Tetracyclines

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Questions and Answers

Which of the following is NOT a tetracycline antibiotic?

  • Doxycycline (DXC)
  • Oxytetracycline (OTC)
  • Lincomycin (correct)
  • Chlortetracycline (CTC)

Tetracyclines are classified as ________________ spectrum antibiotics

Broad

What property of tetracyclines contributes to variations in their liposolubility?

  • Their ability to form covalent bonds
  • Their amphoteric nature (correct)
  • Their resistance to acid environments
  • Their rapid metabolism in the liver

Why should tetracyclines be protected from UV light?

<p>They degrade due to photosensitivity</p> Signup and view all the answers

What effect do multivalent cations (Ca²⁺, Mg²⁺, Zn²⁺) have on tetracyclines?

<p>They form insoluble complexes and reduce absorption (C)</p> Signup and view all the answers

Tetracyclines have moderate oral bioavailability

<p>False (B)</p> Signup and view all the answers

Which route of administration is associated with high bioavailability for tetracyclines?

<p>Subcutaneous (SC) and Intramuscular (IM) (C)</p> Signup and view all the answers

What does amphoteric mean?

<p>The drug is capable of acting as acids or bases</p> Signup and view all the answers

Why is the long-acting effect of tetracyclines lost when administered intravenously (IV)?

<p>The drug is rapidly cleared from circulation without delayed absorption (A)</p> Signup and view all the answers

What type of pharmacokinetic behavior is associated with tetracyclines?

<p>Large volume of distribution (Vd) and enterohepatic circulation (B)</p> Signup and view all the answers

In which body fluids or tissues are tetracyclines well distributed?

<p>Milk, synovial fluid, peritoneal fluid, and endometrial tissues</p> Signup and view all the answers

The tetracyclines are eliminated in ___________ unchanged primarily by _______________

<p>Urine, glomerular filtration.</p> Signup and view all the answers

How does renal impairment affect the elimination of most tetracyclines (excluding DXC)?

<p>It increases elimination half-life (C)</p> Signup and view all the answers

Why does doxycycline (DXC) not accumulate in patients with renal insufficiency?

<p>It is excreted in an inactive form via feces (B)</p> Signup and view all the answers

Doxycycline is highly protein bound

<p>True (A)</p> Signup and view all the answers

Tetracyclines are known for their ability to chelate. What is chelate?

<p>Chelate means to be able to bind to divalent cations, such as calcium (calcium containing products) and magnesium</p> Signup and view all the answers

What is the consequence of chelation?

<p>It interferes with gastrointestinal absorption</p> Signup and view all the answers

MOA: Tetracyclines bind to the __________ and interfere with bacterial protein synthesis

<p>30s ribosomal subunit (B)</p> Signup and view all the answers

Word bank (bactericidal, bacteriostatic): Tetracyclines are _____________ at usual therapeutic concentrations, but _______________ at high concentrations

<p>Bacteriostatic, bactericidal.</p> Signup and view all the answers

Tetracyclines were originally considered time-dependent antimicrobials. What is their current classification?

<p>Co-dependent (both time- and concentration-dependent) (C)</p> Signup and view all the answers

Tetracyclines are most active at which pH?

<p>Acidic (pH &lt;7) (C)</p> Signup and view all the answers

Why is oral administration (PO) of tetracyclines not recommended in equids?

<p>It has poor absorption and disrupts gastrointestinal flora (B)</p> Signup and view all the answers

Which tetracycline is less likely to cause adverse gastrointestinal effects?

<p>Doxycycline (DXC) (C)</p> Signup and view all the answers

Which of the following factors is associated with nephrotoxicity caused by oxytetracycline (OTC)?

<p>High doses, outdated parenteral products, endotoxemia, dehydration, and hypovolemia (B)</p> Signup and view all the answers

What type of nephrotoxicity is associated with oxytetracycline (OTC)?

<p>Renal tubular necrosis (A)</p> Signup and view all the answers

What is the primary cause of cardiovascular collapse following rapid IV administration of oxytetracycline (OTC)?

<p>Intravascular chelation of calcium and/or decreased blood pressure from the drug vehicle (B)</p> Signup and view all the answers

How can cardiovascular collapse due to rapid IV administration of oxytetracycline (OTC) be prevented?

<p>Pre-treatment with calcium borogluconate IV (B)</p> Signup and view all the answers

What severe adverse effect has been observed when doxycycline (DXC) is administered intravenously to horses?

<p>Tachycardia, systemic arterial hypertension, collapse, and death (C)</p> Signup and view all the answers

What musculoskeletal adverse effect can occur following intramuscular (IM) injection of long-acting oxytetracycline (OTC) formulations?

<p>Localized pain and swelling at the injection site (A)</p> Signup and view all the answers

Which species is especially susceptible to drug fever from tetracyclines?

<p>Cats (C)</p> Signup and view all the answers

What precaution should be taken when administering doxycycline (DXC) tablets or capsules to small animals?

<p>They should be followed with water to prevent esophageal erosion and stricture formation (A)</p> Signup and view all the answers

Why do tetracyclines cause discoloration of teeth and inhibit bone growth in young animals?

<p>They bind to calcium in developing teeth and bones (B)</p> Signup and view all the answers

Which tetracycline is least likely to cause tooth discoloration in young animals?

<p>Doxycycline (DXC) (C)</p> Signup and view all the answers

Word bank (aerobe; anaerobe): Most ___________ are susceptible to doxycycline

<p>Anaerobes</p> Signup and view all the answers

What is a primary mechanism of acquired tetracycline resistance in bacteria?

<p>Plasmid-mediated mechanisms such as increased drug efflux and ribosomal protection proteins (B)</p> Signup and view all the answers

What are the resistant mechanisms of tetracycline?

