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New Perspectives on Vancomycin Use in Home Care, Part 1

Author(s):  Kastango Eric S, Hadaway Lynn

Issue:  Nov/Dec 2001 - High-Tech Compounding
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Abstract:  With the advent of new venous access devices (VADs) and medication delivery technology, pharmacists must reconsider the historical literature and administration guidelines that pertain to vancomycin. Current literature1-3 supports the conclusion that there is no direct correlation between vancomycin concentration or rate of administration and side effects (particularly red man syndrome). Venous access devices such as midclavicular catheters, midlines, and peripheral inserted central catheters (PICCs) enable more concentrated solutions of vancomycin to be infused safely without an increased incidence of adverse events. Advances in medication delivery technology ensure the consistency of therapy protocols (including catheter flushing and administration rate) that reduce the potential for adverse events and medication errors, particularly in the unmonitored home setting.

The American Society of Health-System Pharmacists4 states that by fulfilling their responsibilities in pharmaceutical care, pharmacists have a role in meeting the primary care needs of patients. Pharmaceutical care is the direct, responsible provision of medicationrelated care to achieve an outcome that improves a patient’s quality of life. Pharmacists establish relationships with patients to ensure the appropriateness of medication therapy, to verify patients’ understanding of that therapy, and to monitor the effects of treatment. In collaborative drug therapy management, physicians and other prescribers authorize pharmacists to select appropriate medication therapies and regimens and adjust them on the basis of patients’ responses to treatment.

The delivery of pharmaceutical care requires specialized knowledge about pharmacology, vascular access devices and their placement, compounding factors (eg, osmolarity, pH, stability, particulate matter), delivery systems, and patient management. In this article, those factors will be addressed with respect to optimizing the medication delivery of and patient response to vancomycin therapy.

Related Keywords: Catheters, peripheral, characteristics of, Vancomycin, in home care, Vancomycin, infusions, rate of administration, Vancomycin, solutions, osmolarity of, Vancomycin, solutions, pH of, Vancomycin, solutions, stability of


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