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A patient admitted to the intensive care unit (ICU) is to receive vancomycin. When administering vancomycin,...

A patient admitted to the intensive care unit (ICU) is to receive vancomycin. When administering vancomycin, the nurse should assess for which potential toxic effect?

  1. Hepatotoxicity
  2. Nephrotoxicity
  3. Neurotoxicity
  4. Retinal toxicity

Answer and why?

Solutions

Expert Solution

Nephrotoxicity

Vancomycin is a time-dependent antibiotic with bactericidal activity useful for treating patients with infections caused by Gram-positive microorganisms, including methicillin-resistant Staphylococcus aureus. It presents a 2 or 3 compartment pharmacokinetic profile and high interindividual variability, which result in the need for a routine therapeutic drug monitoring (TDM). Adverse effects associated with the use of this antibiotic include mainly those related to infusion and nephrotoxicity. Currently, these toxicities are related to long periods of treatment, concomitant nephrotoxic agents, high dosages, and high vancomycin plasma trough levels.

Extremely excessive tiers of vancomycin can cause severe renal toxicity. Vancomycin has often been associated with nephrotoxicity. Generally, this toxicity is added as proximal tubular cells harm with or barring necrosis and as acute interstitial nephritis.

The use of the antibiotic causes oxidative consequences on the proximal renal tubule ensuing in renal tubular ischemia. ... Doses of vancomycin in excess of 4 g/day have been linked to elevated toxicity.In the past, vancomycin has been mentioned to cause renal failure during intravenous administration; however, greater recently, such renal toxicity is alleged no longer to occur due to the fact of elevated purity of the vancomycin preparations. ... Vancomycin was administered for an common of 15 days.

Vancomycin may affect kidney function; the risk is greatest in those older than 65 years. Monitoring of kidney function during and immediately following treatment may be required. Most cases have occurred within one week of cessation of vancomycin treatment.

Nightingale answered 2 years ago
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