Micafungin and a case of polymorphic ventricular tachycardia

Shah, Punit J.; Sundareshan, Vidya; Miller, Brian; Bergman, Scott

doi:10.1111/jcpt.12386

Cited by 5 publications

(1 citation statement)

References 8 publications

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“…However, no such observation has been reported in humans and other species [197]. A report on polymorphic ventricular tachycardia, possibly associated with torsades de pointes, has been reported on treatment with micafungin [198].…”

Section: Antifungal Drugsmentioning

confidence: 99%

Potent antifungal agents and use of nanocarriers to improve delivery to the infected site: A systematic review

2021

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There are four major classes of antifungals with the predominant mechanism of action being targeting of cell wall or cell membrane. As in other drugs, low solubility of these compounds has led to low bioavailability in target tissues. Enhanced drug dosages have effects such as toxicity, drug–drug interactions, and increased drug resistance by fungi. This article reviews the current state‐of‐the‐art of antifungals, structure, mechanism of action, other usages, and toxic side effects. The emergence of nanoformulations to transport and uniformly release cargo at the target site is a boon in antifungal treatment. The article details research that lead to the development of nanoformulations of antifungals and potential advantages and avoidance of the lacunae characterizing conventional drugs. A range of nanoformulations based on liposomes, polymers are in various stages of research and their potential advantages have been brought out. It could be observed that under similar dosages, test models, and duration, nanoformulations provided enhanced activity, reduced toxicity, higher uptake and higher immunostimulatory effects. In most instances, the mechanism of antifungal activity of nanoformulations was similar to that of regular antifungal. There are possibilities of coupling multiple antifungals on the same nano‐platform. Increased activity coupled with multiple mechanisms of action presents for nanoformulations a tremendous opportunity to overcome antifungal resistance. In the years to come, robust methods for the preparation of nanoformulations taking into account the repeatability and reproducibility in action, furthering the studies on nanoformulation toxicity and studies of human models are required before extensive use of nanoformulations as a prescribed drug.

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Section: Antifungal Drugsmentioning

confidence: 99%

Potent antifungal agents and use of nanocarriers to improve delivery to the infected site: A systematic review

2021

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New developments and directions in the clinical application of the echinocandins

2017

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The echinocandins-caspofungin, anidulafungin and micafungin-are semi-synthetic cyclic hexapeptide antimicrobial agents with modified N-linked acyl lipid side chains which anchor the compounds to the phospholipid bilayer of the fungal cell membrane, thereby inhibiting synthesis of fungal cell wall glucan. Over the last 10 years, echinocandins have become the first-line antifungal treatment of candidaemia and other forms of invasive candidiasis (IC). Echinocandins are generally well tolerated, but their use is limited by their requirement for daily intravenous dosing, lack of oral formulation and limited spectrum. In critically ill patients, it is also recognised that achievement of their pharmacokinetic/pharmacodynamic targets shows large inter-individual variability. As a drug class, they are safe to use and are associated with few adverse reactions and few drug-drug interactions of significance. Recent discovery of their ability to prevent and treat Candida biofilm formation particularly in the presence of invasive medical devices and also their ability to penetrate into mucosal surfaces such as vulvovaginal candidiasis has opened up new opportunities for research into their drug delivery. New dosing intervals are being explored to allow less frequent intravenous dosing in the ambulatory setting, and a new long-acting echinocandin, CD101, is being developed for weekly and topical administration.

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Antifungal Dosing Strategies for Critically Ill Patients

Dietrich

Pfeifer

Aker

et al. 2017

Curr Fungal Infect Rep

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Micafungin and a case of polymorphic ventricular tachycardia

Abstract: This is the first known case of polymorphic ventricular tachycardia with micafungin as the possible cause. Clinicians should be aware of this potential adverse event and monitor patients receiving concomitant drugs that can prolong QT interval.

Cited by 5 publications

References 8 publications

Potent antifungal agents and use of nanocarriers to improve delivery to the infected site: A systematic review

Potent antifungal agents and use of nanocarriers to improve delivery to the infected site: A systematic review

New developments and directions in the clinical application of the echinocandins

Antifungal Dosing Strategies for Critically Ill Patients

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