Table of Contents
Can you run Vanco through a PICC?
Vancomycin was administered along with other antibiotics in 92% of the PICC group and in 93% of the midline group (Tab.
What tube is a Vanco trough drawn in?
Red-top tube, lavender-top (K2- or K3- EDTA) tube, or green-top (heparin) tube. Do not use a gel-barrier tube. The use of gel-barrier tubes is not recommended due to slow absorption of the drug by the gel.
Can you run Vanco through a peripheral line?
Because of its low pH, this drug is highly irritating to blood vessels and destroys tissue if it extravasates. Consequently, you shouldn’t administer it via peripheral veins—despite what you read in the package insert.
How do you draw a vancomycin trough?
When to draw levels: Trough: just before 4th dose of a new regimen (prior to 3rd dose for dosing intervals ≥ 24 hours or changing renal function) – Trough levels should be obtained within 30 minutes before the next scheduled dose.
How do you infuse vancomycin IV?
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.
Is vancomycin a Vesicant?
Vancomycin is acidic (pH 2.5–4.0) and hyperosmolar (328 mOsm/L), which may make it a vesicant when administered through a peripheral line. Bohm and Wong describe bullous dermatitis as a result of vancomycin extravasation.
What is trough levels for vancomycin?
Vancomycin is an antibiotic drug used to treat serious, life-threatening infections by gram-positive bacteria that are resistant to less-toxic agents. The reference range for vancomycin trough levels is 5-15 mcg/mL. The reference range for vancomycin peak levels is 20-40 mcg/mL.
What labs are needed for vancomycin?
Kidney function tests such as creatinine and creatinine urine or eGFR may be requested prior to the start of vancomycin therapy and at intervals, or as needed, to evaluate changes in kidney status.
Do you centrifuge Vanco trough?
Centrifuge to separate serum or plasma. Transport temperature: Refrigerated (preferred) or frozen.
Can vancomycin be administered through a central line?
Background: According to the 2011 Infusion Nursing Standards of Practice, the low pH of intravenous vancomycin requires that it be administered through a central line.
What nursing considerations are essential when giving vancomycin?
Some considerations for nurses administering vancomycin include ensuring a patent IV line, planning for administration of the preoperative dose as much as two hours before the initial incision is made, and including information about the dose and timing of preoperative vancomycin administration in the surgical time out.
Why are Midlines used?
A Midline is used for intravenous treatments of more than 6 days, prolonged therapies (cardiological or antibiotic for serious infections), for nutritional or hydro-electrolytic support or in cases where a central venous catheter can lead to immediate complications for the patient.
Why do we draw vancomycin levels?
Vancomycin can also be given before certain surgeries to prevent an infection. Monitoring the level of vancomycin is important because its effectiveness relies on keeping blood levels above a minimum concentration for the entire duration of therapy (also referred to as total drug exposure).
When are trough levels drawn?
A trough level is drawn immediately before the next dose of the drug is administered. A peak level is drawn 1 to several hours after the drug is administered (depending on the drug).
How often should vancomycin trough be drawn?
Subsequent trough levels: o With dosage change: trough should be taken at new steady state* as described above. o Once target trough achieved: trough should be taken every 7-10 days in hemodynamically stable patients; may need more frequently if hemo-dynamically unstable, renal function changing, or patient is on.
How do you administer vancomycin injection?
Vancomycin injection comes as a powder to be added to fluid and injected intravenously (into a vein). It is usually infused (injected slowly) over a period of at least 60 minutes once every 6 or 12 hours, but may be given every 8 hours in newborn babies.
How do you load vancomycin?
Load 20 to 35 mg/kg (based on actual body weight, rounded to the nearest 250 mg increment; not to exceed 3000 mg). Within this range, we use a higher dose for critically ill patients; we use a lower dose for patients who are obese and/or are receiving vancomycin via continuous infusion.
When is a vancomycin trough used in pediatrics?
Vancomycin troughs are recommended to be drawn within 1 hour prior to next dose. Vancomycin peak levels are not routinely recommended because of lack of correlation to efficacy. In general, a trough concentration of 10-15 mcg/mL is desired.
What is the difference between infiltration and extravasation?
The difference between an infiltration and extravasation is the type of medicine or fluid that is leaked. Infiltration – if the fluid is a non-vesicant (does not irritate tissue), it is called an infiltration. Extravasation – if the fluid is a vesicant (a fluid that irritates tissue), it is called an extravasation.
How do you recognize extravasation?
Extravasation may occur if the administration of the drug is too quick, the medication is very acidic or basic, or there is an obstruction in the intravenous (IV) line. The symptoms of extravasation include a painful stinging or burning sensation, swelling, and skin discoloration.
What do you do with vancomycin extravasation?
Vancomycin extravasation was successfully managed by utilizing cold compress for the first 24 hours post-extravasation with common gauze open dressings and silver sulfadiazine 1% until the wound was healed.
Why are trough levels drawn?
To adequately evaluate the appropriate dosage levels of many drugs, the collection and testing of specimens for trough and peak levels is necessary. The trough level is the lowest concentration in the patient’s bloodstream, therefore, the specimen should be collected just prior to administration of the drug.
What is C trough?
In medicine and pharmacology, a trough level or trough concentration (Ctrough) is the concentration reached by a drug immediately before the next dose is administered, often used in therapeutic drug monitoring.
