Chapter 28: Tetracyclines, Glycylcines, Aminoglycosides, And Fluroquinones

Question 1

Why do we use/treatment of tetracyclines? (3)

Answer 1

Acne
Tick diseases
Stis

Very broad

MRSA & helicobacter pylori

Question 2

Why do we not give tetracyclines to kids under 8?

Answer 2

Discoloration of permanent teeth, tongue and nails

Question 3

Why do we tell patients to not take calcium/iron when on tetracyclines?

Answer 3

Cause tetracycline becomes inactive because it binds to calcium

Question 4

Tetracycline cause a lot of photosensitivity, so what do we tell the patient?

Answer 4

Sunscreen
Sunglasses
Get out of sun during peak times
Long sleeve/pants

Question 5

What’s the biggest side effect of tetracyclines?

Answer 5

Teratogenic effects

Question 6

Can tetracycline’s cause hepatotoxic and nephrotic?

Why?

Answer 6

Yes

Super!!
Increases with other medications

Question 7

So if the patient is on loop diuretic or other medications that cause nephrotic toxic while on a Tetracycline, what do we do?

Is it contradiction?

Answer 7

We watch their BUN & creatine
( LFTS & reneal labs )
No!

Question 8

How should patient take tetracyclines??(2)

Answer 8

A big gulp of water & empty stomach

Question 9

What are the only two medications that can be taken for food of tetracycline?

Answer 9

Doxycycline & minocycline

Question 10

If your tetracycline expires, what do you tell the patient?

Answer 10

SUPER TOXIC!!!!

Question 11

Tetracyclines decrease the effectiveness of what?

So what do we telll them?

Answer 11

Birth control pills

Use back up birth control

Question 12

If a pregnant mom takes a tetracycline, what happens to the baby?

Answer 12

Birth defects, especially bones

Question 13

Why don’t we give penicillins and tetracyclines together?

Answer 13

Becusss they cancel each other out

Question 14

Aminogkycosides and tetracyclines together increases the risk of what for patient?

Answer 14

Nephrotoxicity !!

Question 15

What is a subset of tetracycline?

Answer 15

Glycylcycline

Question 16

Aminoglycosides
End in mycin but they aren’t macrolides!!!

When do we use these?
Like is this first line treatment?

Answer 16

No
It’s for serious infections

Question 17

Is aminoglycosides absorbed by the GI tract?
So instead we give?

Answer 17

Nope!!
IV

Question 18

Why do we give aminoglycosides orally?

Answer 18

It kills the bacteria in the gut
So it’s given before surgery to kill off the bacteria, so the patient is less likely to have post op infection

Question 19

What are the 3 big aminoglycosides side effects?

Answer 19

Ototoxicity
Nephrotoxicy
Neurotoxicity ( paranesthesis )

Question 20

One of the side effects of INH ( tb drugs ) cause parepherl neuropathy
What do we treat it with?

How does this apply to aminoglycosides?

Answer 20

Vitamin B6

Because we have that deficiency

Question 21

Aminoglycosides have that narrow therupatic window?

So we do what?

Answer 21

Yes

Peak and trough levels

Question 22

When we draw peak level?

When we draw trough level?

Answer 22

30-hour completion of Iv infusion
Highest level

15-30mins right before next administration
Lowest level

Question 23

Test question
The peak may be high so what do we do?

Answer 23

Hold medication

Question 24

Drugs interactions of aminoglycosides? (2)

Answer 24

Penicillins decrease the Aminoglycosides effectiveness

Increase action of oral anticoagulants
( increase INR/bledding )

Question 25

How would we monitor patients with aminoglycosides since it causes ototoxicity?

Answer 25

Hearing test
Or asking of any changes?

Question 26

When the patients have ringing in the hearing, what do we do?

If we keep going what happens?

Answer 26

We stop
Permanent damage

Question 27

If we see nephrotoxify, it’s also effecting there?

Answer 27

Ears!!

Question 28

Test questions
30ML an hour for urine healthy!
Decrease urine output means what?

So we look for?

Answer 28

No peeing!!!

BUN & creatinine levels !

Question 29

What’s the function for fluoroquinolones? ( sipro )

Should be reserved for patients who do not response to other treatment !!!!!!!

Are they first line?

Answer 29

Anthrax
STIs

NO!!!

Question 30

Why does fluoroquinolones have a black box warning?

Answer 30

It’s super dangerous!!!!!!!!!!!
Super common!!!

Question 31

What are the big side effects of fluoroquinolones? (6)

Answer 31

Tendon rupture ( joint pain ) ( Achilles)
Tendinitis
Peripheral neuropathy
CNS effects
Exacerbations of myasthenia gravis
Photosensitivity

Question 32

If the patient experiences joint pain with fluoroquinolones, what do we do? And why?

Answer 32

Change it because if we contuine they have higher risk of a rupture

Question 33

What’s the most common tendon rupture?

Risk increases with
- 60+
- steroids
- transplant
- under 18

Answer 33

Achilles

Question 34

Since fluoroquinolones is photosensitivity, what do we tell?

Answer 34

Sunscreen
Protective clothing

Question 35

Test questions
Stop taking medications if they are experiencing tendon pain
- call the doctor and explain

Patient needs to know that until that tendon pain goes away, no excerise!!
No pain !!!
Cause pain will cause higher risk of rupture

Question 36

What decreases the absorption of fluoroquinolones ?

Answer 36

Aluminum
Magnesium
Antacids
Iron
Since
Calcium