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Pharmacologic class:乐动体育开户 Tetracycline
Therapeutic class: Anti-infective
Pregnancy risk category D
Unclear. Thought to inhibit bacterial protein synthesis at 30S and 50S ribosomal subunit and to alter cytoplasmic membrane of susceptible organisms.
Capsules: 50 mg, 100 mg, 150 mg
Capsules (coated pellets): 40 mg, 75 mg, 100 mg
Powder for injection: 100 mg, 200 mg
Powder for oral suspension:乐动体育开户 25 mg/5 ml
Syrup: 50 mg
Tablets: 20 mg, 50 mg, 75 mg, 100 mg
Indications and dosages
Adults: 40 mg P.O. daily in the morning
➣ Infections caused by various organisms, including Mycoplasma, Chlamydia, and Rickettsia organisms, and Borrelia burgdorfer
Adults and children weighing more than 45 kg (99 lb): 100 mg P.O. q 12 hours on first day, followed by 100 to 200 mg P.O. once daily; or 50 to 100 mg P.O. q 12 hours; or 200 mg I.V. once daily; or 100 mg I.V. q 12 hours on first day, followed by 100 to 200 mg I.V. once daily; or 50 to 100 mg I.V. q 12 hours
Children weighing 45 kg (99 lb) or less:乐动体育开户 2.2 mg/kg P.O. q 12 hours on first day, followed by 2.2 to 4.4 mg/kg/day P.O. once daily; or 1.1 to 2.2 mg/kg P.O. q 12 hours; or 4.4 mg/kg I.V. once daily; or 2.2 mg/kg I.V. q 12 hours on first day, followed by 2.2 to 4.4 mg/kg I.V. once daily; or 1.1 to 2.2 mg/kg I.V. q 12 hours
➣乐动体育开户 Gonorrhea in penicillin-allergic patients
Adults and children weighing more than 45 kg (99 lb):乐动体育开户 100 mg P.O. q 12 hours for 7 days; or 300 mg P.O. initially, followed by another 300 mg P.O. 1 hour later
➣ Lyme disease
Adults and children weighing more than 45 kg (99 lb):乐动体育开户 100 mg P.O. b.i.d. for 10 to 30 days
Adults and children weighing more than 45 kg (99 lb): 20 mg P.O. b.i.d. for up to 9 months
Adults and children weighing more than 45 kg (99 lb):乐动体育开户 100 mg P.O. b.i.d. for 60 days; or 100 mg I.V. q 12 hours for 60 days, changing to oral route when appropriate
Children weighing 45 kg (99 lb) or less:乐动体育开户 2.2 mg/kg P.O. b.i.d. for 60 days; or 100 mg I.V. q 12 hours for 60 days, changing to oral route when appropriate
➣ Prevention of malaria caused by Plasmodium falciparum in short-term travelers (less than 4 months)
Adults:乐动体育开户 100 mg/day P.O. starting 1 to 2 days before travel begins and continuing during and for 4 weeks after travel
Children:乐动体育开户 2 mg/kg/day P.O., up to adult dosage of 100 mg/day, starting 1 to 2 days before travel begins and continuing during and for 4 weeks after travel
• Traveler's diarrhea
• Pleural effusion
• Hypersensitivity to drug, other tetracyclines, or bisulfites (with some drug products)
Use cautiously in:
• renal disease, hepatic impairment, nephrogenic diabetes insipidus, cachexia
• pregnant or breastfeeding patients
乐动体育开户• children younger than age 8.
• Obtain specimens for culture and sensitivity testing, as ordered, before first dose.
☞ Don't give in conjunction with methoxyflurane anesthetic. Severe or fatal kidney damage may result.
• Reconstitute powder for injection with dextrose 5% in water, normal saline solution, lactated Ringer's solution, or dextrose 5% in lactated Ringer's solution.
• Don't infuse solutions with concentrations above 1 mg/ml.
乐动体育开户• Infuse 100-mg dose over at least 1 hour.
• Complete infusion within 12 hours of dilution, unless diluted with lactated Ringer's solution or dextrose 5% in lactated Ringer's solution; in this case, complete infusion within 6 hours.
☞ Don't give during last half of pregnancy or to children under age 8 unless other drugs are likely to be ineffective or are contraindicated. Drug may retard bone growth and cause tooth discoloration and malformation.
乐动体育开户• Be aware that capsules with coated pellets contain immediate- and delayed-release pellets.
CNS: paresthesia, pseudotumor cerebri
CV: phlebitis, thrombophlebitis, pericarditis
EENT: vestibular reactions, hoarseness, pharyngitis
GI: nausea, vomiting, diarrhea, esophagitis, epigastric distress, enterocolitis, anogenital lesions or inflammation, glossitis, oral candidiasis, black hairy tongue, pancreatitis
GU: dark yellow or brown urine, vaginal candidiasis
Hematologic: hemolytic anemia, neutropenia, thrombocytopenia
Musculoskeletal:乐动体育开户 bone growth retardation (in children younger than age 8)
Skin: photosensitivity, maculopapular or erythematous rash, hyperpigmentation, urticaria
Other: tooth enamel defects, increased appetite, phlebitis at I.V. site, superinfection, hypersensitivity reactions including anaphylaxis
Drug-drug. Adsorbent antidiarrheals; antacids; calcium, iron, and magnesium preparations: decreased doxycycline absorption
Barbiturates, carbamazepine, hormonal contraceptives containing estrogen, phenytoin, rifamycin: decreased doxycycline efficacy
Cholestyramine, colestipol: decreased oral absorption of doxycycline
Methoxyflurane: increased nephrotoxicity
Penicillin:乐动体育开户 decreased penicillin activity
Sucralfate:乐动体育开户 prevention of doxycycline absorption from GI tract
Warfarin: enhanced warfarin effects
Drug-diagnostic tests. Alkaline phosphatase, alanine aminotransferase, amylase, aspartate aminotransferase, bilirubin, blood urea nitrogen (BUN), eosinophils: increased levels
Hemoglobin, neutrophils, platelets, white blood cells: decreased levels
Urine catecholamines: false elevations
Drug-food. Calcium-containing foods:乐动体育开户 decreased drug absorption
Drug-behaviors. Alcohol use: decreased anti-infective effect of doxycycline
Sun exposure:乐动体育开户 increased risk of photosensitivity
乐动体育开户• Evaluate I.V. site regularly. Apply cool compresses as needed.
☞ Monitor for hypersensitivity reactions, including anaphylaxis.
乐动体育开户• Monitor hepatic profile, CBC, BUN, and creatinine levels.
• Assess for hypercoagulability in patients taking warfarin concurrently.
乐动体育开户• Monitor for digoxin toxicity in patients taking digoxin concurrently.
乐动体育开户• Advise patient to take with 8 oz of water to ensure passage into stomach.
乐动体育开户• Tell patient to take on empty stomach at least 1 hour before meals or 2 hours afterwards.
• Instruct patient to take at least 1 hour before bedtime to prevent esophagitis.
☞ Tell patient to immediately report painful swallowing, abdominal pain, easy bruising or bleeding, or signs of hypersensitivity (such as rash).
乐动体育开户• Advise female patient to tell prescriber if she is pregnant.
乐动体育开户• Instruct patient to avoid alcohol use and large amounts of calcium-containing foods (such as dairy products and some green leafy vegetables, such as spinach).
• Stress importance of good oral hygiene.
• As appropriate, review all other significant and life-threatening adverse reactions and interactions, especially those related to the drugs, tests, foods, and behaviors mentioned above.