P+T for vanc and gent

[Serenyd]

When do you draw your peak and troughs for vanc and gent ivpb? I have heard 30 min after infusion is through, or 1 hour after or 2 hours after.

Seren

[letina]

We do the trough immediately prior to infusion, and peak 15 - 20 minutes after infusion complete.

[soliant12]

The key is to see the trough level results before you give the next dose.

[letina]

The key is to see the trough level results before you give the next dose.

oops ......sorry, yes, I omitted to say the trough level results are obtained first, before you start the next infusion, to allow for dosage to be determined.

[Larry77, RN]

At our facility we are no longer doing peaks for our Vanco, but still are doing them on our Gent and Tobra. Not sure where the "guidelines" came from but our pharmacy told me personally that we no longer do peaks on Vanco because the new "guidelines" state they are not necessary.

Not sure why the peaks would not be necessary for Vanco but still Gent and Tobra? Anyone have input on this?

[chloeysmom]

We do our Peaks exactly 30 mins after the infusion has ended (I put my Pumps on Callback, it beeps when IVPB has infused). The pharmacist at my hospital says that the body starts to break down the drug after 30 mins and peaks will eventually lower after that time frame. We still do Vanco peaks and troughs....thank goodness. I had a pt who an MD did not order p&t on, I contacted supervisor, she said to contact MD and tell him it is hosptial policy, we did them, and my pt had a very high critical level, the highest I have seen yet!

[General E. Speaking, RN, RN]

our ID doc says peaks aren't necessary and usually only orders troughs. Other docs order both.