{"id":120,"date":"2019-09-22T17:53:46","date_gmt":"2019-09-22T17:53:46","guid":{"rendered":"https:\/\/pressbooks.publishdot.com\/nursingpharmacology\/chapter\/3-13-tetracyclines\/"},"modified":"2021-12-07T11:06:24","modified_gmt":"2021-12-07T11:06:24","slug":"3-13-tetracyclines","status":"publish","type":"chapter","link":"https:\/\/pressbooks.publishdot.com\/nursingpharmacology\/chapter\/3-13-tetracyclines\/","title":{"raw":"3.13 Tetracyclines","rendered":"3.13 Tetracyclines"},"content":{"raw":"Tetracyclines are broad-spectrum antibiotics that are bacteriostatic, subsequently inhibiting bacterial growth.\n\nIndications:<\/strong> Tetracycline medications are useful for the treatment of many gram-positive and gram-negative infectious processes, yet are limited due to the significance of side effects experienced by many patients.\n\nMechanism of Action:<\/strong> Tetracyclines work by penetrating the bacterial cell wall and binding to the 30S ribosome, inhibiting the protein synthesis required to make the cellular wall.[footnote]This work is a derivative of Microbiology<\/a> by OpenStax<\/a> licensed under CC BY 4.0<\/a>. Access for free at https:\/\/openstax.org\/books\/microbiology\/pages\/1-introduction<\/a>[\/footnote]<\/sup>\n\nSpecial Administration Considerations:<\/strong> Significant side effects of tetracycline drug therapy include photosensitivity, discoloration of developing teeth and enamel hypoplasia, and renal and liver impairment.[footnote]This work is a derivative of Microbiology<\/a> by OpenStax<\/a> licensed under CC BY 4.0<\/a>. Access for free at https:\/\/openstax.org\/books\/microbiology\/pages\/1-introduction<\/a>[\/footnote]<\/sup> Tetracyclines are contraindicated in pregnancy and for children ages 8 and under. Small amounts may be excreted in breast milk.\n\nPatient Teaching & Education<\/strong>: Patients should be instructed to avoid direct sunlight exposure and wear sunscreen to prevent skin sensitivities. Additionally, it is important for patients to be educated regarding potential impaired absorption of tetracycline with the use of dairy products.\u00a0 Patients who are on oral contraceptives should be educated that tetracyclines may impede the effectiveness of the oral contraceptive and an alternative measure of birth control should be utilized while on the antibiotic. Female patients must be aware to immediately stop tetracycline if they become pregnant.\u00a0 Expired tetracycline should be immediately disposed of as it can become toxic.[footnote]uCentral from Unbound Medicine. https:\/\/www.unboundmedicine.com\/ucentral<\/a>[\/footnote]<\/sup>\n\nNow let's take a closer look at the medication grid for tetracycline in Table 3.13.[footnote]Daily Med, https:\/\/dailymed.nlm.nih.gov\/dailymed\/index.cfm<\/a>, used for hyperlinked medications in this module. Retrieved June 27, 2019[\/footnote]<\/sup>\n\nTable 3.13 Tetracycline Medication Grid\n\n\n\n\n
\n
Class\/Subclass<\/strong><\/h5>\n<\/th>\n
\n
Prototype\/Generic<\/strong><\/h5>\n<\/th>\n
\n
Administration Considerations<\/strong><\/h5>\n<\/th>\n
\n
Therapeutic Effects<\/strong><\/h5>\n<\/th>\n
\n
Side\/Adverse Effects<\/strong><\/h5>\n<\/th>\n<\/tr>\n
Tetracyclines<\/th>\ntetracycline<\/a><\/td>\nCheck allergies\n\nAlert: Check expiration date. Using outdated or deteriorated drug has been linked to severe reversible nephrotoxicity (Fanconi syndrome)\n\nEffectiveness is reduced when drug is given with milk or other dairy products, antacids, or iron products\n\nFor best drug absorption, give drug with a full glass of water on an empty stomach at least 1 hour before or 2 hours after meals\n\nGive drug at least 1 hour before bedtime to prevent esophageal irritation or ulceration\n\nUse caution with renal or hepatic impairment\n\nAvoid using in children younger than age 8 because drug may cause permanent discoloration of teeth, enamel defects, and bone growth retardation\n\nAvoid in pregnancy due to toxic effects on the developing fetus (often related to retardation of skeletal development and teeth)<\/td>\nMonitor for systemic signs of infection:\n\n-WBCs\n\n- Fever\n\nMonitor actual site of infection<\/td>\nGastrointestinal symptoms\n\nC-diff\n\nPhotosensitivity\n\nOral candidiasis\n\nPermanent teeth discoloration if given to patients < 8 y.o.\n\nIntracranial hypertension: Monitor for headache, blurred vision, diplopia, and vision loss\n\nDecreased effectiveness of oral contraceptives<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n \n

