Implementation

PO: Use calibrated measuring device for liquid preparations. IV dose form may be diluted in 30 mL of water for oral or nasogastric tube administration. Resulting solution has bitter, unpleasant taste. May mix with a flavoring syrup to mask taste. Stable for 14 days if refrigerated

IV Adminstration:

• Intermittent Infusion:

Diluent: To reconstitute, add 10 mL of sterile water for injection to 500-mg vial or 20 mL of sterile water for injection to 1-g vial for a concentration of 50 mg/mL. Dilute further with at least 100 mL of 0.9% NaCl, D5W, D5/0.9% NaCl, or LR for every 500 mg of vancomycin being administered. Reconstituted vials stable for 14 days if refrigerated. Infusion is stable for 96 hr if refrigerated
Concentration: C5 mg/mL

• Rate:
Infuse over at least 60 min (90 min for doses >1 g). Do not administer rapidly or as a bolus, to minimize risk of thrombophlebitis, hypotension, and "red-man (neck)" syndrome (sudden, severe hypotension; flushing and/or maculopapular rash of face, neck, chest, and upper extremities). May need to slow infusion further to 1.5–2 hr if red-man syndrome occurs

• IT:

Diluent: Dilute with preservative-free NS
Concentration: 1–5 mg/mL

• Rate:
Directly instill into ventricular cerebrospinal fluid

• Y-Site Compatibility:

» acyclovir

» aldesleukin

» allopurinol

» amifostine

» aldesleukin

» alfentanil

» allopurinol

» alprostadil

» amifostine

» amikacin

» amiodarone

» amsacrine

» anidulafungin

» atracurium

» atropine

» bumetanide

» buprenorphine

» butorphanol

» calcium chloride

» calcium gluconate

» carboplatin

» caspofungin

» cefonicid

» chlorpromazine

» cimetidine

» cisatracurium

» cisplatin

» clindamycin

» cyanocobalamin

» cyclophosphamide

» cyclosporine

» cytarabine

» dactinomycin

» dexamethasone

» dexmedetomidine

» digoxin

» diltiazem

» diphenhydramine

» dobutamine

» docetaxel

» dopamine

» doripenem

» doxacurium

» doxapram

» doxorubicin hydrochloride

» doxorubicin liposome

» doxycycline

» enalaprilat

» ephedrine

» epinephrine

» epirubicin

» ertapenem

» erythromycin

» esmolol

» etoposide

» etoposide phosphate

» famotidine

» fenoldopam

» fentanyl

» filgrastim

» fluconazole

» fludarabine

» folic acid

» gemcitabine

» gentamicin

» glycopyrrolate

» granisetron

» hetastarch

» hydromorphone

» ifosfamide

» imipenem/cilastatin

» insulin

» isoproterenol

» labetalol

» levofloxacin

» lidocaine

» linezolid

» lorazepam

» magnesium sulfate

» mannitol

» mechlorethamine

» melphalan

» meperidine

» meropenem

» metaraminol

» methoxamine

» methyldopate

» methylprednisolone

» metoclopramide

» metoprolol

» metronidazole

» midazolam

» milrinonemitoxantrone

» morphine

» mycophenolate

» nalbuphine

» naloxone

» nesiritide

» nicardipine

» nitroglycerin

» nitroprusside

» norepinephrine

» octreotide

» ondansetron

» oxacillin

» oxaliplatin

» oxytocin

» paclitaxel

» palonosetron

» pancuronium

» papaverine

» pemetrexed

» penicillin G

» pentamidine

» pentazocine

» pentobarbital

» perphenazine

» phenobarbital

» phentolamine

» phenylephrine

» phytonadione

» potassium chloride

» procainamide

» prochlorperazine

» promethazine

» propranolol

» protamine

» pyridoxime

» ranitidine

» remifentanil

» sodium acetate

» sodium bicarbonate

» sodium citrate

» succinylcholine

» sufentanil

» tacrolimus

» teniposide

» theophylline

» thiamine

» thiotepa

» tigecycline

» tirofiban

» tobramycin

» tolazoline

» trastuzumab

» trimethaphan

» vasopressin

» vecuronium

» verapamil

» vincristine

» vinorelbine

» voriconazole

» zidovudine

• Y-Site Incompatibility:

» albumin

» amphotericin B cholesteryl

» amphotericin B colloidal

» amphotericin B liposome

» azithromycin

» bivalirudin

» cefoperazone

» chloramphenicol

» dantrolene

» daptomycin

» diazepam

» diazoxide

» drotrecogin

» epoetin alfa

» fluorouracil

» furosemide

» ganciclovir

» heparin

» idarubicin

» indomethacin

» ketorolac

» pantoprazole

» phenytoin

» rituximab

» streptokinase

» trimethoprim/sulfamethoxazole

» urokinase

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