They are easy to identify as they all end in -cycline.
- Tetracycline (Sumycin, Tetracyn) – p.o., inj
- Doxycycline (Vibramycin) – p.o., inj.
- Minocycline (Minocin) – p.o.
Tetracyclines are used for chlamydia, acne, COPD and cholera.
Tetracyclines are bacteriostatic and extremely broad spectrum, so we are definitely risking a super infection with this use. There’s also a food/drug interaction: Anything that contains minerals such as magnesium, calcium, iron, aluminum (antacids) will block the absorption of tetracyclines. We have to wait about 2 hours to eat after taking one.
We should never give tetracyclines to children who don’t have their adult teeth grown in because they will be deformed. It also causes photo sensitivity so they need to wear sunscreen. Coincidentally, teenagers use tetracyclines a lot because they use it for acne.
Expiration date: The expiration date is a theoretical date that the medication has reached 90% of its potency. The other 10% has decomposed into something else. Most medications decompose into something of minimal consequences, but tetracyclines decompose into something toxic. Expired tetracyclines should NEVER be touched. If it is used it can lead into Fanconi syndrome where every organ will be inflamed.
There’s been ethical issues: If we get a wholesale delivery of something we don’t use often and find that our drug has expired two days ago. Legally, you can’t sell it. Ethically, you don’t want to refrain from giving the drug to the patient for 2 days while you wait for the next shipment. So what do you do? Ethically, it would be okay to give it since it’s extremely close to the expiration date. Legally, it would not be okay. If the Joint Commission (JCAHO) walks in tomorrow and see’s expired medication was administered, you’re in trouble.
Recap
- Bacteriostatic
- Use
- Chlamydia, acne, COPD, cholera
- Extremely Broad Spectrum – risk of super-infection
- Food/Drug Interaction
- Minerals: Mg, Ca, Fe, Al (antacids)
- Avoid in Children: affects teeth and long bone
- Side Effects
- Photosensitivity, GI upset
- Do not use expired medication
- May lead to Fanconi Syndrome
