Pediatric antimicrobial dosing at benioff childrens. Caspofungin was the first of a new class of parenterally administered antifungal agents, the echinocandins, that act by inhibiting the synthesis of a component of the fungal cell wall. The information on dosage adjustments in renal impairment given in this book is based on. For hd, draw trough prehd, and peak 30 min after end of each infusion streptococci, streptococcus bovis, strep. For oncedaily dosing, draw a single random level 8 to 12 hours after dose given adjustments are made based on a published hartford nomogram. Caspofungin is the first of a new class of antifungal agents, the echinocandins, that inhibit the synthesis of the fungal cell wall component beta1,3dglucan. Common and rare side effects for caspofungin intravenous. The development of inhibitors of the synthesis of fungal cell wall glucan represents an important advancement in antifungal chemotherapy. Plus, this new edition features brandnew guidance on pediatric dosing, making it the most complete. Concurrent ingestion of a highfiber meal may v absorption.

Dglucan synthase inhibitors include the acidic terpenoids, the papulocandins, and the echinocandins, cyclic hexapeptides that are nlinked to a fatty acyl side chain. Note that dosing is by crcl per kg mlminkg crclkg 1. These patients should be dosed on a mgkg basis in the same way as patients of normal bodyweight, with adjustment for renal impairment if needed. Pharmacology and metabolism of anidulafungin, caspofungin.

Caspofungin exhibits a small vd, but also a high degree of protein binding and very limited renal clearance. Flucytosine exhibits a low vd, low degree of protein binding, is mainly renally cleared and will, therefore, be removed by hd. Globalrph medical calculators, clinicians guide to drug. Nacetylgalactosamine polymer and a novel linear b1,31,4 glucan 811. Pediatric drugs analgesics antihypertensive and cardiovascular agents antimicrobial agents miscellaneous agents sedatives, hypnotics, and other drugs used in psychiatry. Rifampin reduces caspofungin blood levels by approximately 30%, and the daily dosage of caspofungin should be increased. In a series of 239 patients with invasive candidiasis, although fewer hepatic adverse events were. Caspofungin is used to treat fungal infections of the stomach, lungs, esophagus, or. Trimethoprim has a potassiumsparing effect on the distal nephron and may induce hyperkalemia, especially in patients with preexisting risk factors, such as geriatric patients. Medical calculators for the clinician, comprehensive guide to drug therapy, intravenous iv drug dilution, dosing calculators, nutrition and diet calculators. Caspofungin is effective for treating invasive aspergillosis in patients who cannot. Easytoread tables put the information physicians need when determining dosages for more than 450 drugs at their fingertips.

Currently, three echinocandins, anidulafungin, caspofungin and micafungin are licensed for clinical use in various indications. Optimization of antiinfective dosing regimens during. Antifungal dosage adjustment in kidney dysfunction. Caspofungin acetate is the first antifungal medication of the echinocandins class to. They have a broad spectrum of activity against all candida. Caspofungin mechanism, indication, contraindications.

Caspofungin, an echinocandin antifungal, inhibits formation of b 1, 3 glucan of the fungal cell wall. Caspofungin clinical infectious diseases oxford academic. Single and multipledose administration of caspofungin in. Caspofungin is administered once daily by slow intravenous infusion and is used to treat infections caused by candida spp. Typically, fixed adjustments in the dose or duration are made for. Caspofungin is an antifungal medicine that fights infections caused by fungus. It is a member of a new class of antifungals termed the echinocandins. In the multipledose study, 8 patients with mild hepatic insufficiency and healthy matched controls received 70. Administer digoxin 1 hour before or 2 hours after such a meal. Hepatic impairment plasma concentrations of caspofungin after a single 70 mg dose in adult patients with mild hepatic impairment childpugh score, 5 to 6 were increased by approximately 55% in the area under the curve auc, compared to healthy. Caspofungin 123 cefaclor 124 cefadroxil 125 cefalexin 126 cefixime 127 cefotaxime 128 cefpodoxime 129.

Use 400mg5ml suspension high dose pneumococcal 45 mg amoxicillinkgdose bid. Using a similar dosing regimen to those for caspofungin, the response rate for anidulafungin in esophageal candidiasis was 85%. Use 600mg5ml suspension for wt 40kg caspofungin iv idr. Moseley, in druginduced liver disease third edition, 20. Drug prescribing in renal failure, 5th edition acp books. In the singledose study, 8 patients each with mild and moderate hepatic insufficiency received 70 mg of caspofungin. If the 50 mgm2 daily dose is well tolerated but does not provide adequate clinical response, the daily dose can be increased to 70 mg. Bactrimbactrim ds sulfamethoxazoletrimethoprim dose.