Its currently approved therapeutic indications by both organisations include the empirical therapy of presumed fungal infections in febrile, neutropenic adult patients and for salvage therapy in patients treatment of invasive aspergillosis in adult patients whose disease is refractory to, or who are intolerant of, other antifungal agents (i.e., conventional or lipid formulations of amphotericin B and/or itraconazole). Additionally, the FDA approval includes indication for the treatment of candidemia and some specific Candida infections (intra-abdominal abscesses, peritonitis, pleural cavity infections, and esophagitis) and the EMEA approval includes indication for the treatment of general invasive candidiasis in adult patients. Metabolism
Slowly metabolized by peptide hydrolysis and N-acetylation in liver. Therefore, in case of liver impairment the dose needs to be reduced. Caspofungin also undergoes spontaneous chemical degradation to an open-ring peptide compound, L-747969. Additional metabolism involves hydrolysis into constitutive amino acids and their derivatives, including dihydroxyhomotyrosine and N-acetyl-dihydroxyhomotyrosine. Clinical efficacy
About 36% of patients refractory to other therapies responded well to caspofungin therapy, while even 70% of patients intolerant to other therapies were classified as responders. Direct comparative studies to other drugs in the treatment of invasive aspergillosis have so far not been undertaken. Contraindications
Known hypersensitivity to caspofungin acetate or any other ingredient contained in the formulation contraindicate its use. Warnings
Hepatic effectsThe concomitant use of caspofungin and cyclosporine in healthy volunteers led to a more frequent increase of liver enzymes (ALT=SGPT and AST=SGOT) than noted with cyclosporine alone. Combination treatment is only indicated if the potential benefit for the patient outweighs the potential risk.
Ectasia (), also called ectasis (), is dilation or distention of a tubular structure, either normal or pathophysiologic but usually the latter (except in atelectasis, where absence of ectasis is the problem). Specific conditions
Bronchiectasis, chronic dilatation of the bronchi
Duct ectasia of breast, a dilated milk duct. Duct ectasia syndrome is a synonym for nonpuerperal (unrelated to pregnancy and breastfeeding) mastitis. Dural ectasia, dilation of the dural sac surrounding the spinal cord, usually in the very low back. Pyelectasis, dilation of a part of the kidney, most frequently seen in prenatal ultrasounds. It usually resolves on its own. Rete tubular ectasia, dilation of tubular structures in the testicles. It is usually found in older men. Acral arteriolar ectasia
Corneal ectasia (secondary keratoconus), a bulging of the cornea.Vascular ectasiasMost broadly, any abnormal dilatation of a blood vessel, including aneurysms
Annuloaortic ectasia, dilation of the aorta. It can be associated with Marfan syndrome. Dolichoectasias, weakening of arteries, usually caused by high blood pressure. Intracranial dolichoectasias, dilation of arteries inside the head. Gastric antral vascular ectasia, dilation of small blood vessels in the last part of the stomach. Telangiectasias are small dilated blood vessels found anywhere on the body, but commonly seen on the face around the nose, cheeks, and chin. Venous ectasia, dilation of veins or venules, such as:
Chronic venous insufficiency, often in the leg
Jugular vein ectasia, in the jugular veins returning blood from the head

See also
All pages with titles beginning with Ectasia
All pages with titles containing Ectasia


== References ==