卡泊芬淨
卡泊芬淨 (Caspofungin) 是一種**棘白菌素類 (Echinocandins)** 的新型靜脈注射抗真菌藥物。它在伴侶動物中具有治療侵入性麴菌症 (invasive aspergillosis) 或散播性念珠菌感染的潛力。 > **臨床提示**：由於其作用機制為專一性破壞真菌細胞壁，這類藥物常被稱為「抗真菌藥中的青黴素」，對哺乳動物的毒性較低。目前在獸醫學中的臨床經驗極為有限，且藥費非常昂貴，通常僅作為其他抗真菌藥物無效時的後線選擇。
作用機制: Caspofungin acts as a **beta-glucan synthase inhibitor**. It blocks the synthesis of **beta-(1,3)-D-glucan**, an essential structural component found in the cell walls of many filamentous fungi and yeast. **Inhibition of beta-glucan synthase** → **Depletion of beta-(1,3)-D-glucan** → **Loss of cell wall structural integrity** → **Osmotic instability and fungal cell death (fungicidal activity)**.
各物種劑量
- Invasive aspergillosis or disseminated candidal infections (Investigational) · 0.8-1.6 mg/kg · IV · Not specified · Extrapolated from human pediatric studies. Highly investigational in veterinary patients.
- Invasive aspergillosis or disseminated candidal infections (Investigational) · 0.8-1.6 mg/kg in patients weighing less than 50 kg and 50-75 mg (total dose) in those weighing more than 50 kg · IV · Not specified · Extrapolated from human pediatric studies. Highly investigational in veterinary patients.
劑量為持牌獸醫專業人員的臨床參考。請務必對照最新藥品說明書及個別病患確認。
給藥途徑
禁忌症
- Hypersensitivity to caspofungin
- Significant hepatic impairment
不良反應
- Histamine-mediated signs (rash, facial swelling, pruritus)
- Anaphylaxis
- Intravenous site reactions (pain, redness, phlebitis)
- Hepatic dysfunction
藥物相互作用
- Carbamazepine · Reduced caspofungin plasma levels
- Cyclosporine · Increased caspofungin plasma levels and increased risk of hepatic enzyme increases
- Dexamethasone · Reduced caspofungin plasma levels
- Phenytoin · Reduced caspofungin plasma levels
- Rifampin · Reduced caspofungin plasma levels
監測
- Clinical efficacy
- Periodic liver function tests
- CBC
- Serum electrolytes
過量
Limited information is available for veterinary patients. - **Humans**: Dosages of 210 mg (about 3X normal) were well tolerated. - **Primates**: Monkeys receiving 5-8 mg/kg (approx. 4-6X normal) over 5 weeks developed sites of microscopic subcapsular necrosis on their livers.
VetSheet 藥物參考供持牌獸醫專業人員作臨床決策輔助之用,不能取代專業判斷或廠方最新藥品說明書。