Anidulafungin

INTRODUCTION

Indications

Candidemia and other serious candidal infections including intra-abdominal abscess, peritonitis. Esophageal candidiasis.

Action

Inhibits the synthesis of fungal cell wall. Therapeutic Effects: Death of susceptible fungi. Spectrum: Active against Candida albicans, C. glabrata, C. parapsilosis, and C. tropicalis.

Adverse Reactions/Side Effects

Resp: dyspnea. CV: hypotension. GI: diarrhea, ↑ liver enzymes. Derm: flushing, rash, urticaria. F and E: hypokalemia.

PHYSICAL THERAPY IMPLICATIONS

Examination and Evaluation

• Assess blood pressure periodically, and compare to normal values (See Appendix F). Report low blood pressure (hypotension), especially if patient experiences dizziness, fatigue, or other symptoms.

• Monitor any muscle weakness, aches, or cramps that might indicate low potassium levels (hypokalemia). Report prolonged or excessive muscle problems to the physician.

• Monitor respiratory function at rest and during exercise. Report difficult or labored breathing (dyspnea) to the physician.

Interventions

• Always wash hands thoroughly and disinfect equipment (whirlpools, electrotherapeutic devices, treatment tables, and so forth) to help prevent the spread of infection. Use universal precautions or isolation procedures as indicated for specific patients.

Patient/Client-Related Instruction

• Instruct patient to report other troublesome side effects such as prolonged or severe diarrhea or skin reactions (rash, hives, itching, flushing).

Pharmacokinetics

Absorption: IV administration results in complete bioavailability.

Distribution: Crosses the placenta.

Metabolism and Excretion: Undergoes chemical degradation without hepatic metabolism; <1% excreted in urine.

Half-life: 40–50 hr.

Contraindications/Precautions

Contraindicated in: Hypersensitivity.

Use Cautiously in: Underlying liver disease (may worsen); OB: Pregnancy or lactation (use only if benefits outweigh potential risk; Pedi: Safe use in children not established.

Interactions

Drug-Drug: None noted.

Route/Dosage

IV (Adults): Esophageal candidiasis—100 mg loading dose on day 1, then 50 mg daily. Candidemia and other candidal infections—200 mg loading dose on day 1, then 100 mg daily.

Availability

Lyophilized powder for IV use (requires reconstitution): 50 mg/vial