Tetracyclines used to treat - Answer *H.Pylori
*Acne Vulgaris
*Rickettsial disease
* Chlamydia Trachomatis
*Cholera
*M. pneumonia
*Lyme Disease
*Anthrax
Tetracyclines - Answer Demeclocycline
Doxycycline
Minocycline
Tetracyline
Tetracycline mode of action - Answer broad-spectrum; bacteriostatic via inhibition of
bacterial protein synthesis
Tetracycline adverse effects - Answer GI Distress
Hepatotoxicity
Photosensitivity
Vestibular problems (Vertigo)
Candida infections; C. diff
Tetracycline drug/food interactions - Answer *Milk products and antacids, oral
contraceptives, digoxin absorption is increased leading to toxicity.
*Administer 1 hour before or 2 hours after
Tetracycline contraindications - Answer *Avoid administration in children younger than 8
and pregnant women or breastfeeding (Category D). Use cautiously in patients with
liver, kidney disease.
*Pt exposed to direct sunlight
Caution in pt's with liver or kidney disease
Pt with esophageal obstruction or dysfunction
Tetracycline monitoring - Answer None
Rx Tetracycline - Answer *Bacterial infections-1-2g/day PO divided qid( give 1 hr before
or 2 hr after meals)
*H.Pylori-500mg PO qid x 10-14 days ( Part of multi-drug regimine
*Syphilis (primary, secondary, latent less than a year)- 500mg PO qid x 14 days ( for
PCN hypersensitive patients). Latent grater than a year- 500mg PO qid x 28 days.
Macrolides - Answer Azithromycin
Clarithromycin
Erythromycin
, NR566 midterm
Macrolides mode of action - Answer inhibition of protein synthesis
Macrolides treat - Answer *Corynebacterium diphtheria
*Used for diagnosed allergy to PCN for H. Pylori, Chlamydia, disseminated
mycobacterium, and M. pneumonia
Macrolides Complications - Answer *GI symptoms, epigastric pain
*Prolonged QT interval which could leat to torsade's and death
*High doses can cause Ototoxicity
Macrolide Contraindications and Precautions: - Answer *Avoid in those taking
antidysrhythmic drugs, CYP3A4 inhibitors, CCB( verapamil, diltiazem), Antifungals (-
azole), HIV protease inhibitors and nefazodone
*Can increase drug levels of Theophylline, Carbamazepine, and Warfarin
*Hx of liver disease use with caution
*Don't use Chloramphenicol and Clindamycin together
Macrolide age related concerns - Answer Safe in the pediatric population
Clindamycin MOA and use - Answer *Binds to 50S ribosomal subunit and inhibits
protein synthesis
*Anaerobic infections ( does not cross blood-brain barrier)
*Preferred for A Streptococcal infection, Gas Gangrene.
*Clostridium perfringens, Fusobacterium, Anaerobic streptococci
*Used as an alternative for PCN because of efficacy to gram positive cocci
Clindamycin contraindications - Answer *History of GI or, hepatic or renal disease
*older adults and children, (caution), pregnancy and lactation
*Fever, ABD pain, and leukocytosis
*C.diff can start the first week of treatment or develop 4 to 6 weeks after treatment is
complete. Can be fatal if left untreated.
Clindamycin C.Diff treatment - Answer *Discontinue medication and give oral
Vancomycin or metronidazole
*Hydrate with water and electrolytes
Aminoglycosides MOA - Answer Bactericidal; inhibit formation of initiation complex and
cause misreading of mRNA. Also block translocation. Require O2 for uptake; therefore
ineffective against anaerobes.
Aminoglycosides - Answer *Gentamycin
*Kanamycin
*Neomycin
*Streptomycin
*Tobramycin
* Amikacin