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Tetracyclines - Coggle Diagram
Tetracyclines
Activity/Use
Broad spectrum
Skin/soft tissue infection
For those with a Penicillin allergy
Respiratory tract infections
Gram + bacteria
Gram - bacteria
Atypical organisms
Mycoplasma
Rickettsia
Typhus
Q fever
Chlamydia
Pelvic inflammatory disease
Trachoma
Psittacosis
Some spirochetes and protozoa
Leptospirosis (first line)
Brucellosis
Cholera
Plague
Acne
Minocycline
SIADH
Demeclocycline
Avoid in...
Children
Nursing mothers
Pregnancy
Side Effects
GIT
Irritation
Vitamin B deficiency
C. difficile
infection
Phototoxicity
Photosensitivity
Demeclocycline
Vestibular disturbances
Dizziness
Nausea
Minocycline
Renal Damage
Bone marrow suppression (long-term)
Dizziness
Chelation of calcium
Deposition in teeth and bones
Staining
Dental hypoplasia
Bone deformity
ADME
Concentration + Time-dependent
Administration
PO (mainly)
IV
Absorption
Chelate metals
Decreased absorption
Decreased in presence of milk, antacids, and iron
Distribution
Crosses placenta
Crosses into breast milk
Crosses into saliva
Does NOT cross BBB
Excretion/Metabolism
Excreted in bile and kidney (unchanged)
Dose reduction required in renal impairment
Non-renal route
Doxycycline
Minocycline
Partly metabolised in liver
Plasmid-mediated resistance common
Examples
Tetracycline
Doesn't stay in bloodstream
High affinity for tissue/bone
Oxytetracycline
Doxycycline
Seen more in hospitals
Minocycline
Glycylcyclines (Tetracycline derivatives)
Tigecycline
Mechanism of Action
Competes with tRNA for A site on bacteria ribosome
Inhibits protein synthesis
Requires active transport into cells
Bacteriostatic