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afsha - infections > tetracyclines > Flashcards

tetracyclines Flashcards

1
Q

cautions for all tetracyclines (2)

A

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

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2
Q

common side effects

A
  • 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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3
Q

what is Henoch-Schonlein purpora?

A

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

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4
Q
A

Henoch Schonlein purpura
common side effect of tetracyclines

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5
Q

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

A

benign intracranial hypertension
discontinue if raised intracranial pressure

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6
Q

can you use in pregnancy and why

A
  • 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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7
Q

can you use in BF and why

A

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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8
Q

DLM

A

do like milk - doxy, Lyme, minocycline

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9
Q

DOT

A

don’t like milk - demeclo, oxytetra, tetracycline

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10
Q

photosensitivity reactions are more likely with this abx than other tetracyclines

A

demeclocycline

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11
Q

tetracyclines are …. toxic

A

hepatotoxic

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12
Q

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?

A

demeclocycline

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13
Q

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…..

A

15 weeks gestation

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14
Q

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

A
  • 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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15
Q

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

A

doxycycline

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16
Q

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

A

minocycline

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17
Q

which abx sometimes causes irreversible pigmentation?

A

minocycline

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18
Q

tetracyclines are contraindicated in this age … because…

A
  • <12
  • deposition in growing bone and teeth, by binding to calcium, causes staining and occasionally dental hypoplasia
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19
Q

dairy products decrease the exposure to these 3 abx

A

demeclo, oxytetra, tetracycline

avoid 1 hour before or 2 hours

DOT

20
Q

interactions - retinoids

A

increased risk of being intracranial hypertension. avoid

21
Q

interactions - warfarin, acenocoumarol, pheninidoine

A

increases AC effect - monitor INR

22
Q

interactions - which drugs increase risk of hepatotoxicity

A
  • azoles
  • vitamin A
  • valproate
  • thalidomide
  • testosterone
  • statins
  • paracetamol
  • MTX
  • mercaptopurine
  • heparin
  • isoniazid
  • fluorouracil
  • amiodarone
23
Q

does MTX interact?

A

increased risk of hepatotoxicity

24
Q

does lithium interact?

A

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

25
Q

can you take iron and tetracyclines at the same time

A

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

26
Q

can you take calcium at the same time as tetracyclines

A

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

27
Q

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

A

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

28
Q

can you take zinc at the same time as tetracyclines

A

decreases absorption of abx separate administration by 2-3 hours

29
Q

dose of doxycycline in CAP, acute cough, acute sinusitis

A

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

30
Q

dose of doxycycline for HAP

A

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

31
Q

dose of doxycycline for acute exacerbation of bronchiectasis

A

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

32
Q

dose of doxycycline for acute exacerbation of COPD

A

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

33
Q

dose of doxycycline for PID

A

100mg BD for 14 days

34
Q

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

A

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

35
Q

does doxycycline need to be taken with food

A

doesnt matter

36
Q

this tetracycline has a broader spectrum than the others

A

minocycline

37
Q

labelling requirements for oxytetracycline (3)

A
  • do not take milk, indigestion remedies, iron, zinc 2h before or after
  • space dose evenly …
  • empty stomach (1h before, 2 h after food)
38
Q

tetracycline labelling requirmenets (3)

A
  • no milk, indigestion remedies, iron, zinc 2h before or after
  • space doses evenly
  • empty stomach
39
Q

minocyclcine labelling requirements

A
  • no indigestion remedies, iron or zinc 2h before or after
  • space doses evenly
40
Q

demecleocycline labelling requirments (4)

A
  • no milk, indigestion, iron, zinc 2 h before or after
  • space doses evenly
  • protect skin from sun
  • empty stomach
41
Q

lymecycline labelling requirements (2)

A

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

41
Q

Summarise which tetracyclines need to be taken on an empty stomach

A

DOT - demecleo, oxytet, tetra

41
Q

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

A

doxy & demecleo

41
Q

which 3 tetracyclines need to be taken on an empty stomach

A

demecleo
tetra
oxytetra

42
Q

DOT is applicable for 3 things

A

demecleo, oxytetra, tetracycline

no milk
empty stomach
avoid dairy 1h before or 2h after

43
Q

which one causes tongue discolouration

A

minocycline

afsha - infections (57 decks)

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