Vancomycin Quiz
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Questions and Answers

What is the peak concentration range associated with ototoxicity?

  • 20 to 25 mg/L
  • 30 to 35 mg/L
  • 40 to 45 mg/L
  • Greater than 50 mg/L (correct)
  • What is the limited postantibiotic effect duration of the medication?

  • 4 to 6 hours
  • 0.5 to 3 hours (correct)
  • 7 to 9 hours
  • 10 to 12 hours
  • Who are the patients requiring monitoring due to high clearances and short half lives?

  • Elderly patients
  • Adult patients
  • Pediatric patients (correct)
  • Adolescent patients
  • What is a common side effect of the medication?

    <p>Phlebitis</p> Signup and view all the answers

    How should the medication be infused to minimize histamine response?

    <p>Over 60 minutes</p> Signup and view all the answers

    What is the incidence of nephrotoxicity when the medication is used as a single agent?

    <p>&lt;5%</p> Signup and view all the answers

    What is the bioavailability after oral administration?

    <p>Poorly absorbed after oral administration</p> Signup and view all the answers

    What is the primary spectrum of activity of Vancomycin?

    <p>Gram-positive</p> Signup and view all the answers

    What is the recommended route of administration for systemic infections?

    <p>Intravenous</p> Signup and view all the answers

    What is the ideal peak plasma concentration range for Vancomycin?

    <p>Less than 40 to 50 mg/L</p> Signup and view all the answers

    What is the primary reason for the resurgence in the use of Vancomycin?

    <p>Increased prevalence of Nafcillin-resistant Staphylococcus</p> Signup and view all the answers

    What is the recommended peak concentration range for Vancomycin to minimize the risk of ototoxicity?

    <p>5 to 15 mg/L</p> Signup and view all the answers

    What is the maximum concentration associated with ototoxicity?

    <p>50 mg/L</p> Signup and view all the answers

    What is the maximum MIC for sensitive bacteria?

    <p>&lt; 5 mg/L</p> Signup and view all the answers

    What is the duration of limited postantibiotic effect of Vancomycin?

    <p>0.5 to 3 hours</p> Signup and view all the answers

    What is the recommended infusion duration to minimize histamine response?

    <p>Over 60 min</p> Signup and view all the answers

    What is the bioavailability of Vancomycin after oral administration?

    <p>Poorly absorbed</p> Signup and view all the answers

    What are the patients requiring monitoring due to high clearances and short half lives?

    <p>Pediatric patients</p> Signup and view all the answers

    What is the recommended dosing for Vancomycin in patients with normal renal function?

    <p>1g administered intravenously over 60 minutes every 12 hours</p> Signup and view all the answers

    What is the bioavailability of Vancomycin after oral administration?

    <p>Poorly absorbed orally</p> Signup and view all the answers

    What is the primary spectrum of activity of Vancomycin?

    <p>Gram-positive organisms, except against enterococci</p> Signup and view all the answers

    What is the ideal peak plasma concentration range for Vancomycin?

    <p>Less than 40 to 50 mg/L</p> Signup and view all the answers

    What is a common side effect of Vancomycin?

    <p>Nephrotoxicity</p> Signup and view all the answers

    What is a common side effect of Vancomycin?

    <p>Phlebitis</p> Signup and view all the answers

    What are the patients requiring monitoring due to high clearances and short half lives?

    <p>Elderly and patients with diminished renal function</p> Signup and view all the answers

    What is a common adverse effect associated with intramuscular administration of Vancomycin?

    <p>Painful injection site and local irritation</p> Signup and view all the answers

    What is the primary reason for monitoring both peak and trough concentrations of Vancomycin in overweight or underweight patients?

    <p>Wide fluctuation in concentration</p> Signup and view all the answers

    What is the maximum incidence of nephrotoxicity when Vancomycin is used as a single agent?

    <p>Low incidence</p> Signup and view all the answers

    What is the recommended time to obtain peak plasma concentrations if peak levels are to be measured?

    <p>1 or 2 hours after the end of infusion period</p> Signup and view all the answers

    What is the recommended dosing interval for Vancomycin based on its half-life?

    <p>Approximately one half-life</p> Signup and view all the answers

    What is the primary risk associated with poor renal function in patients receiving Vancomycin?

    <p>Greater risk of toxicity and inflammation</p> Signup and view all the answers

    What kind of model does Vancomycin follow, making it difficult to avoid distribution phase when measuring peak levels?

    <p>Multicompartment model</p> Signup and view all the answers

    What is the recommended range for steady state trough concentrations of Vancomycin?

    <p>5 to 15 mg/L</p> Signup and view all the answers

    What is the recommended range for steady state trough concentrations of Vancomycin?

    <p>10 to 15 mg/L</p> Signup and view all the answers

    What combination is used to treat Clostridium difficile?

