Generic Name-Vancomycin
Mechanism of Action
The bactericidal action of vancomycin results primarily from inhibition of cell-wall
biosynthesis. Specifically, vancomycin prevents incorporation of N-acetylmuramic acid
(NAM)- and N-acetylglucosamine (NAG)-peptide subunits from being incorporated into the
peptidoglycan matrix, which forms the major structural part of Gram-positive cell walls.
Vancomycin forms hydrogen bonds with the terminal D-alanyl-D-alanine moieties of the
NAM/NAG-peptides, preventing the incorporation of the NAM/NAG-peptide subunits into
the peptidoglycan matrix. In addition, vancomycin alters bacterial-cell-membrane
permeability and RNA synthesis. (Vancomycin-stat pearls)
Common Side Effects:
 increased diarrhea that is watery or bloody.
 hearing loss, ringing in your ears.
 kidney problems - swelling, rapid weight gain, pain in your side or lower back, little
or no urination; or
 low potassium level - leg cramps, constipation, irregular heartbeats, fluttering in
your chest, increased thirst or urination, numbness or tingling, muscle weakness or
limp feeling.( Ummu; 2021)
References:
Ummu. (2022, October 16). Vancomycin nursing implications: Patient teachings: MOA was. Nurseship.com. https://nurseship.com/vancomycin-nursing-implications-patient-teachings-moa/
Vancomycin - statpearls - NCBI bookshelf. (n.d.-b). https://www.ncbi.nlm.nih.gov/books/NBK459263/
Trade Name- Firvanq, Vancocin
Intended Use:
 Staphylococcus enterocolitis, Pseudomembranous colitis, Catheter-related
infections
 Endocarditis: Diphtheroid, Enterococcal, Staphylococcal,  and  Streptococcal species
 Staphylococcal infections: septicemia, skin and soft tissue infections, bone
infections, lower respiratory tract infections, etc.
 Intra-abdominal infections due to MRSA or ampicillin-resistant enter Surgical-site.
(Ummu; 2021)
Nursing Considerations:
Assessment:
 Collect the health history and note any allergy to vancomycin.
 Assess for the interaction with any other antibiotics or medicines the client is taking,
Perform a baseline auditory assessment.
 Assess vital signs and urine output, Confirm the client’s pregnancy or lactation
status, Obtain baseline CBC and RFTs.
Intervention:
 Monitor heart rate and BP throughout during administration of Vancomycin.
 Maintain strict intake and output chart and check for any changes in urination, urine
color, and pattern.
 Observe closely for signs (e.g., chills, fever, flushing of the neck, hypotension,
tachycardia, and nausea and vomiting) of red-man syndrome during IV infusion.