What happens if Vanco trough is high?

What happens if Vanco trough is high?

Vancomycin trough concentrations above the therapeutic range may increase the risk of nephrotoxicity. Vancomycin peak concentrations above the therapeutic range may be associated with an increased the risk of nephrotoxicity, although peak concentrations do not correlate well with toxicity.

What causes high vancomycin trough levels?

Several risk factors have been identified for VIN, which high trough vancomycin level (especially >20 mg/L) or doses (>4 g/day), concomitant use of nephrotoxic agents, prolonged therapy (more than 7 days), and admission to an intensive care unit (especially prolonged stay) are the most common ones (1-4, 14).

What do you do if your vancomycin level is high?

If the high trough level appears genuine, use the vancomycin dose adjustment calculator to obtain a new dosage regime. Consider omitting dose based on the level: – If vancomycin trough level is 20-25mg/L, give new dosage regime without omitting any doses. Take a level before the 4th new dose.

What is a therapeutic vancomycin level?

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.

What are the signs and symptoms of Vancomycin toxicity?

Side Effects

• Black, tarry stools.
• blood in the urine or stools.
• continuing ringing or buzzing or other unexplained noise in the ears.
• cough or hoarseness.
• dizziness or lightheadedness.
• feeling of fullness in the ears.
• fever with or without chills.
• general feeling of tiredness or weakness.

What does a high trough level mean?

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. The peak level is the highest concentration of a drug in the patient’s bloodstream.

When do you get a Vanco trough?

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. – Weekly vancomycin levels should be obtained for long-term vancomycin use with stable renal function. i.

Why are trough levels important?

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.

When do you draw a Vanco trough?

How often do you draw Vanco trough?

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 to check a vancomycin trough?

Typically, the medication reaches peak concentration between one and two hours after administration. Depending on the size of the dose, the patient’s general health, and other factors, the timing of the trough may vary. A doctor can request a peak reading after administration and check back to see when the patient hits the trough.

How much blood is needed for Vanco trough?

Guidelines from 2009 by pharmacists and infectious disease specialists recommend that only trough levels be performed, with a minimum of 10 mcg/mL considered necessary to control an infection. The guidelines recommend a therapeutic range of 15-20 mcg/mL for significant infections.

When to draw Vanc peak and trough?

The trough level should be collected about ½ hour prior to administration of the drug. It actually would be OK to collect it sooner, but the ½ hour allows to not be rushed and adequate time for set-up of the infusion. The peak level should be collected 15-30 minutes after the administration of the drug is completed.

What is the normal trough 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 10-20 µg/mL (15-20 µg/mL for complicated infections). The reference range for vancomycin peak levels is 25-50 µg/mL.