Chapter 28: Tetracyclines, Glycylcines, Aminoglycosides, And Fluroquinones Flashcards
Why do we use/treatment of tetracyclines? (3)
Acne
Tick diseases
Stis
Very broad
MRSA & helicobacter pylori
Why do we not give tetracyclines to kids under 8?
Discoloration of permanent teeth, tongue and nails
Why do we tell patients to not take calcium/iron when on tetracyclines?
Cause tetracycline becomes inactive because it binds to calcium
Tetracycline cause a lot of photosensitivity, so what do we tell the patient?
Sunscreen
Sunglasses
Get out of sun during peak times
Long sleeve/pants
What’s the biggest side effect of tetracyclines?
Teratogenic effects
Can tetracycline’s cause hepatotoxic and nephrotic?
Why?
Yes
Super!!
Increases with other medications
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?
We watch their BUN & creatine
( LFTS & reneal labs )
No!
How should patient take tetracyclines??(2)
A big gulp of water & empty stomach
What are the only two medications that can be taken for food of tetracycline?
Doxycycline & minocycline
If your tetracycline expires, what do you tell the patient?
SUPER TOXIC!!!!
Tetracyclines decrease the effectiveness of what?
So what do we telll them?
Birth control pills
Use back up birth control
If a pregnant mom takes a tetracycline, what happens to the baby?
Birth defects, especially bones
Why don’t we give penicillins and tetracyclines together?
Becusss they cancel each other out
Aminogkycosides and tetracyclines together increases the risk of what for patient?
Nephrotoxicity !!
What is a subset of tetracycline?
Glycylcycline
Aminoglycosides
End in mycin but they aren’t macrolides!!!
When do we use these?
Like is this first line treatment?
No
It’s for serious infections
Is aminoglycosides absorbed by the GI tract?
So instead we give?
Nope!!
IV
Why do we give aminoglycosides orally?
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
What are the 3 big aminoglycosides side effects?
Ototoxicity
Nephrotoxicy
Neurotoxicity ( paranesthesis )
One of the side effects of INH ( tb drugs ) cause parepherl neuropathy
What do we treat it with?
How does this apply to aminoglycosides?
Vitamin B6
Because we have that deficiency
Aminoglycosides have that narrow therupatic window?
So we do what?
Yes
Peak and trough levels
When we draw peak level?
When we draw trough level?
30-hour completion of Iv infusion
Highest level
15-30mins right before next administration
Lowest level
Test question
The peak may be high so what do we do?
Hold medication
Drugs interactions of aminoglycosides? (2)
Penicillins decrease the Aminoglycosides effectiveness
Increase action of oral anticoagulants
( increase INR/bledding )
How would we monitor patients with aminoglycosides since it causes ototoxicity?
Hearing test
Or asking of any changes?
When the patients have ringing in the hearing, what do we do?
If we keep going what happens?
We stop
Permanent damage
If we see nephrotoxify, it’s also effecting there?
Ears!!
Test questions
30ML an hour for urine healthy!
Decrease urine output means what?
So we look for?
No peeing!!!
BUN & creatinine levels !
What’s the function for fluoroquinolones? ( sipro )
Should be reserved for patients who do not response to other treatment !!!!!!!
Are they first line?
Anthrax
STIs
NO!!!
Why does fluoroquinolones have a black box warning?
It’s super dangerous!!!!!!!!!!!
Super common!!!
What are the big side effects of fluoroquinolones? (6)
Tendon rupture ( joint pain ) ( Achilles)
Tendinitis
Peripheral neuropathy
CNS effects
Exacerbations of myasthenia gravis
Photosensitivity
If the patient experiences joint pain with fluoroquinolones, what do we do? And why?
Change it because if we contuine they have higher risk of a rupture
What’s the most common tendon rupture?
Risk increases with
- 60+
- steroids
- transplant
- under 18
Achilles
Since fluoroquinolones is photosensitivity, what do we tell?
Sunscreen
Protective clothing
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
What decreases the absorption of fluoroquinolones ?
Aluminum
Magnesium
Antacids
Iron
Since
Calcium