    <p>Oral Vancomycin and Metronidazole</p> Signup and view all the answers

    What describes distribution of Vancomycin?

    <p>Two or three compartment model best describes distribution</p> Signup and view all the answers

    Vancomycin is eliminated primarily by:

    <p>Renal route</p> Signup and view all the answers

    How much percentage of vancomycin dose is metabolized in the liver?

    <p>5%</p> Signup and view all the answers

    What should be done with those patients having hemo or peritoneal dialysis vancomycin loss?

    <p>Both A &amp; B</p> Signup and view all the answers

    What is the half life of Vancomycin?

    <p>5 to 10 hours</p> Signup and view all the answers

    Patients with normal renal function receives vancomycin every:

    <p>8 to 12 hours</p> Signup and view all the answers

    In patients with end stage renal disease half life of vancomycin may approach:

    <p>10 days</p> Signup and view all the answers

    End stage renal disease receive dose of vancomycin:

    <p>Once a week</p> Signup and view all the answers

    What advantage can be gained from limited oral availability of Vancomycin?

    <p>Treating enterocolitis</p> Signup and view all the answers

    Study Notes

    Vancomycin Pharmacology and Administration

    • Peak concentration range associated with ototoxicity: 50-60 mg/L
    • Limited postantibiotic effect duration: 1-2 hours
    • Patients requiring monitoring due to high clearances and short half-lives: Neonates, infants, and patients with cystic fibrosis
    • Common side effect: Nephrotoxicity
    • Medication infusion to minimize histamine response: Infuse over 60 minutes
    • Incidence of nephrotoxicity when used as a single agent: 5-15%
    • Bioavailability after oral administration: Virtually 0% (not absorbed orally)

    Spectrum of Activity and Administration

    • Primary spectrum of activity: Gram-positive bacteria
    • Recommended route of administration for systemic infections: Intravenous
    • Ideal peak plasma concentration range: 15-20 mg/L
    • Primary reason for the resurgence in the use of Vancomycin: Increased methicillin-resistant Staphylococcus aureus (MRSA) infections

    Pharmacokinetics and Adverse Effects

    • Recommended peak concentration range to minimize ototoxicity risk: 15-20 mg/L
    • Maximum concentration associated with ototoxicity: 80-100 mg/L
    • Maximum MIC for sensitive bacteria: 1-2 mcg/mL
    • Duration of limited postantibiotic effect: 1-2 hours
    • Recommended infusion duration to minimize histamine response: 60 minutes
    • Bioavailability after oral administration: Virtually 0% (not absorbed orally)
    • Patients requiring monitoring due to high clearances and short half-lives: Neonates, infants, and patients with cystic fibrosis

    Dosing and Monitoring

    • Recommended dosing for Vancomycin in patients with normal renal function: 30-60 minutes
    • Bioavailability after oral administration: Virtually 0% (not absorbed orally)
    • Primary spectrum of activity: Gram-positive bacteria
    • Ideal peak plasma concentration range: 15-20 mg/L
    • Common side effect: Nephrotoxicity
    • Patients requiring monitoring due to high clearances and short half-lives: Neonates, infants, and patients with cystic fibrosis
    • Common adverse effect associated with intramuscular administration: Pain and inflammation

    Special Considerations

    • Primary reason for monitoring both peak and trough concentrations of Vancomycin in overweight or underweight patients: To adjust dosing based on body weight
    • Maximum incidence of nephrotoxicity when Vancomycin is used as a single agent: 15%
    • Recommended time to obtain peak plasma concentrations if peak levels are to be measured: 1-2 hours after infusion
    • Recommended dosing interval for Vancomycin based on its half-life: Every 8-12 hours
    • Primary risk associated with poor renal function in patients receiving Vancomycin: Nephrotoxicity
    • Model describing Vancomycin distribution: Multi-compartmental model
    • Recommended range for steady-state trough concentrations of Vancomycin: 10-15 mg/L
    • Combination used to treat Clostridium difficile: Vancomycin + metronidazole
    • Description of Vancomycin distribution: Complex, multi-compartmental
    • Elimination route: Primarily renal excretion
    • Percentage of Vancomycin dose metabolized in the liver: <10%
    • Recommendation for patients with hemo or peritoneal dialysis Vancomycin loss: Supplemental dose after dialysis
    • Half-life of Vancomycin: 4-6 hours
    • Dosing interval for patients with normal renal function: Every 8-12 hours
    • Half-life of Vancomycin in patients with end-stage renal disease: Up to 200 hours
    • Dosing recommendation for patients with end-stage renal disease: Individualized based on creatinine clearance
    • Advantage gained from limited oral availability of Vancomycin: Reduced systemic absorption and side effects

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    Test your knowledge on the pharmacokinetics of Vancomycin, including therapeutic and toxic plasma concentrations, bioavailability, volume of distribution, half-life, clearance, sampling time, and side effects.

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