| [ Summary ] |
Vancomycin hydrochloride (VCM) is a glycopep tide antibiotic isolated from Amycolatopsis orientalis, which is a drug administered orally or intravenously. As VCM is excreted from kidney without undergoing any metabolic changes, it is necessary to determine the loading dose of VCM and to monitor its blood concentration in patients with renal dysfunction. VCM induces a common adverse reaction known as red man syndrome, charactererized by erythematous rash or flushing on the face, neck, or torso, pruritus and, in severe cases, hypotension or cardiac arrest attributed to histamine release. Their adversed side effects generally occur with rapid administration of VCM. The recommended infusion of VCM at no faster than 1g over 1hr may prevent them. Studies of orally administered VCM have shown that it is not appreciably absorbed from the gastrointestinal tract in normal adults, but patients with renal impairement and pseudomembranous colitis may absorb and accumulate significant amounts of drug. There are some modalities to treat VCM overdose, including hemodialysis, hemofiltration and hemodiafiltration with high-flux membranes, hemoperfusion, peritoneal dialysis and multiple-dose activated charcoal. The choice of optimal modality for clearing a toxin should take into the availability of equipment, age, underlying disease, and inherent risks of them. |