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Questions and Answers
A 26-year-old female, who is 8 weeks pregnant, presents with a community-acquired pneumonia. Considering the patient's condition and the need for a broad-spectrum antibiotic, which of the following antibiotics should be avoided due to potential harm to the fetus?
A 26-year-old female, who is 8 weeks pregnant, presents with a community-acquired pneumonia. Considering the patient's condition and the need for a broad-spectrum antibiotic, which of the following antibiotics should be avoided due to potential harm to the fetus?
- Doxycycline (correct)
- Azithromycin
- Amoxicillin
- Ceftriaxone
A patient is prescribed tetracycline as part of a four-drug regimen for Helicobacter pylori eradication. Which of the following instructions should the patient receive to maximize the absorption of tetracycline?
A patient is prescribed tetracycline as part of a four-drug regimen for Helicobacter pylori eradication. Which of the following instructions should the patient receive to maximize the absorption of tetracycline?
- Take the medication with an iron supplement to prevent anemia.
- Take the medication on an empty stomach, at least 1 hour before or 2 hours after consuming dairy products or antacids. (correct)
- Take the medication with a glass of milk to prevent gastric irritation.
- Take the medication with an antacid to reduce stomach acidity.
A 68-year-old patient with a history of chronic kidney disease is diagnosed with a Chlamydia pneumoniae infection. Which tetracycline antibiotic would be most appropriate, considering the patient's renal impairment?
A 68-year-old patient with a history of chronic kidney disease is diagnosed with a Chlamydia pneumoniae infection. Which tetracycline antibiotic would be most appropriate, considering the patient's renal impairment?
- Doxycycline (correct)
- Minocycline
- Tetracycline
- Demeclocycline
A patient taking warfarin for chronic atrial fibrillation is newly prescribed tetracycline for a respiratory infection. What is the most important counseling point to ensure patient safety?
A patient taking warfarin for chronic atrial fibrillation is newly prescribed tetracycline for a respiratory infection. What is the most important counseling point to ensure patient safety?
A young adult is diagnosed with SIADH. Which tetracycline is indicated for the treatment of this condition?
A young adult is diagnosed with SIADH. Which tetracycline is indicated for the treatment of this condition?
Flashcards
Tetracyclines Mechanism
Tetracyclines Mechanism
Inhibits peptide elongation by blocking tRNA binding to the A site, thus stopping protein synthesis. Bacteriostatic.
Tetracyclines Spectrum
Tetracyclines Spectrum
Gram positives, gram negatives, atypical organisms (Chlamydia, Legionella, Mycoplasma). Doxycycline treats MRSA and Lyme. Demeclocycline treats SIADH. Tetracycline for H. pylori.
Tetracyclines Contraindications
Tetracyclines Contraindications
Children under 8, pregnancy/breastfeeding (teeth discoloration/bone growth issues). Expired drugs cause Fanconi syndrome. Adjust dose (except doxycycline) in renal impairment.
Tetracyclines Resistance
Tetracyclines Resistance
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Tetracyclines Side Effects
Tetracyclines Side Effects
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Study Notes
Tetracyclines
- Specific antibiotics in this class include doxycycline, tetracycline, minocycline, and demeclocycline.
- Tetracyclines inhibit bacterial protein synthesis.
- They achieve this by blocking tRNA from binding to the A site, which prevents peptide elongation.
- This mechanism makes them bacteriostatic.
Spectrum of Activity
- Effective against gram-positive bacteria, especially Streptococcus and MSSA.
- Effective against gram-negative bacteria like H. influenzae.
- Effective against atypical organisms such as Chlamydia pneumoniae, Legionella, and Mycoplasma pneumoniae.
- Doxycycline is effective against community-acquired MRSA.
- Doxycycline is the drug of choice for Lyme disease.
- Demeclocycline is used to treat Syndrome of Inappropriate Antidiuretic Hormone Secretion (SIADH).
- Tetracycline can be used in a four-drug regimen for H. pylori.
- Effective against Rickettsia.
Contraindications
- Should not be used in children under 8 years old.
- Contraindicated in pregnant and breastfeeding women.
- May cause permanent teeth discoloration and impaired bone/teeth growth.
- Use after the expiration date can cause Fanconi syndrome.
- Dosage adjustment is necessary for all tetracyclines, except doxycycline, in cases of renal impairment.
Resistance
- Resistance occurs through active drug efflux or decreased uptake.
Side Effects
- Photosensitivity.
- Intracranial hypertension (pseudotumor cerebri).
- Hepatitis.
- Pill esophagitis.
- Gray teeth and inhibition of bone growth in the fetus if taken during pregnancy.
Interactions
- Absorption decreases with antacids and dairy products containing iron, magnesium, aluminum, calcium, or zinc.
- May increase the risk of bleeding when taken with warfarin.
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