Tetracyclines and Glycylcyclines Flashcards
What are tetracyclines (TCNs) useful alternatives of?
Common respiratory tract infections
What are TCNs a DOC for?
Uncommon infections
Which TCN is preferred over the other TCNs?
Doxycycline is preferred over minocycline and tetracycline
Which medication is a novel agent and glycylcyclines?
Tigecycline
What is beneficial of tigecycline?
Evades most TCN resistant mechanisms and has broad spectrum activity
Which medication is a novel aminomethylcycline, within the TCN class with a broad-spectrum activity?
Omadacycline
What is the MOA of the TCNs?
Binding to the 30s ribosomal subunit blocking the bacterial protein synthesis leading to a bacteriostatic activity
What are the mechanism of resistance for TCNs?
- Modification of the 30s subunit
- Efflux pumps
TCNs have a good spectrum over which bacteria?
- Atypicals
- Rickettsia
- Spirochetes
- Plasmodium spp (malaria)
Glycylcylines have a good spectrum over which bacteria?
- Enterococci (including VRE)
- Staphylococcus (including MRSA)
- S. pneumoniae
- Atypicals
Aminomethylcyclines have a good spectrum over which bacteria?
- Enterococci (including VRE)
- Staphylococcus (including MRSA)
- Atypicals
- S. pneumoniae
- H. influenzae
- Klebsiella pneumoniae
- Enterobacteriaceae
What common adverse events occur with TCNs/glycylcyclines?
- GI effects
- Photosensitivity
- Discoloration of developing teeth
- Esophageal irritation
What are the contraindications of TCNs/glycylcyclines?
- Pregnant pts
- Child < 8 yo
Which medications are IV only?
- Tigecycline
- Omadacycline
Which medications are 100% bioavailable?
- Minocycline
- Doxycycline
What could decrease the oral bioavailability of TCNs?
- Cations (Mg, Ca, Fe, milk, MVIs, anatacids)
What should be done if TCNs and cations are being taken?
Separate by at least 2 hours
Which medication does not need to be renally or hepatically adjusted?
Doxycycline
Which medication is eliminated renally and should be avoided in renal insufficient patients because it can worsen kidneys?
Tetracycline
What are the main utilizations of TCNs/glycylcyclines?
- CAP
- Sinusitis
- Uncomplicated respiratory tract infections
- Acute exacerbations of chronic bronchitis
- Malaria prophylaxis and treatment
What is the DOC for TCNs/glycylcyclines?
Tick borne diseases
Tigecycline has a great activity against?
Polymicrobial complicated infections
Omadacycline was approved in 2019 for which indication(s)?
- CAP
- SSTIs
What is a great counseling point for patients taking TCNs/glycylcylines?
Ask pts about supplemental use at home? Even if they use milk in coffee or tea
