How is vancomycin dosed?
Typically 15 to 20 mg/kg every 8 to 12 hours for most patients (based on actual body weight, rounded to the nearest 250 mg increment).
Do you give vancomycin if trough is low?
Usually only vancomycin troughs are needed. Random levels may be obtained on patients with poor renal function who only receive intermittent or post-dialysis dosing. At minimum, levels should be obtained for all patients by 72 hours of therapy and at least weekly thereafter.
How do you calculate Vanc trough?
To increase the therapeutic utility of an early vancomycin trough concentration, an estimate of the true trough can be determined by extrapolating the measured value using e−Kt, where K = CrCl × 0.00083 + 0.0044 and t is the time difference in hours.
How often do you get Vanc troughs?
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 …
When is Vanco trough and peak?
Do not draw specimens until steady state is achieved (ie, before fourth dose) Draw trough specimen immediately before (≤30 min) next dose. Draw peak specimen 1-2 hours after completion of intravenous dosage.
Why are peak and trough levels drawn for vancomycin?
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 should trough levels be 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).
When do you check Vanc trough?
Frequency of Monitoring All patients on prolonged courses of vancomycin (exceeding three to five days) should have at least one steady-state trough concentration obtained no earlier than at steady state (following the fourth dose) and then repeated as deemed clinically appropriate.
How is dosing interval calculated?
Example
- As an example, calculate the following loading dose (Mass(mg)/Time(h)): Clearance = 2 L/h. Target concentration = 5 mg/L. Bioavailability = 50% Dosing Interval = 12 h.
- Dosing Rate = 2 (L/h) x 5 (mg/L) / 0.50 = 20 mg/h. The liter units cancel. Drug needs to be given at 20 mg/h. We are giving drug every 12 hours.
What is vancomycin AUC dosing?
Clinical Example of Vancomycin Dosing Using AUC A patient with normal renal function is receiving vancomycin 1 gm IV q12h. A trough is drawn 30 minutes before the fourth dose, the fourth dose is infused over one hour, and the peak is drawn one hour after the infusion is complete.
How is vancomycin peak and trough calculated?
Extrapolate to Cmax (peak) and Cmin (trough) Using the first-order elimination equation (Cp=Cp0∗e−kt), a true peak (Cmax) can be calculated using the time elapsed between the end of the vancomycin infusion and the first drug concentration (Cp0).
When is vancomycin at steady state?
Collect sample for steady state vancomycin level approximately 18-30 hours after the start of the infusion (with routine bloods where possible). If the steady state level is within target range, continue vancomycin infusion and repeat steady state level 18–30 hours after the first level.
When is the best time to draw peak and trough levels?
When do you draw peak and trough for vancomycin?
What is a normal vancomycin trough?
Trough concentrations are recommended for therapeutic monitoring of vancomycin, preferably acquired at steady-state (just before fourth dose). To avoid development of resistance, vancomycin trough levels should remain above 10.0 mcg/mL. Complicated infections require higher target levels, typically 15.0 to 20.0 mcg/mL.
How fast should vancomycin be infused?
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 is intermittent dosing?
Intermittent drug dosing intervals are usually initially guided by the terminal pharmacokinetic half life and are dependent on drug formulation. For chronic multiple dosing and for extended release dosage forms, the terminal half life often does not predict the plasma drug accumulation or fluctuation observed.
What is a dosing regimen?
Dosage regimen: includes frequency of administration, the dose per a single administration, the time interval between administrations, duration of treatments, and how a medicine is to be taken. Drugs: interchangeably used with medicines.
When do you draw Vanco AUC?
What does AUC dosing mean?
In pharmacology, the area under the plot of plasma concentration of a drug versus time after dosage (called “area under the curve” or AUC) gives insight into the extent of exposure to a drug and its clearance rate from the body.