Wanko

Vanko is a glycopeptide that is used for injections.

Indications Wanko

It is indicated for the elimination of infectious processes provoked by gram-positive bacteria that are sensitive to drugs. In addition, it is intended for people with intolerance to cephalosporins and penicillins in anamnesis. Promotes treatment:

• sepsis, endocarditis, as well as osteomyelitis;
• infectious processes in the central nervous system;
• infectious processes in the lower part of the respiratory tract (such as pneumonia);
• infectious processes in soft tissues and skin;
• Staphylococcal food poisoning (oral use);
• pseudomembranous form of colitis (oral administration).

Prevents the development of endocarditis in people with intolerance to penicillins, and in addition to these infections in the oral cavity and ENT organs after surgical operations.

[1], [2], [3], [4]

Release form

It is produced in powder form - in 500 mg vials.

[5]

Pharmacodynamics

Vancomycin is an antibiotic from the glycopeptide category. The bactericidal properties of the drug are caused by the suppression of the binding processes of the cell walls of pathogenic microbes.

It shows activity against gram-positive microorganisms: staphylococcus (among them staphylococcus aureus and Staphylococcus aureus, and also methicillin strains), streptococci (among them pneumococcus, streptococcus pyogenes and streptococcus agalactia), fecal enterococci, clostridia (among them clostridium difffile) and diphtheria corynebacterium.

Inactive against fungi, gram-negative microbes, and also mycobacteria.

[6], [7], [8], [9], [10], [11], [12]

Pharmacokinetics

When vancomycin is administered in an amount of 1 g, its indices inside the blood plasma are approximately 63 mg / L (after the infusion) and then 23 mg / L (2 hours) and 8 mg / L (11 hours later). About 55% of the substance is synthesized with a plasma protein.

The suppressing concentration of the component is observed inside the peritoneal, serous, pleural, and in addition synovial and pericardial fluids. In addition, in the muscle and valves of the heart, as well as in the urine. Vancomycin weakly passes through the shell of the brain (if it is in a normal state, in case of inflammation, the substance easily penetrates it).

The half-life is 4-6 hours in people with normal kidneys. About 75% of the dosage for the first 24 hours is excreted together with the urine by glomerular filtration. A small part of the substance is excreted with bile.

In people with impaired renal function, excretion of the component occurs with a delay. In patients with anuria, the mean half-life is 7.5 days.

[13], [14], [15], [16], [17]

Dosing and administration

The drug is injected in / in the method. It is used to eliminate life-threatening infectious processes. It is forbidden to enter Vanco  in the form of a bolus injection or a / m, as this procedure is very painful, and besides it can cause the development of necrosis at the site of administration.

The reactions of the body to the administration of drugs depend on the speed of injection, as well as the concentration of the solution used. Adults require a concentration not exceeding 5 mg / ml with a rate of administration of not more than 10 mg / minute. For some patients who need to limit the introduction of fluid, a concentration of not more than 10 mg / ml should be used, and the rate should not be more than 10 mg / min. Large concentrations of drugs increase the likelihood of negative reactions.

For children from 12 years and adults: the standard IV dose is 2 g per day (500 mg every 6 hours or 1 g every 12 hours). The solution is introduced for at least 1 hour.

For newborns younger than 7 days: the initial dosage is 15 mg / kg, followed by 10 mg / kg every 12 hours. Newborns older than 7 days and up to 1 month - the first dosage is also 15 mg / kg, and then 10 mg / kg every 8 hours.

Children older than 1 month and up to 12 years of age - 40 mg / kg per day in separate dosages (10 mg / kg), which should be administered every 6 hours.

The concentration of injection solution LS in children should not be more than 2.5-5 mg / ml. The introduction of the solution lasts a minimum of 1 hour.

Children can be administered no more than 15 mg / kg once. For a day it is allowed to inject no more than 60 mg / kg (the total amount is not more than 2 g).

[24], [25], [26], [27]

Use Wanko during pregnancy

There is no information on the safety of use of drugs in pregnant women. It is forbidden to apply for 1 trimester. The medicine can be prescribed for 2-3 trimesters, but only if there are life indications, when a possible benefit for a woman will be higher than the risk of developing negative consequences in the fetus. During admission it is required to monitor the serum concentration of vancomycin.

