- angiodema - hypersensivitiy - diarrhhoea - headache - nausea - pericarditis - photosensitivity reaction - skin reactions - SLE exacerbated - vomiting - headache and visual disturbances (may indicate benign intracranial hypertension - discontinue if raised IC pressure develops!)

tetracyclines Flashcards by Hana Manuchar

cautions for all tetracyclines (2)

myasthenia gravis - muscle weakness may be increased
- SLE may be exacerbated

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common side effects

angiodema
hypersensivitiy
diarrhhoea
headache
nausea
pericarditis
photosensitivity reaction
skin reactions
SLE exacerbated
vomiting
headache and visual disturbances (may indicate benign intracranial hypertension - discontinue if raised IC pressure develops!)

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what is Henoch-Schonlein purpora?

inflammation of small blood vessels which leak into skin, joints, intestines and kidneys
appears as purpuric rash

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Henoch Schonlein purpura
common side effect of tetracyclines

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headache and visual disturbances as a side effect of tetracyclines can indicate…

benign intracranial hypertension
discontinue if raised intracranial pressure

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can you use in pregnancy and why

no
1st trimester: animal studies show effects of skeletal development
2nd trimester: can cause discolouration of child teeth
maternal hepatotoxicity with large parenteral doses

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can you use in BF and why

Do not give, although absorption and therefore discoloration of teeth in infant is probably usually prevented by chelation with calcium in milk

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DLM

do like milk - doxy, Lyme, minocycline

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DOT

don’t like milk - demeclo, oxytetra, tetracycline

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photosensitivity reactions are more likely with this abx than other tetracyclines

demeclocycline

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tetracyclines are …. toxic

hepatotoxic

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which abx is used for treatment of hyponatraemia resulting from inappropriate secretion of ADH if fluid restriction alone does not restore sodium conc or is not tolerable?

demeclocycline

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doxycycline is normally contraindicated in pregnancy because of risk of skeletal development impaired and staining of teeth in baby. however, if travel to malarias areas is unavoidable and other regimens are unsuitable, it can be used for malaria prophylaxis if the entire course can be completed before…..

15 weeks gestation

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labelling requirements for doxycycline (in addition to standard abx ones)

do not take indigestion remedies or iron or zinc 2h before or after …
protect skin from sunlight ….
take with full glass of water….

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which abx has an additional warning label of ‘take with full glass of water’?

doxycycline

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which abx is associated with a greater risk of lupus-erythematous like syndrome compared to other tetracyclines?

minocycline

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which abx sometimes causes irreversible pigmentation?

minocycline

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tetracyclines are contraindicated in this age … because…

<12
deposition in growing bone and teeth, by binding to calcium, causes staining and occasionally dental hypoplasia

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dairy products decrease the exposure to these 3 abx

demeclo, oxytetra, tetracycline

avoid 1 hour before or 2 hours

DOT

interactions - retinoids

increased risk of being intracranial hypertension. avoid

interactions - warfarin, acenocoumarol, pheninidoine

increases AC effect - monitor INR

interactions - which drugs increase risk of hepatotoxicity

azoles
vitamin A
valproate
thalidomide
testosterone
statins
paracetamol
MTX
mercaptopurine
heparin
isoniazid
fluorouracil
amiodarone

does MTX interact?

increased risk of hepatotoxicity

does lithium interact?

abx predicted to INCREASE risk of lithium toxicity
avoid or adjust dose

can you take iron and tetracyclines at the same time

Decreases absorption of oral abx Take abx 2-3 hours after iron

can you take calcium at the same time as tetracyclines

oral calcium predicted to decrease absorption of abx. separate by 2-3 hours

can you take oral bismuth and antacids at the same time as tetracyclines

separate by 2-3 hours greatly decreases efficacy of oral abx

can you take zinc at the same time as tetracyclines

decreases absorption of abx separate administration by 2-3 hours

dose of doxycycline in CAP, acute cough, acute sinusitis

200mg stat, then 100mg once daily. total 5 days. total you would prescribe = 6 tablets

dose of doxycycline for HAP

200mg stat, then 100mg once daily. total 5 days, then review

dose of doxycycline for acute exacerbation of bronchiectasis

200mg stat, then 100mg once daily for 7-14 days total

dose of doxycycline for acute exacerbation of COPD

200mg stat then 100mg OD for 5 days total increased if necessary to 200mg OD (severe infections)

dose of doxycycline for PID

100mg BD for 14 days

oxytetracycline labels (in addition to space doses evenly, take course until finished) - 2

DOT - do not take milk, indigestion remedies, or meds containing iron or zinc 2 hr before or after take on empty stomach - an hour before food or 2 h after food

does doxycycline need to be taken with food

doesnt matter

this tetracycline has a broader spectrum than the others

minocycline

labelling requirements for oxytetracycline (3)

- do not take milk, indigestion remedies, iron, zinc 2h before or after - space dose evenly ... - empty stomach (1h before, 2 h after food)

tetracycline labelling requirmenets (3)

- no milk, indigestion remedies, iron, zinc 2h before or after - space doses evenly - empty stomach

minocyclcine labelling requirements

- no indigestion remedies, iron or zinc 2h before or after - space doses evenly

demecleocycline labelling requirments (4)

- no milk, indigestion, iron, zinc 2 h before or after - space doses evenly - protect skin from sun - empty stomach

lymecycline labelling requirements (2)

space doses evenly do not take indigestion, iron, zinc 2h before or after

Summarise which tetracyclines need to be taken on an empty stomach

DOT - demecleo, oxytet, tetra

Which 2 tetracyclines have the additional label 'protect skin even on a bright by cloudy day'

doxy & demecleo

which 3 tetracyclines need to be taken on an empty stomach

demecleo tetra oxytetra

DOT is applicable for 3 things

demecleo, oxytetra, tetracycline no milk empty stomach avoid dairy 1h before or 2h after

which one causes tongue discolouration

minocycline