<p>Decreased influx or acquisition of efflux, ribosomal protection, and enzymatic inactivation</p> Signup and view all the answers

Areobes and facultative anaerobes usually are susceptible to tetracyclines

<p>True (A)</p> Signup and view all the answers

Gram positive intracellular bacteria (e.g. Listeria monocytogenes) are resistant to tetracyclines

<p>False (B)</p> Signup and view all the answers

Which of the following bacterial groups are usually susceptible to tetracyclines?

<p>Gram-negative and positive aerobes and facultative anaerobes (B)</p> Signup and view all the answers

Resistance to tetracyclines is common among which group of bacteria?

<p>Enterobacteriales (E. coli, Klebsiella, Proteus) and Pseudomonas (B)</p> Signup and view all the answers

Which of the following intracellular bacteria are typically susceptible to tetracyclines, with only a few recent reports of resistance?

<p>Anaplasma, Ehrlichia, Neorickettsia, Rickettsia, Lawsonia, and Chlamydia</p> Signup and view all the answers

Which bacterial genus is commonly susceptible to tetracyclines?

<p>Mycoplasma (A)</p> Signup and view all the answers

Which tetracyclines are available as oral veterinary formulations for use in food animals?

<p>Oxytetracycline (OTC), tetracycline (TTC), and chlortetracycline (CTC) (B)</p> Signup and view all the answers

Which tetracycline is available as human oral capsules and tablets, as well as an injectable IV solution?

<p>Doxycycline (DXC) (B)</p> Signup and view all the answers

Injectable oxytetracycline (OTC) products are formulated as:

<p>Both short- and long-acting products (C)</p> Signup and view all the answers

Tetracyclines can be found in which specialized ophthalmic formulation?

<p>Ophthalmic ointment combined with other antibacterials (B)</p> Signup and view all the answers

Veterinary feed additives are also labeled with tetracyclines

<p>True (A)</p> Signup and view all the answers

In small animals, tetracyclines are the drug of choice for treating which of the following diseases?

<p>Tick-borne diseases such as ehrlichiosis and anaplasmosis (A)</p> Signup and view all the answers

In cats, tetracyclines are primarily used for treating which infections?

<p>Feline infectious anemia (Mycoplasma haemofelis) and Chlamydophila felis (B)</p> Signup and view all the answers

Which form of doxycycline (DXC) is recommended for periodontal disease treatment in dogs?

<p>Doxirobe™ Gel (B)</p> Signup and view all the answers

Which of the following is NOT an indication for oral doxycycline as a first-line treatment?

<p>Viral pneumonia (D)</p> Signup and view all the answers

In equines, tetracyclines are the drug of choice for which of the following diseases?

<p>Potomac Horse Fever (Neorickettsia risticii) (A), Anaplasma phagocytophilum (B), Rickettsial diseases (C), Equine proliferative enteropathy Lawsonia intracellularis (D)</p> Signup and view all the answers

Which tetracycline is commonly used for treating the equine diseases (rickettsial, Potomac Horse Fever, Anaplasma phagocytophilum, equine proliferative enteropathy laswonia)?

<p>Oxytetracycline (C), Doxycycline (D)</p> Signup and view all the answers

In ruminants, oxytetracycline (OTC) is used to treat all of the following:

<p>Respiratory diseases, foot rot, mastitis, anaplasmosis, and listeriosis</p> Signup and view all the answers

In pigs, tetracyclines are used to treat infections caused by which pathogens?

<p>Pasteurella multocida and Mycoplasma species (A)</p> Signup and view all the answers

Tetracyclines are considered the drug of choice for treating which disease in pet birds?

<p>Psittacosis (Chlamydia psittaci) (B)</p> Signup and view all the answers

Which of the following is a non-antibacterial use of oxytetracycline (OTC)?

<p>Inducing flexor tendon relaxation in foals and calves (A)</p> Signup and view all the answers

Flashcards

Not a tetracycline

Lincomycin

Tetracycline spectrum

Broad spectrum

Liposolubility variations

Their amphoteric nature

UV light effect

They degrade due to photosensitivity

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Multivalent cation effect

They form insoluble complexes and reduce absorption

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Tetracycline Oral Bioavailability

False

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Tetracycline administration route

Subcutaneous (SC) and Intramuscular (IM)

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Amphoteric

The drug is capable of acting as acids or bases

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Why IV causes tetracycline long-acting effect loss

The drug is rapidly cleared from circulation without delayed absorption

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Tetracycline pharmacokinetic behavior

Large volume of distribution (Vd) and enterohepatic circulation

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Tetracycline Distribution

Milk, synovial fluid, peritoneal fluid, and endometrial tissues

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Tetracycline elimination

Urine, glomerular filtration

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Renal impairment on tetracycline elimination

It increases elimination half-life

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Why does doxycycline not accumulate?

It is excreted in an inactive form via feces

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Doxycycline is highly protein bound

True

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Chelate

Chelate means to be able to bind to divalent cations, such as calcium (calcium containing products) and magnesium

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Consequence of chelation

It interferes with gastrointestinal absorption

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Tetracycline MOA

30s ribosomal subunit

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Tetracycline action

Bacteriostatic, bactericidal

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Tetracycline classification

Co-dependent (both time- and concentration-dependent)

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Tetracycline activity

Acidic (pH <7)

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Why oral tetracycline is not recommended in equids

It has poor absorption and disrupts gastrointestinal flora

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Less GI effects

Doxycycline (DXC)

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Nephrotoxicity factors

High doses, outdated parenteral products, endotoxemia, dehydration, and hypovolemia

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Type of nephrotoxicity

Renal tubular necrosis

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