Tetracyclines

o Tetracyclines act by inhibiting bacterial protein synthesis. By binding to the bacterial

ribosome, which differs in structure from a human ribosome, the tetracyclines slow
microbial growth and exert a bacteriostatic effect. All tetracyclines have the same
spectrum of activity and exhibit similar adverse effects.
Therapeutic Class/ Use: Antibacterial Pharmacologic Class/ Use: Tetracycline
Mechanism of Action: protein synthesis inhibitor

Actions and Uses: Tetracycline is effective against a broad range of gram-positive and gram-
negative organisms, including Chlamydia, Rickettsiae, and Mycoplasma. Its use has increased
over the past decade due to its effectiveness against H. pylori in the treatment of peptic ulcer
disease. Tetracycline is given orally, though it has a short half-life that may require administration
four times per day. Topical and oral preparations are available for treating acne. An IM
preparation is available; injections may cause local irritation and be extremely painful.

Side effects: Nausea, vomiting, abdominal cramping, flatulence, diarrhea, mild phototoxicity,
rash, dizziness, stinging/burning with topical applications

Adverse effects: Being a broad-spectrum antibiotic, tetracycline has a tendency to affect vaginal,
oral, and intestinal flora and cause superinfections. Tetracycline irritates the GI mucosa and may
cause nausea, vomiting, epigastric burning, and diarrhea. Diarrhea may be severe enough to
cause discontinuation of therapy. Other common adverse effects include discoloration of the
teeth and photosensitivity.

Nursing Responsibilities:
o Administer oral drug with full glass of water to decrease esophageal and GI irritation.
o Administer antacids and tetracycline 1 to 3 hours apart.
o Administer antihyperlipidemic drugs at least 2 hours before or after tetracycline.
o Pregnancy category D
Site and Example of Drugs
Drug Route and Adult Dose
demeclocycline (Declomycin) PO; 150 mg every 6 h or 300 mg every 12 h
(max: 2.4 g/day)

doxycycline (Vibramycin, others) PO/IV; 100 mg bid on day 1, then 100 mg/day
(max: 200 mg/day)
minocycline (Minocin, others) PO/IV; 200 mg as single dose followed by 100
mg bid

tetracycline (Sumycin, others) PO; 250–500 mg bid–qid (max: 2 g/day)

tigecycline (Tygacil) IV; 100 mg, followed by 50 mg every 12 h