Vancomycin Flashcards
1
Q
Vancomycin Range Monitoring Warning signs Interaction
A
Therapeutic Range: Trough 10 to 15mg/L (15 to 20mg/L for endocarditis or less sensitive strains of methicillin-resistant Staphylococcus aureus or complicated infections caused by S. aureus).
Loading doses may be required.
Monitoring
Serum potassium, full blood count, renal function, auditory function in elderly, urinalysis
Major Route of Elimination
Renal; 70 to 90% excreted unchanged in urine
Warning Signs
- Hearing loss, vertigo, dizziness, tinnitus
- Flushing of the upper body (‘Red Man Syndrome’)
- Blood disorders (signs of infection such as fever, sore throat, mouth ulcers, also unexplained bruising or bleeding) e.g. neutropenia, thrombocytopenia
- Phlebitis (irritant to tissue)
- Nephrotoxicity e.g. elevated serum creatinine concentrations
- Skin disorders e.g. rashes, toxic epidermal necrolysis, pruritus
Other side effects:
Hypotension and anaphylactic reactions can occur if administered too quickly
Actions Required
• Advise patient to report immediately to a doctor if any warning signs occur
Interactions
- Increased risk of nephrotoxicity and ototoxicity when vancomycin given with ciclosporin, aminoglycosides, polymixin antifungals
- Increased risk of ototoxicity when vancomycin given with loop diuretics
- Vancomycin enhances effects of suxamethonium
