[Vancomycin intoxication in a patient with inappropriate antidiuretic hormone syndrome and diarrhea].
Vancomycin is an antibiotic used for infections by gram-positive bacteria with a two-compartment pharmacokinetic model. Its monitoring has an established therapeutic range (10-20 mg/L) to prevent nephrotoxicity and ototoxicity due to supratherapeutic levels, and inefficiency and development of resistance by subtherapeutic levels. Nephrotoxicity for vancomycin monotherapy at standard doses according to pathogen and typical regimens (usual dose: 15-20 mg/kg/12 h) is rare and usually reversible. Moreover, monitoring plasma concentrations allows to achieve concentrations within therapeutic range to allow safe and effective drug use. The renal hypoperfusion can cause pre-renal damage, resulting in elevated levels of serum creatinine, resulting in decreased antibiotic elimination and nephrotoxicity. We report a case of unexpected vancomycin nephrotoxicity in a patient with syndrome Inappropriate antidiuretic hormone secretion associated paraneoplastic.
Servicio de Farmacia Hospitalaria. Hospital General de Segovia. Segovia.. phidalgocollazos@gmail.com.
Patricia
P
Hidalgo-Collazos
Servicio de Medicina Interna. Hospital General Universitario Gregorio Marañón. Madrid.. phidalgocollazos@gmail.com.
Cristina
C
López González-Cobos
Servicio de Farmacia Hospitalaria. Hospital General Universitario Gregorio Marañón. Madrid.. phidalgocollazos@gmail.com.
Paula
P
Arrabal-Durán
Farmacéutica especialista en Farmacia Hospitalaria. Responsable del Servicio de Farmacia. Hospital General Universitario Gregorio Marañón. Madrid, (España).. phidalgocollazos@gmail.com.
María
M
Sanjurjo-Sáez
D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000009:adverse effects* / Q000627:therapeutic use; D003967:Diarrhea / Q000150:complications*; D006801:Humans; D007177:Inappropriate ADH Syndrome / Q000150:complications*; D007674:Kidney Diseases / Q000139:chemically induced* / Q000473:pathology / Q000503:physiopathology; D008297:Male; D014640:Vancomycin / Q000009:adverse effects* / Q000627:therapeutic use
D000900:Anti-Bacterial Agents; D014640:Vancomycin