Related Experiment Video
Updated: Mar 3, 2026

A Novel Approach for the Administration of Medications and Fluids in Emergency Scenarios and Settings
Published on: November 9, 2016
Vancomycin Overdose and Infusion Rate Error Leading to a Mixed Anticholinergic-Type Syndrome in a Hemodialysis
Waldo-Rodríguez Itzayana Guadalupe1, Arriaga-García Francisco Javier2, Romano-Moreno Silvia1
1Facultad de Ciencias Químicas, Universidad Autónoma de San Luis Potosí, San Luis Potosi, Mexico.
Abstract:
Objective: To describe a mixed anticholinergic-type syndrome not previously associated with vancomycin in a patient with end-stage renal disease on hemodialysis, highlighting the impact of dosing and infusion rate errors. Case: A 61-year-old man with stage 5 chronic kidney disease on hemodialysis was admitted to the internal medicine unit for a catheter-related infection. Vancomycin was initiated at 1 g every 12 hours, infused at 16.6 mg/min. After four doses, the patient developed transient amaurosis, tachycardia, hyperthermia, xerostomia, xeroderma, confusion, agitation, and panic, consistent with a mixed anticholinergic-type syndrome. Symptoms resolved after discontinuation of vancomycin and subsequent hemodialysis. Discussion/Conclusions: This case demonstrates a definite association between vancomycin overdose with rapid infusion and the development of a mixed anticholinergic-type syndrome in a patient on hemodialysis. These findings underscore the importance of careful dose adjustment and strict control of infusion rates in advanced renal disease.
More Related Videos
Related Concept Videos
Renal Failure: Dose Adjustments
Reduced renal clearance and elimination rate are common outcomes of renal impairment. These alterations lead to a prolonged elimination half-life and an altered apparent volume of distribution for drugs. As a result, dosage adjustments are typically necessary to maintain optimal drug levels in the body.
However, dosage adjustments...
Hemodialysis II: Procedure and Complications
Drug Accumulation During Multiple Dosing: Intermittent IV Infusions
Hemodialysis III: Nursing Management
Anticholinesterase Agents: Poisoning and Treatment
Irreversible agents form a strong bond with the cholinesterase enzyme, making it inactive. The breakdown of the phosphorylated enzyme is...
Drug Dosing in Renal Diseases: Dose Adjustments Based on Drug Clearance and Elimination Rate Constant

