It can therefore only be done 2–3 weeks after a hemolytic episode.When a macrophage in the spleen identifies a RBC with a Heinz body, it removes the precipitate and a small piece of the membrane, leading to characteristic "bite cells". However, if a large number of Heinz bodies are produced, as in the case of G6PD deficiency, some Heinz bodies will nonetheless be visible when viewing RBCs that have been stained with crystal violet. This easy and inexpensive test can lead to an initial presumption of G6PD deficiency, which can be confirmed with the other tests.Testing during and for many weeks after a haemolytic episode will lead to false negative results as the G6PD deficient RBC will have been excreted and the young RBC (reticulocytes)will not yet be G6PD deficient. False negative results will also be likely following any blood transfusions. For this reason, many hospitals wait for 3 months after a haemolytic episode before testing for G6PD deficiency. Females should have their G6PD activity measured by quantitative assay to avoid being misclassified by screening tests. Classification
The World Health Organization classifies G6PD genetic variants into five classes, the first three of which are deficiency states.
If no response is seen or if inducers of caspofungin clearance (see above) are coadministered the daily dose may be increased to 70 mg. An infusion should take approximately 1 hour. Dosage forms
Cancidas 50 mg for intravenous infusion (manufacturer Merck)
Cancidas 70 mg for intravenous infusion (manufacturer Merck)
Brand names in countries other than the U.S. may vary. Semisynthesis
Caspofungin is semisynthesized from pneumocandin B0, a fermentation product of Glarea lozoyensis. References
External links
"Caspofungin". Drug Information Portal. U.S. National Library of Medicine. U.S. Full Prescribing Information
EMA on Cancidas (Summary of Product Characteristics)