Tetracyclines and glycylcyclines

Question 1

What is it indicated for?

Answer 1

Acne vulgaris
Lower respiratory infections including exacerbation of COPD and pneumonia
Chlamydial infection including pelvic inflammatory disease
Typhoid
Malaria
Lyme disease
Tigecycline used for severe skin, soft-tissue and abdominal infections

Question 2

What is their spectrum activity?

Answer 2

Relatively broad spectrum against gram positive and negative organsims

Question 3

How do they work?

Answer 3

Tetracyclines inhibit bacterial protein synthesis.

Question 4

What side effects occur with these drugs?

Answer 4

GI upset
Hypersensitivity reactions

Tetracycline-specific side effects:

Oesophageal ulceration and dysphagia
Photosensitivity
Discolouration of tooth enamel in children
Rarely hepatoxicity and intracranial hypertension

Question 5

What are the warnings for these drugs?

Answer 5

Do not prescribe in ✖ pregnancy, ✖ breastfeeding or for ✖ children ≤12years of age.

Caution in renal impairment

Question 6

What interactions with other agents occur with these drugs?

Answer 6

They bind to divalent cations so do not give within 2 hours of calcium, antacids or iron as it will affect absorption

Tetracyclines can enhance the anticoagulant effect of warfarin

Question 7

What are the names of some of these drugs?

Answer 7

doxycycline, lymecycline (tetracyclines); tigecycline (glycylcycline)