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kyleannkelsey
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Is tetracycline absorbed well by the oral route?
No
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What is the half-life of tetracycline?
6-9 hours
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How is tetracycline excreted?
Primarily unchanged through the kidney, also goes through the enterohepatic cycle but ends up in the kidney
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Is Demecyclocycline absorbed well by the oral route?
Moderate absorption
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What is the half-life of demecyclocycline?
16 hours
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Is Doxycycline well absorbed by the oral route?
Yes
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What is the half-life of Doxycycline?
17-20 hours
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How is doxycycline excreted?
Mostly eliminated in the feces, some endohepatic cycling, very little kidney excretion (though the chart she gave us says hepatic)
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What special indication does demecyclocycline have?
Opposes high ADH and induces urine flow
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How is demecyclocycline eliminated?
Renal system
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Is Minocycline absorbed well by the oral route?
Yes
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What is the half-life of minocycline? 17-20 hours
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Does Minocycline get into the saliva and tears well?
Yes
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How is Minocycline metabolized and excreted?
Metabolized in the liver and excreted renaly
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What side effect often pushes providers to choose a drug other than Minocycline?
Vestibular toxicity
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For a renal compromised patient would you choose doxycycline or tetracycline, why?
Doxycycline, because it is mainly eliminated in the feces
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What are the major adverse effects of Tetracyclines?
Allergies, GI irritation, superinfection, photosensitivity and leukocytosis, hepatic toxicity, enamel staining and hypoplasia, vestibular toxicity and depression of skeletal growth
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What adverse effect can occur from taking tetracyclines that are outdated?
Fanconi Syndrome
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What is different about GI irritation that can be caused by Tetracyclines and how would you counsel patient on this effect?
Can cause esophageal irritation, take while standing, do not take right before bed
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Why is superinfection a potential adverse effect of Tetracyclines?
Because of their broad spectrum
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What group of patients are most likely to suffer from depression of skeletal growth due to tetracycline use?
Pre-mature infants
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Which tetracycline causes vestibular toxicity?
Minocycline
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Photosensitivity is an issue with all Tetracyclines, which one more than the others causes this problem?
Doxycycline
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What is leukocytosis?
Increase in WBCs
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Is Leukocytosis common with tetracycline use?
No
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If a patient develops Leukocytosis when using a tetracycline, what action should be taken?
Discontinue use
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Hepatic toxicity due to tetracycline use is exacerbated under what conditions?
Pregnancy
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What is dental hypoplasia?
When the dental enamel does not fill in
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What age of patient would have dental hypoplasia to their temporary teeth?
A fetus
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What age of patient would have dental hypoplasia to their permanent teeth?
2months to 8 years
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Should you use tetracyclines in pregnancy or young children why or why not?
No, it binds to the teeth and bones and can cause dental and bone growth abnormalities, plus increased risk of hepatotoxicity during pregnancy
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What is Fanconi syndrome?
Damage to renal tubules causing excessive glucose, AA, Na and K excretion
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What are the main indications for tetracyclines?
Traveler’s diarrhea (E.coli), Rickettsia, Mycoplasma pneumoniae, Chlamydia pneumoniae/trachmoatus/psittaci, Borrelia Burgdorferi ( and other Borrelia), H. pylori
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What does Chlamydia psittaci cause, how is it transmitted and who is susceptible to this disease?
Psittacosis (serious brain, lung and heart valve infection), transmitted through bird droppings and immunocomprimised patients are susceptible
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Tetracyclines can be used to treat Lyme disease, what is another common antibiotic to be used (probably more common)?
Amoxacillin
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What are the “alternative” indications for tetracyclines?
Pelvic inflammatory disease, Plague, M. pneumoniae and brucellosis
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Why are tetracyclines not used for Staph or Strep?
Too much resistance
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How might you treat Acne with tetracyclines?
Topically or orally
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