The drug passes into the mother's milk, so that during the period of treatment should be abandoned breast-feeding.

Contraindications

Contraindication is the patient's intolerance to vancomycin.

[18], [19]

Side effects Wanko

The most common adverse reactions to the use of drugs are pseudoallergies and phlebitis, which develop due to the rapid administration of the solution. In addition, there may be such negative effects:

• organs of the lymphatic and circulatory system: occasionally develops eosinophilia, thrombocytopenia or neutropenia, as well as agranulocytosis;
• immune system: occasionally there are reactions of intolerance or anaphylaxis;
• auditory organs: sometimes the hearing deteriorates for a while, in rare cases, vertigo develops, or there may be ringing or noises in the ears. Ototoxic effects mainly result from the use of large dosages of drugs or as a result of combined administration with other drugs with ototoxic effect (also with hearing problems or with impaired renal function);
• organs of the cardiovascular system: mainly thrombophlebitis or lowering blood pressure; rarely develops vasculitis; single - there is a cardiac arrest (similar symptoms, as a rule, arise because of rapid infusion);
• respiratory organs: mainly dyspnoea develops;
• digestive organs: occasionally - diarrhea, as well as vomiting along with nausea; the pseudomembranous form of colitis develops sporadically;
• subcutaneous tissue and skin: often mucous membranes, hives and itching, and also develops exanthema; single-leaf dermatitis, Lyell's syndrome or Stevens-Johnson syndrome, and in addition, IgA-bullous dermatitis;
• kidney and urinary system: often develop kidney failure, which manifests itself in the form of increased levels of urea and creatinine in the serum; occasionally there is tubulointerstitial nephritis (especially in the case of a combination of drugs with aminoglycosides or with a history of renal dysfunction) or an acute form of kidney failure;
• general disorders, as well as local reactions: often spasms or pain in the musculature of the back and chest, and in addition reddening of the upper parts of the face and body; Occasionally there is a chill, a medicamentous form of fever, and besides medicamentous eruptions against the background of eosinophilia and systemic manifestations (DRESS-syndrome). Also, the growth of insensitive fungi or microbes occasionally begins, there is itching and inflammation at the site of administration, and in addition wheezing; there is a strong lacrimation occasionally, which sometimes lasts up to 10 hours. As a result of accelerated infusion, anaphylaxis may develop. Such reactions, as a rule, pass after 20 minutes, but sometimes can last several hours. In the case of slow administration of drugs, such effects are almost not observed. Because of incorrect (not in / in) introduction on the site of the procedure can develop inflammation, tissue necrosis, irritation, as well as pain.

[20], [21], [22], [23]

Overdose

As a result of an overdose, side reactions may increase.

A treatment is required that will help maintain normal glomerular filtration. The drug can not be withdrawn by dialysis. The use of hemodialysis and hemofiltration using polysulfone membranes contributes to an increase in the rate of purification of vancomycin, as well as a decrease in its level in the blood. There is no specific antidote.

[28], [29], [30], [31], [32]

Interactions with other drugs

As a result of combined or sequential administration of vancomycin with other drugs that have a nephro- or neurotoxic effect (among them are ethacrynic acid, gentamicin, Amphotericinum B, and in addition kanamycin, streptomycin, amikacin and neomycin, also viomycin with tobramycin and colistin with bacitracin, of the polymyxin B with cisplatin) may increase the nephro- or ototoxic effect of vancomycin.

Since a synergistic effect develops in combination with gentamicin, it is required to limit the maximum dosage of Vanko to 500 mg every 8 hours.

Anesthetics in combination with vancomycin increase the likelihood of hypotension, and in addition provoke anaphylaxis, histamine-like hot flushes and the development of erythema.

In the case of drug administration during the operation or immediately after it, the effect of muscle relaxants (for example, succinylcholine) is able to increase or lengthen.

The combination of the drug with aminoglycosides has a synergistic effect in vitro on staphylococcus aureus, streptococci of the non-enterococcus type D, and in addition to various types of Streptococcus species and enterococci.

[33], [34], [35], [36], [37],

Storage conditions

Keep the medicine should be in conditions standard for medicines, inaccessible to small children. Temperature - not more than 25 ° C.

[38], [39], [40], [41]

Shelf life

Vanko is allowed to be used within 3 years from the date of release of the drug.

[42], [43], [44],