Updated: 2/26/2019

Echinocandins

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Topic
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Questions
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Evidence
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Snapshot
  • A 36-year-old man presents to the emergency department with worsening vision impairment. The patients finds that his field of vision has been increasingly blurry, and his symptoms are associated with fever and generalized malaise. He also endorses to having odynophagia. He has a past medical history of HIV, and he has been non-adherent to his antiretroviral therapy. His temperature is 102°F (38.9°C), blood pressure is 95/68 mmHg, pulse is 112/min, and respirations at 19/min. Ophthalmology was consulted, a dilated exam was performed, and demonstrated chorioretinitis with vitritis involving her left eye. Oral thrush was appreciated on exam. The patient was admitted to the hospital, blood cultures were obtained, and antiretroviral and empiric treatment were started. Blood cultures returned positive for Candida albicans and his empiric treatment was narrowed to micafungin. (Invasive candidemia)
Introduction
  • Mechanism of action
    • impairs β-D-glucan synthesis via noncompetitive inhibition of 1,3-β-glucan synthase
      • β-D-glucans are crosslinking components in the cell wall of many fungi
  • Medications
    • anidulafungin
    • caspofungin
    • micafungin
  • Clinical use
    • infections caused by
      • Candida spp.
      • Aspergillus
  • Adverse effects
    • gastrointestinal upset
    • flushing (secondary to histamine release)
 

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Questions (1)

(M1.MC.14.72) An 11-year-old boy with HIV and esophageal candidiasis is being treated with caspofungin. What is the mechanism of action of this drug? Tested Concept

QID: 100875
1

Pore formation in cell membranes

9%

(15/166)

2

Inhibition of ergosterol synthesis

17%

(28/166)

3

Inhibition of squalene epoxidase

16%

(26/166)

4

Inhibition of pyrimidine synthesis

11%

(19/166)

5

Inhibition of 1,3-Beta-glucan synthase

38%

(63/166)

L 1 E

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Evidences (2)
Topic COMMENTS (1)
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