Vangacin 500/Vangacin 1 g

Vangacin 500/Vangacin 1 g Overdosage

vancomycin

Manufacturer:

Able Medical

Distributor:

Universal Medical Industry

Marketer:

Able Medical
Full Prescribing Info
Overdosage
Three premature infants developed apnea, hypotension, flushed skin, and inflammation at the infusion site following inadvertent overdose of vancomycin (300 to 400 mg/kg).
Two premature infants with peak plasma vancomycin concentrations greater than 300 mcg/mL following inadvertent 10-fold overdoses did not experience any renal (except for one infant with a transient increase in serum creatinine to 1.4 mg/dL), auditory, or other toxicity.
Toxicity is reported at serum concentrations sustained above 80 to 100 mcg/mL.
Treatment: Management of mild to moderate toxicity: Treatment is symptomatic and supportive. Manage mild hypotension with IV fluids.
Management of severe toxicity: severe hypotension with IV 0.9% NaCl at 10 to 20 mL/kg. Add dopamine or norepinephrine if unresponsive to fluids.
Red Man Syndrome: Antihistamines can be used as pretreatment. Increasing the dilution of vancomycin and slowing the rate intravenous administration may also help.
Antidote: None.
Enhanced elimination procedure: Enhanced elimination is generally only necessary in patients with severe renal insufficiency. Hemoperfusion, hemofiltration, high-flux hemodialysis, and hemodiafiltration have been effective in reducing serum vancomycin concentrations when high-porosity hemofilters are used.
Multiple dose activated charcoal (MDAC): May decrease the half-life of intravenously administered vancomycin but has not been shown to affect outcome. It is not routinely recommended but can be considered for patients with large overdoses when the patient is expected to have prolonged clearance, if the potential benefits are felt to outweigh risks. MDAC should not be administered in patients who are at risk for the abrupt onset of seizures or mental status depression or who are not able to protect airway.
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