vancomycin

Mode of action

· bacteriocidal

· inhibits bacterial cell wall synthesis

uses

· pseudomembranous colitis

· staphylococcal infections with methicillin resistance

· as an alternative to penicillins or cephalosporins in prophylaxis

kinetics

· very poorly absorbed from GIT

· eliminated unchanged in urine

· half-life is 8 hrs

· very irritant to veins

administration

Route

· only effective orally for pseudomembranous colitis

· otherwise IV

Dose

· prophylaxis

· 1 g 30 min preoperatively

· treatment

· 1g q12h

Administration

· dilute in 200 ml saline

· administer over 30 min

adverse effects

Ototoxicity

· dose-related

· do not use with hearing impairment

· withdraw if tinnitus occurs

Nephrotoxicity

· dose-related

· do not use with renal impairment

· monitor renal function

Hypersensitivity

· “red man’s syndrome”

· due to histamine release

· from too rapid infusion

Extravasation

· causes tissue necrosis

interactions

· care with other nephrotoxic drugs

· aminoglycosides