Names and pronunciation
(tet-ra-sye′kleen)
Source page 1283
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Individual generic drug information
Extracted information for tetracycline only.
(tet-ra-sye′kleen)
Source page 1283
Func. class.: Broad-spectrum antiinfective Func. class.: Vit B1
Source pages 1283, 1285
Chem. class.: Tetracycline Chem. class.: Water soluble
Source pages 1283, 1285
ACTION: Inhibits protein synthesis and phosphorylation in microorganisms; bacteriostatic ACTION: Needed for pyruvate metabolism, carbohydrate metabolism
Source pages 1283, 1285
USES: Syphilis, Chlamydia tracho- matis, gonorrhea, lymphogranuloma venereum; uncommon gram-positive, gram-negative organisms; rickettsial infections Acinetobacter sp., Actinomyces sp., Bacillus anthracis, Bacteroides sp., Balantidium coli, Bartonella bacilli- formis, Borrelia recurrentis, Brucella sp., Campylobacter fetus, Chlamydia trachomatis, Chlamydophila psittaci, Clostridium sp., Entamoeba histolyt- ica, Entamoeba sp., Escherichia coli, Francisella tularensis, Fusobacterium fusiforme, Haemophilus ducreyi, Hae- mophilus influenzae (beta-lactamase negative), Haemophilus influenzae (beta-lactamase positive), Klebsiella aerogenes, Klebsiella granulomatis, Klebsiella sp., Listeria monocytogenes, Mycoplasma pneumoniae, Neisseria gonorrhoeae, Rickettsia sp., Shigella sp., Staphylococcus aureus (MRSA), Staphylococcus aureus (MSSA), Strep- tococcus pneumoniae, Streptococ- cus pyogenes (group A beta-hemolytic streptococci), Treponema pallidum, Treponema pertenue, Vibrio cholerae, Yersinia pestis USES: Vit B1 deficiency or polyneuritis, cheilosis adjunct with thiamine beriberi, Wernicke-Korsakoff syndrome, pellagra, metabolic disorders, alcoholism
Source pages 1283, 1285
Do not confuse: thiamine/Tenormin
Source page 1285
Extracted information for tetracycline only.
CONTRAINDICATIONS: Preg- nancy, breastfeeding, children <8 yr, hypersensitivity to tetracyclines, severe renal/hepatic disease, myasthenia gravis Precautions: Renal/hepatic disease, UV exposure, geriatrics CONTRAINDICATIONS: Hyper- sensitivity Precautions: Pregnancy
Source pages 1283, 1285
SIDE EFFECTS CNS: Fever, headache, paresthesia, ICP CV: Pericarditis EENT: Dysphagia, glossitis, decreased calcification, discoloration of deciduous teeth, oral candidiasis, oral ulcers GI: Nausea, abdominal pain, vomiting, diarrhea, anorexia, enterocolitis, hepato toxicity, flatulence, abdominal cramps, epi- gastric burning, stomatitis, hepatitis, CDAD GU: Increased BUN, azotemia, acute renal failure HEMA: Eosinophilia, neutropenia, thrombo cytopenia, leukocytosis, hemolytic anemia INTEG: Rash, urticaria, photosensitiv- ity, increased pigmentation, exfoliative dermatitis, pruritus, angioedema, Ste vens-Johnson syndrome MISC: Increased intracranial pressure, candidiasis SIDE EFFECTS CNS: Weakness, restlessness CV: edema, Collapse, pulmonary hypotension EENT: Tightness of throat GI: Hemorrhage, nausea, diarrhea INTEG: Angioneurotic edema, cyanosis, sweating, warmth SYST: Anaphylaxis
Source pages 1284, 1285
INTERACTIONS Fatal nephrotoxicity: methoxyflurane; do not use together Do not take iron supplements, multivita- mins, calcium supplements, antacids, laxatives within 2 hr of this product Increase: Pseudotumor cerebi—ISOtret- inoin; avoid concurrent use Increase: effect of warfarin—digoxin Decrease: hormonal contraceptive (pos- sible but unlikely); use additional contraception Decrease: effect of tetracycline—antac- ids, sodium bicarbonate, alkali products, iron, cimetidine Decrease: effect of penicillins Drug/Herb • Photosensitivity: dong quai Drug/Food Decrease: tetracycline effect—dairy products Drug/Lab Test Increase: BUN, LFTs
Source page 1284
Extracted information for tetracycline only.