Critical Thinking Activity 3.13a<\/strong><\/h2>\nUsing the above grid information, consider the following clinical scenario question:<\/strong>\n\nThe nurse is providing medication teaching to a parent of a six-year-old child with strep throat in a clinic setting.\u00a0 Due to multiple drug allergies, tetracycline was prescribed by a doctor who is new to the clinic. What is the nurse's best response and why?\n\nNote: Answers to the Critical Thinking activities can be found in the \"Answer Key\" sections at the end of the book.","rendered":"

Tetracyclines are broad-spectrum antibiotics that are bacteriostatic, subsequently inhibiting bacterial growth.<\/p>\n

Indications:<\/strong> Tetracycline medications are useful for the treatment of many gram-positive and gram-negative infectious processes, yet are limited due to the significance of side effects experienced by many patients.<\/p>\n

Mechanism of Action:<\/strong> Tetracyclines work by penetrating the bacterial cell wall and binding to the 30S ribosome, inhibiting the protein synthesis required to make the cellular wall.[1]<\/sup><\/a><\/sup><\/p>\n

Special Administration Considerations:<\/strong> Significant side effects of tetracycline drug therapy include photosensitivity, discoloration of developing teeth and enamel hypoplasia, and renal and liver impairment.[2]<\/sup><\/a><\/sup> Tetracyclines are contraindicated in pregnancy and for children ages 8 and under. Small amounts may be excreted in breast milk.<\/p>\n

Patient Teaching & Education<\/strong>: Patients should be instructed to avoid direct sunlight exposure and wear sunscreen to prevent skin sensitivities. Additionally, it is important for patients to be educated regarding potential impaired absorption of tetracycline with the use of dairy products.\u00a0 Patients who are on oral contraceptives should be educated that tetracyclines may impede the effectiveness of the oral contraceptive and an alternative measure of birth control should be utilized while on the antibiotic. Female patients must be aware to immediately stop tetracycline if they become pregnant.\u00a0 Expired tetracycline should be immediately disposed of as it can become toxic.[3]<\/sup><\/a><\/sup><\/p>\n

Now let’s take a closer look at the medication grid for tetracycline in Table 3.13.[4]<\/sup><\/a><\/sup><\/p>\n

Table 3.13 Tetracycline Medication Grid<\/p>\n\n\n\n\n
\n
Class\/Subclass<\/strong><\/h5>\n<\/th>\n
\n
Prototype\/Generic<\/strong><\/h5>\n<\/th>\n
\n
Administration Considerations<\/strong><\/h5>\n<\/th>\n
\n
Therapeutic Effects<\/strong><\/h5>\n<\/th>\n
\n
Side\/Adverse Effects<\/strong><\/h5>\n<\/th>\n<\/tr>\n
Tetracyclines<\/th>\ntetracycline<\/a><\/td>\nCheck allergies<\/p>\n

Alert: Check expiration date. Using outdated or deteriorated drug has been linked to severe reversible nephrotoxicity (Fanconi syndrome)<\/p>\n

Effectiveness is reduced when drug is given with milk or other dairy products, antacids, or iron products<\/p>\n

For best drug absorption, give drug with a full glass of water on an empty stomach at least 1 hour before or 2 hours after meals<\/p>\n

Give drug at least 1 hour before bedtime to prevent esophageal irritation or ulceration<\/p>\n

Use caution with renal or hepatic impairment<\/p>\n

Avoid using in children younger than age 8 because drug may cause permanent discoloration of teeth, enamel defects, and bone growth retardation<\/p>\n

Avoid in pregnancy due to toxic effects on the developing fetus (often related to retardation of skeletal development and teeth)<\/td>\n

