Vancomycin

Vancomycin

Drug monograph · NCLEX study reference
Trade names	Vancocin
Therapeutic class	Antibacterial
Pharmacologic class	Glycopeptide
Onset / peak / duration	Rapid IV; dosed by level (trough or AUC).
Half-life / level	Half-life 4 to 6 hours (longer in renal impairment); trough goal often 10 to 20 mcg/mL by indication.
Routes	PO (oral), IV
High-alert (ISMP)	No
Black box warning	None
Antidote / reversal	Stop or slow infusion and give antihistamine for flushing reaction; supportive care.
Pregnancy / lactation	Use if clearly needed.

Nursing pharmacology study reference (NCLEX-style monograph). Numeric values are standard teaching ranges for study and must be verified against current manufacturer labeling before clinical use. This is educational content, not prescribing guidance.

Vancomycin (brand name Vancocin) — Antibacterial; Glycopeptide.

Identification

• Therapeutic class: Antibacterial.
• Pharmacologic class: Glycopeptide.

Pharmacology

• Mechanism of action: Inhibits cell wall synthesis (bactericidal); IV for systemic MRSA, oral for C. difficile (not absorbed).
• Onset / peak / duration: Rapid IV; dosed by level (trough or AUC).
• Half-life / therapeutic level: Half-life 4 to 6 hours (longer in renal impairment); trough goal often 10 to 20 mcg/mL by indication.

Clinical use

• Indications: MRSA and serious gram-positive infections (IV), C. difficile colitis (PO).
• Usual dose, route, frequency: IV every 8 to 12 hours by level; PO four times daily for C. difficile.
• Maximum dose / adjustments: Adjust by renal function and level; infuse slowly.

Safety

• Contraindications: Hypersensitivity.
• Black box warning: None.
• Interactions: Other nephrotoxic and ototoxic drugs (aminoglycosides, loop diuretics), anesthetics (infusion reaction).
• Pregnancy / lactation: Use if clearly needed.
• High-alert: No.

Adverse effects

• Common side effects: Vancomycin flushing syndrome (formerly red man syndrome) with rapid infusion, phlebitis.
• Serious effects to report: Nephrotoxicity, ototoxicity, severe infusion reaction, DRESS rash.
• Antidote / reversal: Stop or slow infusion and give antihistamine for flushing reaction; supportive care.

Nursing process

• Assessment before administration: Renal function, level, IV site, infection source.
• Interventions during therapy: Infuse over at least 60 minutes (slower for larger doses) to prevent flushing; draw troughs before the dose.
• Monitor: Trough or AUC level, renal function, infusion reactions, infection resolution.
• Evaluation / expected outcome: Resolution of infection.

Patient teaching

• Patient teaching: Flushing during infusion can be reduced by slowing the rate; complete the course.
• Notify provider if: Rash or flushing during infusion, hearing changes, decreased urination.
• Administration tips: Slow IV infusion; oral form only for GI infection.