Vancobac1gm
Type:Injection
Generic Name:Vancomycin
Manufacturer:Popular Pharmaceuticals Ltd.
Price:৳552.08
Indication
Septicaemia, Soft tissue infections, Osteomyelitis, Enterocolitis, Colitis, Serious staphylococcal or other Gm +ve infections, Bacterial endocarditis
Administration
IV Preparation Add 10 mL of SWI to 500-mg vial and 20 mL of SWI to 1-g vial to yield 50 mg/mL solution; further dilution is required, depending on method of administration Intermittent infusion: Dilute 500 mg with ?100 mL of diluent and 1 g with ?200 mL of diluent (NS or D5W) Continuous infusion: Dilute in sufficient amount to permit infusion over 24 hours IV Administration Intermittent (preferred): Administer over 60 minutes; not to exceed 10 mg/min Continuous: Administer over 24 hours
Adult Dose
Intravenous Severe staphylococcal or other Gram-positive infections, Endocarditis Adult: 500 mg 6 hrly, infused over at least 60 min or 1 g 12 hrly, infused over at least 100 min. Elderly: Dosage adjustment needed.
Child Dose
Intravenous Children Severe staphylococcal or other Gram-positive infections, Endocarditis <1 month: 15 mg/kg followed by 10 mg/kg IV q12hr for neonates in first week of life and q8hr thereafter up to 1 month of age; longer dosing intervals recommended in premature infants >1 month: 10 mg/kg/day IV divided q6hr; individual dose not to exceed 1 g
Renal Dose
Renal impairment: Patient on intermittent haemodialysis: Loading dose: 15-25 mg/kg on day 1, followed by 5-10 mg/kg maintenance dose after each dialysis run. Anuric patient (w/o kidney function) on dialysis: Initially, 15 mg/kg. Maintenance: 1.9 mg/kg 24 hrly. CrCl (ml/min) Dosage Recommendation <20 Longer intervals; determine by serum concentration monitoring. 20-49 Initially, 15-20 mg/kg/dose (usual: 750-1,500 mg) 24 hrly. >50 Initially, 15-20 mg/kg/dose (usual: 750-1,500 mg) 8-12 hrly.
Contraindication
Hypersensitivity to the drug; history of impaired hearing; IM administration.
Mode of Action
Vancomycin binds tightly to D-alanyl-D-alanine portion cell wall precursor causing blockage of glycopeptide polymerisation which produces immediate inhibition of cell wall synthesis and secondary damage to the cytoplasmic membrane.
Precaution
Patient w/ allergic reaction to teicoplanin, previous hearing loss, inflammatory bowel disease. Renal impairment. Elderly. Pregnancy and lactation. Monitoring Parameters Determine regularly serial tests of auditory function and serum or blood vancomycin concentrations during treatment. Periodic urinalysis and renal function tests. Monitor leukocyte count in prolonged therapy. Lactation: Drug enters breast milk; not recommended
Side Effect
>10% Erythematous rash on face and upper body (red neck or red man syndrome; related to infusion rate),Hypotension accompanied by flushing 1-10% Chills,Drug fever,Eosinophilia,Rash,Reversible neutropenia,Phlebitis <1% Nephrotoxicity,Ototoxicity (especially with large doses),Stevens-Johnson syndrome,Thrombocytopenia,Vasculitis Potentially Fatal: Stevens-Johnson syndrome; toxic epidermal necrolysis, blood dyscrasias such as neutropenia or thrombocytopenia.
Interaction
General anaesth may enhance the adverse effects of vancomycin. Increased risk of ototoxicity and nephrotoxicity w/ aminoglycosides, polymyxins, ciclosporin, cisplatin and loop diuretics. Increased potential of neuromuscular blockade w/ suxamethonium or vecuronium.
