Mosby's 2014 Nursing Drug Reference (271 page)
Read Mosby's 2014 Nursing Drug Reference Online
Authors: Linda Skidmore-Roth
Canada only Side effects:
italics
= common;
bold
= life-threatening 
Nurse Alert
(min-oh-sye′kleen)
Arestin, Dynacin, Minocin, Solodyn
Func. class.:
Broad-spectrum antiinfective
Chem. class.:
Tetracycline
Inhibits protein synthesis, phosphorylation in microorganisms by binding to ribosomal subunits, reversibly binding to ribosomal subunits; bacteriostatic
Syphilis,
Chlamydia trachomatis
, gonorrhea, lymphogranuloma venereum, rickettsial infections, inflammatory acne,
Neisseria meningitidis, Neisseria gonorrhoeae, Treponema pallidum, Chlamydia trachomatis, Ureaplasma urealyticum, Mycoplasma pneumoniae, Nocardia
, periodontitis, methicillin-resistant
S. aureus
(MRSA) infection, nonnodular moderate to severe acne vulgaris,
Rickettsia
sp.
Unlabeled uses:
Rheumatoid arthritis, bullous pemphigoid, dental infection, prostatis, pleural effusion
Pregnancy (D), children <8 yr, hypersensitivity to tetracyclines
Precautions:
Hepatic disease, breastfeeding
Calculator
• Adult:
PO/IV
200 mg then 100 mg q12hr, max 400 mg/24 hr
IV; SUBGINGIVAL
inserted into periodontal pocket
• Child >8 yr:
PO/IV
4 mg/kg then 4 mg/kg/day
PO
in divided doses q12hr
• Adult:
PO/IV
200 mg, then 100 mg q12hr
• Child ≥8 yr/adolescent:
PO/IV
4 mg/kg, then 2 mg/kg q12hr, max adult dose
• Adult:
PO
200 mg then 100 mg q12hr × ≥4 days
• Adult:
PO
100 mg bid × 7 days
• Adult:
PO
200 mg then 100 mg q12hr × 10-15 days
• Adult:
PO
100 mg q12hr × 5 days
• Adult/adolescent/child ≥12 yr:
ext rel 1 mg/kg/day × 12 wk or those weighing 126-136 kg—135 mg/day; 111-125 kg—115 mg/day; 97-110 kg—105 mg/day; 85-96 kg—90 mg/day; 72-84 kg—80 mg/day; 60-71 kg—65 mg/day; 50-59 kg—55 mg/day; 45-49 kg—45 mg/day
• Adult/adolescent/child ≥12 yr:
ext rel 1 mg/kg × 12 wk or 91-136 kg, 135 mg/day; 60-90 kg, 90 mg/day; 45-59 kg, 45 mg/day
• Adult:
PO
100 mg bid for ≤48 wk
• Adult:
PO
50 mg/day; may increase to 100 mg/day after 1-2 wk
Available forms:
Caps 50, 75, 100 mg; powder for inj 100 mg; caps, pellet filled 50, 100 mg; tabs 50, 75, 100 mg; ext rel tabs 45, 55, 65, 80, 90, 105, 115, 135 mg
•
After C&S obtained
•
With full glass of water; with food for GI symptoms
•
2 hr before or after laxative or ferrous products; 3 hr after antacid
•
After diluting 100 mg/5 ml sterile water for inj; further dilute in 500-1000 ml of NaCl, dextrose sol, LR, Ringer’s sol; run 100 mg/6 hr
Y-site compatibilities:
Alfentanil, amikacin, atracurium, benztropine, buprenorphine, butorphanol, calcium chloride, CARBOplatin, caspofungin, cefonicid, chlorpromazine, cimetidine, cisatracurium, codeine, cyclophosphamide, cycloSPORINE, cytarabine, DACTINomycin, dexmedetomidine, diltiazem, diphenhydrAMINE, DOBUTamine, DOCEtaxel, doxacurium, doxycycline, enalaprilat, ePHEDrine, EPINEPHrine, eptifibatide, etoposide, fenoldopam, fentaNYL, filgrastim, fludarabine, gatafloxacin, gemcitabine, gentamicin, glycopyrrolate, granisetron, heparin, hetastarch, IDArubicin, ifosfamide, inamrinone, isoproterenol, labetalol, levofloxacin, lidocaine, linezolid, LORazepam, magnesium sulfate, mannitol, melphalan, metaraminol, methotrexate, methyldopa, metoclopramide, metoprolol, midazolam, mitoXANtrone, nalbuphine, naloxone, perphenazine, potassium chloride, remifentanil, sargramostim, teniposide, vinorelbine, vit B/C
CNS:
Dizziness
, fever, lightheadedness, vertigo,
seizures, increased intracranial pressure
CV:
Pericarditis
EENT:
Dysphagia, glossitis, decreased calcification of deciduous teeth, permanent discoloration of teeth, oral candidiasis
GI:
Nausea
, abdominal pain,
vomiting, diarrhea
, anorexia, enterocolitis,
hepatotoxicity,
flatulence, abdominal cramps, epigastric burning, stomatitis,
pseudomembranous colitis
GU:
Increased BUN
, polyuria, polydipsia,
renal failure, nephrotoxicity
HEMA:
Eosinophilia, neutropenia, thrombocytopenia, hemolytic anemia, pancytopenia
INTEG:
Rash, urticaria, photosensitivity, increased pigmentation
,
exfoliative dermatitis,
pruritus, blue-gray color of skin, mucous membranes
MS:
Myalgia, arthritis, bone discoloration, joint stiffness
SYST:
Angioedema, Stevens-Johnson syndrome
PO:
Peak 1-4 hr, half-life 11-22 hr; excreted in urine, feces, breast milk; crosses placenta; 70%-75% protein bound
Increase:
effect of warfarin, digoxin, insulin, oral anticoagulants, theophylline, neuromuscular blockers
Increase:
chance of pseudomotor cerebri—retinoids; do not use concurrently
Decrease:
effect of minocycline—antacids, sodium bicarbonate, alkali prod-ucts, iron, kaolin/pectin, cimetidine, quinapril, sucralfate
Decrease:
effect of barbiturates, carBAMazepine, phenytoin, penicillins, oral contraceptives, calcium
False negative:
urine glucose with Clinistix or Tes-Tape
Pseudomembranous colitis:
diarrhea, abdominal cramps, fever; may start up to 2 mo after treatment ends
•
I&O ratio
•
Age and tooth development
•
Blood tests: PT, CBC, AST, ALT, BUN, creatinine
•
Signs of anemia: Hct, Hgb, fatigue
Allergic reactions:
rash, itching, pruritus, angioedema
•
Nausea, vomiting, diarrhea; administer antiemetic, antacids as ordered
Overgrowth of infection:
fever, malaise, redness, pain, swelling, drainage, perineal itching, diarrhea; changes in cough or sputum; black, furry tongue
•
Storage in airtight, light-resistant container at room temp
•
Therapeutic response: decreased temp, absence of lesions, negative C&S
•
To avoid sunlight, wear protective clothing; sunscreen does not seem to decrease photosensitivity
•
That all prescribed medication must be taken to prevent superinfection; not to use outdated product because Fanconi’s syndrome may occur
•
To avoid taking antacids, iron, cimetidine; use 2 hr before, 6 hr after this product; absorption may be decreased
•
That teeth discoloration, joint or muscle pain may occur
Canada only Side effects:
italics
= common;
bold
= life-threatening Nurse Alert