What are nursing considerations for vancomycin?

Monitor signs of hypersensitivity reactions and anaphylaxis, including pulmonary symptoms (tightness in the throat and chest, wheezing, cough dyspnea) or skin reactions (rash, pruritus, urticaria). Notify physician or nursing staff immediately if these reactions occur.

What are contraindications of vancomycin?

Vancomycin is contraindicated in patients with known hypersensitivity to this antibiotic. Solutions containing dextrose may be contraindicated in patients with known allergy to corn or corn products.

What are the most common adverse effects of vancomycin?

Side Effects

  • Black, tarry stools.
  • blood in the urine or stools.
  • continuing ringing or buzzing or other unexplained noise in the ears.
  • cough or hoarseness.
  • dizziness or lightheadedness.
  • feeling of fullness in the ears.
  • fever with or without chills.
  • general feeling of tiredness or weakness.

What is the expected pharmacological action of vancomycin?

Mechanism of Action: Inhibits cell wall synthesis by binding to the D-Ala-D-Ala terminal of the growing peptide chain during cell wall synthesis, resulting in inhibition of the transpeptidase, which prevents further elongation and cross-linking of the peptidoglycan matrix (see glycopeptide pharm).

What happens when vancomycin is infused too quickly?

During or soon after rapid infusion of vancomycin, patients may develop anaphylactoid reactions, including hypotension (see Animal Pharmacology), wheezing, dyspnea, urticaria, or pruritus. Rapid infusion may also cause flushing of the upper body (“red neck”) or pain and muscle spasm of the chest and back.

How fast can you run vancomycin?

Vancomycin shall only be administered as slow intravenous infusion of at least one hour duration or at a maximum rate of 10 mg/min (whichever is longer) which is sufficiently diluted (at least 100 ml per 500 mg or at least 200 ml per 1000 mg) (see section 4.4).

Who should not take vancomycin?

Most reactions resolve within 20 minutes; however, some may persist for several hours. May not be suitable for some people including those with inflammatory bowel disease (including Crohn’s disease or ulcerative colitis), kidney disease, or hearing loss.

What antibiotic is stronger than vancomycin?

Ceftaroline, telavancin and daptomycin were associated with comparable clinical cure rates compared with vancomycin in the treatment of complicated MRSA skin and soft tissue infections.

What happens if you have too much vancomycin?

In large amounts, vancomycin can cause kidney problems such as acute kidney injury (AKI). To calculate kidney function, clinicians collect a serum creatinine value. Creatinine is produced when muscles are broken down.

When should you not give vancomycin?

Do not take levels if the vancomycin has been started within the last 6 hours, i.e. after 2:00am; instead, wait until the following morning to check levels. Adjust the maintenance infusion dose (by altering the infusion rate) according to the serum levels, using the Continuous IV infusion dose adjustment calculator.

How fast should you give vancomycin?

Vancomycin should be infused slowly in a dilute solution (2.5 to 5.0 mg/ml) at a rate no greater than 10 mg/min and over a period not less than 60 minutes to avoid rapid infusion-related reactions. Stopping the infusion usually results in a prompt cessation of these reactions.

What should a nurse know about vancomycin levels?

Nurses should be aware of the following when interpreting a vancomycin level: Obtaining the blood specimen for the vancomycin level from the I.V. line used for vancomycin administration will give falsely elevated levels. Missed doses may result in unintentionally low levels.

How much vancomycin can you give at a time?

Further dilute each 1 g with at least 200 mL of D5W, NS, or RL. ADMINISTER: Intermittent: Give a single dose at a rate of 10 mg/min or over NOT LESS than 60 min. Avoid rapid infusion, which may cause sudden hypotension. Monitor IV site closely; necrosis and tissue sloughing will result from extravasation.

Are there any contraindications to taking vancomycin?

Contraindications. Known hypersensitivity to vancomycin, allergy to corn or corn products, previous hearing loss, concurrent or sequential use of other ototoxic or nephrotoxic agents, IM administration.

How is vancomycin oral solution prepared for injection?

Oral solution is prepared by adding to 10 g oral powder 115 mL of distilled water. The solution may be further diluted in 10 g of water. PREPARE: Intermittent: Reconstitute 500 mg vial or 1 g vial with 10 mL or 20 mL, respectively, of sterile water for injection to yield 50 mg/mL. Further dilute each 1 g with at least 200 mL of D5W, NS, or RL.