Tetracycline Group

• Group of antiinfectives composed of natural and semisynthetic compounds.
• Usful in select infections when organism shows sensitivity.
• Ex:  Cholera, Rocky Mt. Spotted Fever, Typhus.

Tetracyclines - Action

• Exert their effect by inhibiting bacterial protein synthesis, a process needed for reproduction.

Tetracyclines - Uses

• Effective in the treatment of infections caused by a wide range of gram-negative and gram-positive microorganisms.
• Broad spectrum antibiotics when penicillin is contraindicated.

Tetracyclines - Uses

(infections treated with)

• Rickettsial diseases - Rocky Mt. Spotted Fever, Typhus Fever, Tick Fever
• Intestinal amebiasis
• Some soft tissue and skin infections - Specifically Tigecycline
• Clamydia trachomatis - Uncomplicated urethral, endocervical, or rectal infections.
• Severe Acne - adjunctive treatment
• Helicobacter pylora - in combination with metronidazole and bismuth subsalicylate.

Tetracyclines - Problem

• Growing resitance to the drugs

Tetracyclines - Adverse Reactions - G.I.

• G.I. -
  • Nausea or vomiting*
  • Diarrhea*
  • Epigastric Distress
  • Stomatitis
  • Sore Throat
  • pseodomembranous colitis

* Tigecycline Adverse Reations - limited to these

Tetracyclines - Contraindications

• Known hypersensitivity
• Pregnancy
• Lactation
• Children under 9

Tetracyclines - Interactions

• Antacids containing aluminum, zinc, magnesium or bismuth salts. -
  • Decreased effectiveness of tetracyclines
• Oral Anticoagulants -
  • Increased risk of bleeding
• Oral contraceptives -
  • decreased effect of contraceptive (pregnancy), break though bleeding
• Digoxin -
  • Increased risk of digitalis toxicity

Tetracycline - Adverse Reactions - Other

• Skin Rashes
• Photosensitivity Reactions - especially demeclocycline
• Hemotological changes
• Headache
• Dizziness
• Teeth discoloration in young kids and fetus

Tetracyclines - Recognition

*Generic name always ends with cycline

*Trade name usually ends with mycin, cin or cil

Tetracyclines - Names

Generic                                    Trade Demeclocycline                     Declomycin

       Doxycycline                 Vibra Tabs, Vibramycin

     Minocycline                    Minocin, Minocin IV

Oxytetracycline                     Terramycin Tetracycline                           Sumycin  

Tigecycline                             Tygacil   

  Tetracyclines

Dosage Ranges:

Demeclocycline

• 150 mg PO QID or 300 mg BID;  Gonorrhea:  600 mg PO initially then 300mg PO q12h for 4 days

Tetracyclines

Dosage Range:

Doxycline

• 100 mg PO q12h first day then 100 mg/d PO
• Severe infections:  100 mg q12h

Tetracyclines

Dosage Range:

Minocycline

• 200 mg PO intitially then 100 mg PO q12h

Tetracycline

Dosage Range:

Oxytetracycline

• 250 mg IM Daily

 Tetracyclines

Dosage Range:

Tetracycline

• 1-2 g/d PO in 2-4 divided doses

Tetracycline

Dosage Range:

Tigecycline

• 100 mg intitially then 50 mg IV q12h

Tetracyclines, Macrolides and Lincosamides

Preadministration Assessment - S/Sx

• Identify and record s/sx: may vary by organ or system effected or internal vs. externa 

     -pain         -fever         -swelling         -redness

     -drainage   -chills         -cough           

     -general malaise        

     -changes in apperance of sputum

 Tetracycline, Macrolides and Lincosamides

Preadministration Assessment - History

• allergies
• drug allergies
• hypersensitivity

     *If the pt has a hx of allergies and has not told the primary provider - DO NOT administer first dose until allergie is discussed with primary provider.

Tetracyclines, Macrolides and Linosamides

Preadministration Assessment - Vitals, and Diagonostics

• vitals sould be assessed and recorded
• Culture and sensitivity test may be ordered
• Other Lab tests that may be ordered:
  • renal and hepatic function
  • CBC
  • urinalysis