New Drugs

[AUicuRN]

Anyone have a good resource for new drugs. In the PICU we have started using Caspofungin and I can't find very much info on it like admixture compatability and min concentration etc. Any info will help.

[NotReady4PrimeTime, RN]

I have Davis Drugs on my PDA (from Unbound Medicine). I really like it, if for no other reason than it gives prep instructions and compatibilities under the "Implementation" heading. It auto-updates everytime I hot-sync. Caspofungin is in there... unfortunatley it looks like it's like most other antifungals, it doesn't like anybody else. Here's the text:

"Intermittent Infusion When diluting caspofungin, white cake should dissolve completely. Mix gently until a clear solution is obtained. Do not use a solution that is cloudy, discolored or contains precipitates. Solution must be used within 24 hours if refrigerated.

* To prepare for 70 mg or 50 mg administration, allow refrigerated vial to reach room temperature. Aseptically add 10.5 mL of 0.9% NaCl, sterile water or bacteriostatic water to the 70 mg or 50 mg vial. Solution may be stored for up to 1 hour at room temperature. Transfer 10 mL of 70 mg or 50 mgsolution to an IV bag containing 250 mL of 0.9% NaCL, 0.45% NaCl, 0.225% NaCl or LR for a concentration of 0.28 mg/mL or 0.20 mg/mL respectively. Dilute solution is stable for 24 hours at room temerature or 48 hours if refrigerated.

* If only 50 mg dose is available, to prepare 70 mg dose transfer a total of 14 mL from two 50 mg vials into the 250 mL of compatible desired IV fluid.

* If reduced volume is medically necessary, 50 mg dose can be prepared by adding 10 mL of reconstituted solution to 100 mL of compatible desired IV fluid for a concentration of 0.47 mg/mL.

* To prepare 35 mg dose for patients with hepatic insufficiency reconstitute one 50 mg vial. Transfer 7 mL for 250 mL or if medically necessary for 100 mL of compatible IV fluid for a concentration of 0.14 mg. mL or 0.34 mg/mL respectively.

Rate Administer via slow IV infusion over approximately 1 hour."

It would be in this same section if there were any admixture or Y-site compatibilities. Out of luck there. Safety in children

[Gompers, BSN, RN]

Lots of info out there if you do a Google search. Found this:

http://www.drugs.com/pdr/CASPOFUNGIN_ACETATE.html

Good info there.

When we first started using it in the NICU, the hardest thing for people to remember was that it is not compatible with dextrose, only saline. We're so used to Ampho that people kind of assumed Caspofungin also needed to be flushed with dextrose. We don't infuse it with anything else, and flush the line before and after with normal saline. If we have a line running with normal saline and heparin (2 units/ml) TKO, we even shut that off and flush with saline to clear the heparin.