DOSAGE AND ROUTES Susceptible infections • Adult: PO 250-500 mg q6hr • Child >8 yr: PO 25-50 mg/kg/day in divided doses q6hr, max 3 g/day Chlamydia trachomatis • Adult: PO 500 mg qid × 7 days Syphilis • Adult and adolescent: PO 500 mg qid × 2 wk; if syphilis duration >1 yr, must treat 28 days Brucellosis • Adult: PO 500 mg q6hr × 3 wk with IM 1 g streptomycin bid × 1st wk, then daily × 2nd wk Urethral, endocervical, rectal T infections (C. trachomatis) • Adult: PO 500 mg qid × 7 days Acne • Adult/adolescent: PO 250 mg q6hr, then 125-500 mg/day or every other day Renal dose • Adult: PO CCr 51-90 mL/min, give dose q8-12hr; CCr 10-50 mL/min, give dose q12- 24hr; CCr <10 mL/min, give dose q24hr DOSAGE AND ROUTES RDA • Adult: PO (males) 1.2-1.5 mg; (fe- males) 1.1 mg; (pregnancy) 1.4 mg; (breastfeeding) 1.4 mg • Child 9-13 yr: PO 0.9 mg • Child 4-8 yr: PO 0.6 mg • Child 1-3 yr: PO 0.5 mg • Infant 7 mo-1 yr: PO 0.3 mg • Neonate/infant ≤6 mo: PO 0.2 mg Beriberi • Adult: PO 5-30 mg daily or in 3 di- vided doses × 1 mo; IM/IV 5-30 mg daily or in 3 divided doses, then convert to PO • Infant/child: PO 10-50 mg daily × 2 wk, then 5-10 mg daily × 1 mo; IV/IM 10-25 mg/day × 2 wk, then 5-10 mg daily × 1 mo Wernicke-Korsakoff syndrome • Adult: IV 100 mg, then 50-100 mg every day
Source pages 1283, 1285
Available forms: Caps 250, 500 mg Available forms: Tabs 50, 100, 250, 500 mg; inj 100 mg/mL; enteric-coated tabs 20 mg
Source pages 1283, 1285
Administer: • After C&S obtained, therapy may start before results are received • 2 hr before or after iron products; 1 hr after antacid products • Should be given on empty stomach (1 hr before or 2 hr after meals), avoid using at bedtime and take with a full glass of water to prevent irritation and ulceration • Store in tight, light-resistant container at room temperature Administer: IM route • By IM inj; rotate sites if pain and inflammation occur; do not mix with alkaline sol; Z-track to minimize pain Direct IV route • Undiluted at 100 mg/mL over 5 min Continuous IV INFUSION route • Diluted in compatible IV sol
Source pages 1283, 1284, 1285
Extracted information for tetracycline only.
Assess: • CDAD: diarrhea, abdominal pain, fever, fatigue, anorexia; possible anemia, elevated WBC count, low serum albumin; stop prod uct; usually either vancomycin or IV metro NIDAZOLE is given • Signs of anemia: Hct, HB, fatigue • Fluid status: I&O ratio • Blood studies: PT, CBC, AST, ALT, BUN, creatinine if on prolonged therapy • Hypersensitivity: rash, itching, pruri- tus, angioedema, Stevens-Johnson syn drome, exfoliative dermatitis; report im mediately after stopping product • GI symptoms: Nausea, vomiting, diar- rhea; administer antiemetic, antacids as ordered • Superinfection: fever, malaise, red ness, pain, swelling, drainage, perineal itching, diarrhea, changes in cough or sputum if on prolonged therapy • Pregnancy/breastfeeding: do not use in pregnancy, toxic to fetus; do not breast feed, excreted in breast milk Assess: • Anaphylaxis (IV only): swelling of face, eyes, lips, throat, wheezing • Alcoholism: Give thiamine prior to glucose-containing IV fluids to chronic T alcoholics • Thiamine deficiency: anorexia, weak- ness/pain, depression, confusion, blurred vision, tachycardia • Nutritional status: yeast, beef, liver, whole or enriched grains, legumes • Application of cold to help decrease injection site pain • Pregnancy/breastfeeding: considered compatible with pregnancy, breastfeeding
Source pages 1284, 1285
Evaluate: • Therapeutic response: absence of le- sions, negative C&S, resolution of infec- tion, prevention of malaria Evaluate: • Therapeutic response: absence of nau- sea, vomiting, anorexia, insomnia, tachy- cardia, paresthesias, depression, muscle weakness
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CLINICAL CONSIDERATIONS CLINICAL CONSIDERATIONS
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Patient and caregiver information: • To avoid sun exposure; that sunscreen does not seem to decrease photosensitivity • That all prescribed medication must be taken to prevent superinfection • To avoid milk products, antacids or to separate by 2 hr; to take with full glass of water; to take 1 hr before bedtime to prevent esophageal ulceration • That tooth discoloration may occur, es- pecially in children; not to use in child <8 yr, may cause bone formation abnormalities • To notify prescriber immediately of diar rhea with pus, mucus, fever, abdominal pain • To notify prescriber if pregnancy is planned or suspected • Not to use outdated products; Fanco ni’s syndrome (nephrotoxicity) may occur See Appendix B See Appendix B Vitamin B1 Patient and caregiver information: • About the necessary foods to be in- cluded in diet: yeast, beef, liver, legumes, whole grains
Source pages 1284, 1285, 1286
Extracted information for tetracycline only.
PHARMACOKINETICS PO: Peak 2-3 hr; duration 6 hr; half-life 6-12 hr; excreted in urine, breast milk; crosses placenta; 65% protein bound PHARMACOKINETICS PO/INJ: Unused amounts excreted in urine (unchanged)
Source pages 1284, 1285
Filter the extracted dose blocks for this individual drug.
Susceptible infections
• Infant 7 mo-1 yr: PO 0.3 mg
Candidate age grouping · source pages 1283, 1285
Susceptible infections
• Neonate/infant ≤6 mo: PO 0.2 mg Beriberi
Candidate age grouping · source pages 1283, 1285
Susceptible infections
• Infant/child: PO 10-50 mg daily × 2 wk, then 5-10 mg daily × 1 mo; IV/IM 10-25 mg/day × 2 wk, then 5-10 mg daily × 1 mo Wernicke-Korsakoff syndrome
Candidate age grouping · source pages 1283, 1285