Mosby's 2014 Nursing Drug Reference (389 page)
Read Mosby's 2014 Nursing Drug Reference Online
Authors: Linda Skidmore-Roth
See
Appendix B
See
Appendix B
(tet-ra-sye′kleen)
Apo-Tetra
, Nu-Tetra
Func. class.:
Broad-spectrum antiinfective
Chem. class.:
Tetracycline
Inhibits protein synthesis and phosphorylation in microorganisms; bacteriostatic
Syphilis,
Chlamydia trachomatis
, gonorrhea, lymphogranuloma venereum; uncommon gram-positive, gram-negative organisms; rickettsial infections
Pregnancy (D), breastfeeding, children <8 yr, hypersensitivity to tetracyclines
Precautions:
Renal/hepatic disease, UV exposure
Calculator
• Adult:
PO
250-500 mg q6hr
• Child >8 yr:
PO
25-50 mg/kg/day in divided doses q6hr
• Adult:
PO
500 mg qid × 7 days
• Adult and adolescent:
PO
500 mg qid × 2 wk; if syphilis duration >1 yr, must treat 30 days
• Adult:
PO
500 mg q6hr × 3 wk with
IM
1 g streptomycin bid × 1st wk then daily × 2nd wk
(C. trachomatis)
• Adult:
PO
500 mg qid × 7 days
• Adult and adolescent:
PO
250 mg q6hr then 125-500 mg/day or every other day
• Adult:
PO
CCr 51-90 ml/min, give dose q8-12hr; CCr 10-50 ml/min, give dose q12-24hr; CCr <10 ml/min, give dose q24hr
Available forms:
Caps 250, 500 mg
•
After C&S obtained
•
2 hr before or after iron products; 1 hr after antacid products
•
Should be given on empty stomach (1 hr before or 2 hr after meals)
CNS:
Fever, headache, paresthesia
CV:
Pericarditis
EENT:
Dysphagia, glossitis, decreased calcification, discoloration of deciduous teeth, oral candidiasis, oral ulcers
GI:
Nausea
, abdominal pain,
vomiting, diarrhea
, anorexia, enterocolitis,
hepatotoxicity,
flatulence, abdominal cramps, epigastric burning, stomatitis,
hepatitis, pseudomembranous colitis
GU:
Increased BUN
,
azotemia, acute renal failure
HEMA:
Eosinophilia, neutropenia, thrombocytopenia, leukocytosis, hemolytic anemia
INTEG:
Rash, urticaria, photosensitivity, increased pigmentation
,
exfoliative dermatitis,
pruritus,
angioedema, Stevens-Johnson syndrome
MISC:
Increased intracranial pressure, candidiasis
PO:
Peak 2-3 hr; duration 6 hr; half-life 6-12 hr; excreted in urine, breast milk; crosses placenta; 65% protein bound
Fatal nephrotoxicity: methoxyflurane
Increase:
effect of warfarin, digoxin
Decrease:
effect of tetracycline—antacids, sodium bicarbonate, alkali products, iron, cimetidine
Decrease:
effect of penicillins
•
Photosensitivity: dong quai
Decrease:
tetracycline effect—dairy products
Increase:
BUN, LFTs
Pseudomembranous colitis:
diarrhea, abdominal pain, fever, fatigue, anorexia; possible anemia, elevated WBC count, low serum albumin; stop product; usually either vancomycin or IV metroNIDAZOLE is given
•
Signs of anemia: Hct, Hgb, fatigue
•
I&O ratio
•
Blood studies: PT, CBC, AST, ALT, BUN, creatinine if on prolonged therapy
•
Allergic reactions:
rash, itching, pruritus
•
Serious skin reactions:
angioedema, Stevens-Johnson syndrome, exfoliative dermatitis; report immediately after stopping product
•
Nausea, vomiting, diarrhea; administer antiemetic, antacids as ordered
Superinfection:
fever, malaise, redness, pain, swelling, drainage, perineal itching, diarrhea, changes in cough or sputum if on prolonged therapy
•
Storage in tight, light-resistant container at room temp
•
Therapeutic response: absence of lesions, negative C&S, resolution of infection, prevention of malaria
•
To avoid sun exposure; that sunscreen does not seem to decrease photosensitivity
•
That all prescribed medication must be taken to prevent superinfection
•
To avoid milk products, antacids or to separate by 2 hr; to take with full glass of water, to take 1 hr before bedtime to prevent esophageal ulceration
•
That tooth discoloration may occur
•
To notify prescriber immediately of diarrhea with pus, mucous, fever, abdominal pain
To notify prescriber if pregnancy is planned or suspected, pregnancy (D)
•
Not to use outdated products, Fanconi syndrome (nephrotoxicity) may occur
Canada only Side effects:
italics
= common;
bold
= life-threatening Nurse Alert