Vancomycin

Question 1

What are the therapeutic ranges for vancomycin

Answer 1

Trough: 10 to 15mg/L

Endocarditis: 15 to 20mg/L or less sensitive strains

Question 2

What should you monitor in all glycopeptides

Answer 2

Blood counts
Hepatic and renal function
Urinanalysis
Plasma levels
Auditory function in elderly

Question 3

What are the warning signs you should report in vancomycin

Answer 3

ototoxicity (hearing loss)

Red man syndrome (flushing of upper body)

Blood disorders (fever, bruising, unexplained bleeding, sore throat)

Phlebitis (drug irritates tissue causing inflammation)

Nephrotoxicity (elevated serum creatinine levels)

Skin disorders (rashes, pruritis)

Hypotension and anaphlaxis can occur if administered too quickly

Question 4

What are the pregnancy and breastfeeding requirements of vancomycin

Answer 4

Avoid- monitor plasma concentration if used

Present in milk- significant absorption unlikely

Question 5

What are the common drug interactions with vancomycin

Answer 5

Increased risk of nephrotoxicity and ototoxicity when given with ciclosporin, aminoglycosides, antifungals

Increased ototoxicty when given with furosemide (loop diuretics)