Chapter 86
how are tetracyclines absorbed?
Calcium supplements, milk products, iron supplements, magnesium-containing laxatives, and most antacids all decrease the absorption
what are the four members of the tetracycline
-Tetracycline -Demeclocycline -Doxycycline -Minocycline
what are the adverse effects of Clindamycin [Cleocin]?
CDAD hepatic toxicity blood dyscrasias diarrhea hypersensitivity reactions
what are the uses of tetracyclines?
-Treatment of infectious disease -Treatment of acne -Peptic ulcer disease -Periodontal disease -Rheumatoid arthritis -Mycoplasma pneumoniae -Lyme disease -Anthrax -Helicobacter pylori (gastric ulcers)
what is the use of Linezolid [Zyvox]?
-active against mult-drug resitant, gram positive pathogens this included vancomysin resitant and MRSA
what are the common side effects with Linezolid [Zyvox]
-diarrhea -nausea - vomit -headache
what are the adverse effects of Macrolides [Erythromycin]?
-gi effects -QT interval prolongation, sudden cardiac death -superinfection -thrombophlebitis -transient hearing loss
what are the therapeutic uses of Macrolides [Erythromycin]?
-whooping cough -chlamydial infection -m pneumoniae -group a streptococcus pyogenes
A patient is prescribed doxycycline [Vibramycin]. If the patient complains of gastric irritation, what should the nurse do? A. Instruct the patient to take the medication with milk B. Tell the patient to take an antacid with the medication C. Give the patient food, such as crackers or toast, with the medication D. Have the patient stop the medication immediately and contact the health care provider
Answer: C Rationale: Tetracyclines form insoluble chelates with calcium, iron, magnesium, aluminum, and zinc; absorption is decreased. Tetracyclines should not be administered together with milk or antacids. Long-acting tetracyclines, such as doxycycline, may be taken with food; food does not affect absorption.
Before administering erythromycin to a patient for an upper respiratory tract infection, it is most important for the nurse to determine if the patient is also prescribed which drug? A. Guaifenesin [Guiatuss] B. Hydrocodone [Vicodin] C. Nitroglycerin [Tridil] D. Verapamil [Calan]
Answer: D Rationale: QT prolongation and sudden cardiac death have occurred in patients taking CYP3A4 inhibitors, such as calcium channel blockers (verapamil), azole antifungal drugs, HIV protease inhibitors, and nefazodone.
Which tetracycline may be administered with meals? A. Tetracycline B. Demeclocycline C. Doxycycline D. Minocycline
Answer: D Rationale: Tetracycline, demeclocycline, and doxycycline should be administered on an empty stomach. Minocycline can be administered with meals.
what are the adverse effects of tetracyclines?
Gastrointestinal irritation Effects on bone and teeth Superinfection Hepatotoxicity Renal toxicity Photosensitivity
what is Clindamycin [Cleocin] active against?
anaerobic bacteria - gram negative and positive
what kind of antibacterial is macrolides (erythromycin)
broad spectrum usually static but can be cidal
what are tetracyclines?
broad spectrum antibiotics
what does Clindamycin [Cleocin] promote?
c-dif associated diarrhea - this can be fatal
what do tetracyclines do?
inhibit protein synthesis
what does Clindamycin [Cleocin] do?
inhibit protein synthesis
what is the mechanism of action for macrolides (erythromycin)
inhibition of protein synthesis
what is a drug reaction with Linezolid [Zyvox]
monoamine oxidase inhibitors
what are Macrolides [Erythromycin] active against?
most gram-postive and some gram negative bacteria
what is a big adverse effect with Linezolid [Zyvox]
myelosuppression in RBC
what kind of antibiotics is Linezolid [Zyvox]?
oxazolidinones (new antibiotic class)S
when is Macrolides [Erythromycin] used?
when a patient is allergic to penicillin