Chapter 28: Tetracyclines, Glycylcines, Aminoglycosides, And Fluroquinones Flashcards

1
Q

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

A

Acne
Tick diseases
Stis

Very broad

MRSA & helicobacter pylori

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2
Q

Why do we not give tetracyclines to kids under 8?

A

Discoloration of permanent teeth, tongue and nails

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3
Q

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

A

Cause tetracycline becomes inactive because it binds to calcium

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4
Q

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

A

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

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5
Q

What’s the biggest side effect of tetracyclines?

A

Teratogenic effects

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6
Q

Can tetracycline’s cause hepatotoxic and nephrotic?

Why?

A

Yes

Super!!
Increases with other medications

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7
Q

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?

A

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

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8
Q

How should patient take tetracyclines??(2)

A

A big gulp of water & empty stomach

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9
Q

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

A

Doxycycline & minocycline

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10
Q

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

A

SUPER TOXIC!!!!

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11
Q

Tetracyclines decrease the effectiveness of what?

So what do we telll them?

A

Birth control pills

Use back up birth control

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12
Q

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

A

Birth defects, especially bones

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13
Q

Why don’t we give penicillins and tetracyclines together?

A

Becusss they cancel each other out

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14
Q

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

A

Nephrotoxicity !!

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15
Q

What is a subset of tetracycline?

A

Glycylcycline

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16
Q

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

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

A

No
It’s for serious infections

17
Q

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

18
Q

Why do we give aminoglycosides orally?

A

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

19
Q

What are the 3 big aminoglycosides side effects?

A

Ototoxicity
Nephrotoxicy
Neurotoxicity ( paranesthesis )

20
Q

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

How does this apply to aminoglycosides?

A

Vitamin B6

Because we have that deficiency

21
Q

Aminoglycosides have that narrow therupatic window?

So we do what?

A

Yes

Peak and trough levels

22
Q

When we draw peak level?

When we draw trough level?

A

30-hour completion of Iv infusion
Highest level

15-30mins right before next administration
Lowest level

23
Q

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

A

Hold medication

24
Q

Drugs interactions of aminoglycosides? (2)

A

Penicillins decrease the Aminoglycosides effectiveness

Increase action of oral anticoagulants
( increase INR/bledding )

25
How would we monitor patients with aminoglycosides since it causes ototoxicity?
Hearing test Or asking of any changes?
26
When the patients have ringing in the hearing, what do we do? If we keep going what happens?
We stop Permanent damage
27
If we see nephrotoxify, it’s also effecting there?
Ears!!
28
Test questions 30ML an hour for urine healthy! Decrease urine output means what? So we look for?
No peeing!!! BUN & creatinine levels !
29
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!!!
30
Why does fluoroquinolones have a black box warning?
It’s super dangerous!!!!!!!!!!! Super common!!!
31
What are the big side effects of fluoroquinolones? (6)
Tendon rupture ( joint pain ) ( Achilles) Tendinitis Peripheral neuropathy CNS effects Exacerbations of myasthenia gravis Photosensitivity
32
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
33
What’s the most common tendon rupture? Risk increases with - 60+ - steroids - transplant - under 18
Achilles
34
Since fluoroquinolones is photosensitivity, what do we tell?
Sunscreen Protective clothing
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
36
What decreases the absorption of fluoroquinolones ?
Aluminum Magnesium Antacids Iron Since Calcium