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7.VANCOMYCIN (type infection can (infective endocarditis (prostethic heart…

- - - - biological
        
        8-10 years
        
        x anticoagulation
        
        x click
      - mechanical
        
        last >20 years
        
        lifelong anticoagulation
        
        click
  - - - adult: 30-45 mg/kg/day
      - children:40-60mg/kg/day (IV) 2-4 divided dose
- - - - slow IV infusion (not faster than 10mg/min, 60 min)
- - - - infuse slower rate
      - prolong infusion
      - increase dosing interval
  - - - overcome?
        
        ask
        
        hearing test
- - - - 1st dose calculate creatinine clearance
        
        creatinine
        
        waste product of muscle metabolism/ eating meat (sikit)
        
        healthy: kidney filter creatinine
        
        excreted out; urine
        
        problem: byk creatinine
        
        normal SrCr
        
        male
        
        0.6-1.2mg/dl
        
        female
        
        0.5-1.1mg/dl
        
        tengok calculation dkt nota
      - 2nd dose TDM
- - - - to achieve quick plasma level of drug