Monitor for systemic signs of infection:<\/p>\n

-WBCs<\/p>\n

– Fever<\/p>\n

Monitor actual site of infection<\/td>\n

Gastrointestinal symptoms<\/p>\n

C-diff<\/p>\n

Photosensitivity<\/p>\n

Oral candidiasis<\/p>\n

Permanent teeth discoloration if given to patients < 8 y.o.<\/p>\n

Intracranial hypertension: Monitor for headache, blurred vision, diplopia, and vision loss<\/p>\n

Decreased effectiveness of oral contraceptives<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

 <\/p>\n

Critical Thinking Activity 3.13a<\/strong><\/h2>\n

Using the above grid information, consider the following clinical scenario question:<\/strong><\/p>\n

The nurse is providing medication teaching to a parent of a six-year-old child with strep throat in a clinic setting.\u00a0 Due to multiple drug allergies, tetracycline was prescribed by a doctor who is new to the clinic. What is the nurse’s best response and why?<\/p>\n

Note: Answers to the Critical Thinking activities can be found in the “Answer Key” sections at the end of the book.<\/p>\n

  1. This work is a derivative of Microbiology<\/a> by OpenStax<\/a> licensed under CC BY 4.0<\/a>. Access for free at https:\/\/openstax.org\/books\/microbiology\/pages\/1-introduction<\/a> ↵<\/a><\/li>
  2. This work is a derivative of Microbiology<\/a> by OpenStax<\/a> licensed under CC BY 4.0<\/a>. Access for free at https:\/\/openstax.org\/books\/microbiology\/pages\/1-introduction<\/a> ↵<\/a><\/li>
  3. uCentral from Unbound Medicine. https:\/\/www.unboundmedicine.com\/ucentral<\/a> ↵<\/a><\/li>
  4. Daily Med, https:\/\/dailymed.nlm.nih.gov\/dailymed\/index.cfm<\/a>, used for hyperlinked medications in this module. Retrieved June 27, 2019 ↵<\/a><\/li><\/ol><\/div>","protected":false},"author":2,"menu_order":13,"template":"","meta":{"pb_show_title":"on","pb_short_title":"","pb_subtitle":"","pb_authors":[],"pb_section_license":"cc-by"},"chapter-type":[49],"contributor":[],"license":[53],"class_list":["post-120","chapter","type-chapter","status-publish","hentry","chapter-type-numberless","license-cc-by"],"part":84,"_links":{"self":[{"href":"https:\/\/pressbooks.publishdot.com\/nursingpharmacology\/wp-json\/pressbooks\/v2\/chapters\/120","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/pressbooks.publishdot.com\/nursingpharmacology\/wp-json\/pressbooks\/v2\/chapters"}],"about":[{"href":"https:\/\/pressbooks.publishdot.com\/nursingpharmacology\/wp-json\/wp\/v2\/types\/chapter"}],"author":[{"embeddable":true,"href":"https:\/\/pressbooks.publishdot.com\/nursingpharmacology\/wp-json\/wp\/v2\/users\/2"}],"version-history":[{"count":1,"href":"https:\/\/pressbooks.publishdot.com\/nursingpharmacology\/wp-json\/pressbooks\/v2\/chapters\/120\/revisions"}],"predecessor-version":[{"id":121,"href":"https:\/\/pressbooks.publishdot.com\/nursingpharmacology\/wp-json\/pressbooks\/v2\/chapters\/120\/revisions\/121"}],"part":[{"href":"https:\/\/pressbooks.publishdot.com\/nursingpharmacology\/wp-json\/pressbooks\/v2\/parts\/84"}],"metadata":[{"href":"https:\/\/pressbooks.publishdot.com\/nursingpharmacology\/wp-json\/pressbooks\/v2\/chapters\/120\/metadata\/"}],"wp:attachment":[{"href":"https:\/\/pressbooks.publishdot.com\/nursingpharmacology\/wp-json\/wp\/v2\/media?parent=120"}],"wp:term":[{"taxonomy":"chapter-type","embeddable":true,"href":"https:\/\/pressbooks.publishdot.com\/nursingpharmacology\/wp-json\/pressbooks\/v2\/chapter-type?post=120"},{"taxonomy":"contributor","embeddable":true,"href":"https:\/\/pressbooks.publishdot.com\/nursingpharmacology\/wp-json\/wp\/v2\/contributor?post=120"},{"taxonomy":"license","embeddable":true,"href":"https:\/\/pressbooks.publishdot.com\/nursingpharmacology\/wp-json\/wp\/v2\/license?post=120"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}