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Tetracycline



- Discussion:
    - for streptococcus and staph when penicillin is contraindicated;
    - tetracycline works by inhibiting the 70s bacterial ribosomes;
    - adult:250-500 mg PO bid/qid (taken between meals);
    - IM/IV routes not recommended;
    - peds: RMSF: 25-50 mg/kg/day q6 hr for 7 to 10 days;
    - supplied: cap 250, 500 mg; syrup 125 mg/5 ml;
    - contraindicated w/ renal failure & hepatic failure;
    - contraindicated with hypersensitivity to tetracycline;
    - contra in Peds < 8yrs;
    - concomitant therapy with antacids impairs Tet absorption;
    - calcium and zinc will decrease absorption;
    - d/c tetracycline if over-growth of nonsuseptable organisms occurs;
    - caution with anticoagulants, Tet depresses plasma prothrombin activity;
    - good diffusion from blood into CSF only with inflammation;
    - note: ratio of CSF to blood level(%): normal meninges: inflammed meninges: 25%;
    - dosing regimens for patients with renal insufficiency:
          - 60% of drug will be excreted in to urine (w/ nl renal (fx)) over 96 hr;
          - dose for 70kg Adult (gm / dosing interval in hours):
          - CrCl: > 80: 0.5/6;
          - CrCl: 50-79: 0.5/6;
          - CrCl: 30-49: 0.5/8-12;
          - CrCl:10-29
    - may cause photosensitivity;
    - tetra will increase digoxin toxicity, and will increase effects of insulin