Tetracyclines: Exam 1 Flashcards

Exam 1

1
Q

What is the MOA of tetracyclines?

A

Inhibit protein synthesis by reversibly binding to the 30S subunit of the bacterial ribosome

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2
Q

Tetracyclines are mostly effective against gram:

A

Positive organisms

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3
Q

How well is doxycycline absorbed?

A

It’s absorbed about 95%-100% (the highest of the tetracyclines)

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4
Q

How well is tetracycline absorbed?

A

It’s absorbed about 60-70% (the highest of the tetracycline

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5
Q

General instructions for taking tetracyclines by mouth include:

A

Take on empty stomach

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6
Q

Tetracyclines interact with these foods/OTC drugs:

A

Antacids, dairy foods, iron salts, and sodium bicarbonate

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7
Q

If taking antacids or dairy products with tetracyclines an individual should do this:

A

Separate doses by 2 hours, and take tetracycline first

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8
Q

What are drugs which interact with tetracyclines?

A

Warfarin
Barbiturates
Carbamazepine
Hydantoins
Cimetidine
Digodix
Lithium
PO Contraceptives
Penicillin

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9
Q

Are doxycycline and tetracycline safe to give during pregnancy?

A

NO!

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10
Q

How is tetracycline typically prescribed?

A

Both topically and orally to treat acne and is one of four drugs in the combination treatment of H. pylori infection

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11
Q

Doxycycline is the most commonly prescribed tetracycline because it has the least:

A

amount of drug-food interactions

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12
Q

How is doxycycline distributed in the body?

A

-Highly lipid soluble
-Readily penetrates body tissues and fluids
-crosses placental membranes
-Fetal plasma concentrations reach 60% of maternal serum levels

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13
Q

Tetracyclines are eliminated & excreted via:

A

-The kidney via glomerular filtration
-Liver metabolism and undergo enterohepatic recirculation

Excretion: bile and feces

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14
Q

Tetracyclines require dose adjustments for:

A

Renal impairment

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15
Q

Tetracyclines are contraindicated in:

A

-Severe hepatic dysfunction
-pregnancy
-children younger than 8 years old
-severe renal impairment

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16
Q

Doxycycline is eliminated via:

A

30-42% unchanged in urine; remainder excreted in bile & feces

17
Q

Tetracycline is eliminated via:

A

20%–55% unchanged in urine

18
Q

What does current evidence say about lactation when using tetracycline?

A

Tetracycline: is excreted in breast milk; however, the it is compatible with breastfeeding because the serum concentrations were below detectable levels and there was no evidence of teeth staining

19
Q

What does current evidence say about lactation when using doxycycline?

A

Doxy is excreted in breast milk; however, because milk levels are low and absorption is inhibited by the calcium in breast milk, a short course is considered safe during lactation

20
Q

Why shouldn’t tetracyclines be given to children?

A

These drugs form a stable calcium complex in any bone-forming tissue, decreasing bone growth. They also may cause permanent yellow/gray/brown discoloration of deciduous and permanent teeth

21
Q

Doxycycline is the primary drug of choice for:

A

Ehrlichiosis and rickettsial infections (e.g., Rocky Mountain spotted fever, typhus, Q fever, and trench fever caused by B. quintana)

22
Q

What are some ADR when taking tetracyclines?

A

GI Upset (anorexia, N/V/D)
Esophageal ulcers
C. Diff
Pseudotumor cerebri (benign intracranial hypertension)
Hepatotoxicity
Superinfection

23
Q

What are dermatological reactions associated with taking tetracyclines?

A
  1. Photosensitivity: manifested by an exaggerated sunburn, and a maculopapular/ erythematous rash.
  2. Severe skin reactions: Stevens–Johnson syndrome, toxic epidermal necrolysis
24
Q

What are the primary drug-drug interactions associated with tetracyclines?

A

Divalent and trivalent cations found in antacids, iron salts, sevelamer, magnesium-containing laxatives, and zinc supplements

25
Q

If the patient needs to eat while taking tetracyclines, give these instructions:

A

Administer tetracyclines 1 hour before or 2 hours after meals

26
Q

To prevent esophageal irritation, give these instructions:

A

Do not take tetracyclines at bedtime and administer with a full 8 oz glass of water

27
Q

Instructions on how to avoid phytotoxicity reactions when taking tetracyclines:

A

Wear sunscreen, hats, and protective clothing if it is necessary to be in the sun for more than a few minutes

28
Q

What are signs of hepatotoxicity from taking tetracyclines?

A

Upper abdominal pain, nausea, vomiting, dark urine, clay-colored stools, or yellowing of skin or eyes

29
Q

What are signs of a superinfection that should be reported?

A

Hoarseness, glossitis, sore throat, dysphagia, or vaginal itching and discharge