Other / May 2, 2019

Can vancomycin cause congestive heart failure?

Vancomycin hydrochloride and teicoplanin were suspected as the causative drugs on the basis of the treatment course. Although congestive heart failure is rare in the case of drug-induced hypereosinophilia, it is one of life-threatening complications.

Which drug class should be used with caution in patients with heart failure?

Drugs that can exacerbate heart failure should be avoided, such as nonsteroidal anti-inflammatory drugs (NSAIDs), calcium channel blockers (CCBs), and most antiarrhythmic drugs (except class III).

What drugs are contraindicated in congestive heart failure?

Drugs to Be Avoided in Congestive Heart Failure

Calcium Channel Blockers.
Antiarrhythmic Agents.
Nonsteroidal Anti-Inflammatory Drugs (NSAID)
COX-2 selective inhibitors.
Aspirin.
Antidepressants.
Chemotherapy.
Tumor Necrosis Factor alpha inhibitors (TNF-alpha)

What is the first line treatment for congestive heart failure?

First-line drug therapy for all patients with HFrEF should include an angiotensin-converting enzyme (ACE) inhibitor and beta blocker. These medications have been shown to decrease morbidity and mortality.

Why do you monitor serum levels of vancomycin?

Vancomycin can also be given before certain surgeries to prevent an infection. Monitoring the level of vancomycin is important because its effectiveness relies on keeping blood levels above a minimum concentration for the entire duration of therapy (also referred to as total drug exposure).

What are contraindications of vancomycin?

Who should not take VANCOMYCIN HCL?

systemic mastocytosis.
low levels of a type of white blood cell called neutrophils.
hearing loss.
kidney disease with likely reduction in kidney function.

Can you take glipizide with heart failure?

Congestive Heart Failure—Glipizide and metformin should not be used in patients who have this medical condition.

Is Albuterol contraindicated in CHF?

One of the cornerstones of treatment of patients with shortness of breath is to avoid inhaled B agonists (e.g., albuterol) if one suspects heart failure (CHF) as the cause.

Why is diltiazem contraindicated in heart failure?

The calcium channel blockers, verapamil and diltiazem, should generally be avoided in patients with CHF, as their negative inotropic effects may exacerbate the disease.

Why are ACE inhibitors first line for heart failure?

ACE inhibitors dilate the blood vessels to improve your blood flow. This helps decrease the amount of work the heart has to do. They also help block a substance in the blood called angiotensin that is made as a result of heart failure.

What is the difference between HFrEF and HFpEF?

HFrEF, mostly occurs in male patients and is the consequence of cardiomyocyte loss. In contrast, HFpEF is often diagnosed in elderly female patients, who suffer from (a cluster of) non-cardiac comorbidities, such as hypertension, T2DM, stroke, anaemia, pulmonary disease, liver disease, sleep apnoea, gout, and cancer.

When are vancomycin troughs indicated in dialysis?

Usually only vancomycin troughs are needed. Random levels may be obtained on patients with poor renal function who only receive intermittent or post-dialysis dosing. At minimum, levels should be obtained for all patients by 72 hours of therapy and at least weekly thereafter. Many patients will require more frequent monitoring.

Does end stage renal disease affect vancomycin clearance?

Why else would we have tl;dr!?!) The next septic patient on your service happens to also have End Stage Renal Disease (ESRD) and typically receives hemodialysis three days a week. Harking back to your previous vanc knowledge, you KNOW that renal dysfunction will affect the patient’s clearance of vancomycin…

What is the normal range for vancomycin?

vancomycin levels should always be maintained above 10 mg/L to avoid development of resistance. Levels are recommended in: o patients who are severely ill and/or require target trough of 15-20 mg/L o patients with anticipated therapy duration of 7 days or greater.

What happens when vancomycin is given twice a week?

In a patient with consistent renal function, repeated dosing of vancomycin eventually leads to steady state, where the peak and trough concentrations are similar from dose to dose. Remember: But then what about our ESRD patient on HD three times a week?