Question

Chapter 38 Erythromycin/Azithromycin/Clarithromycin Antibiotic name Drug Class & Indications(s) Contraindication:s Tetracycvcline/Doxycycline Tigecycline ( Tetracycline antibiotic Tvgacil) Intravenous Onl Macrolide antibiotic Common Adverse Effects Major Interactions ex. CYP450 Nurse considerations: Examples: Age, renal/hepatic precautions, safe administration lab monitoring, teaching)

Answer 1

contraindications

erythromycin: hypersensitivity, hepatic impairment, pregnancy

tetracycline: children less than 8 years, pregnancy, hypersensitivity, hepatic dysfunction

Adverse effects

erythromycin: mild- to-severe epigastric pain, reversible hearing impairment followed by high dose, hypersensitivity

tetracycline: epigastric pain, nausea, vomiting and diarrhoea, oesophagal ulceration, on repeated use thrombophlebitis may occur.

Major interactions

Erythromycin rises plasma levels of theophylline, carbamazepine, valproate, ergotamine and warfarin. Erythromycin inhibits CYP3A4 leads to a rise in serum levels of terfenadine /astemizole/cisapride.

tetracycline: when used with antacids, calcium magnesium or iron supplements result in a reduction in absorption and bioavailability.metabolism increases when used with rifampicin, phenytoin and carbamazepine. increases digoxin toxicity and effects of anticoagulants and oral contraceptives.

nurse considerations

erythromycin:

• cholestatic hepatitis may occur when treatment exceeds more tan 10 days or in patients with a history of erythromycin usage.
• frequent monitoring of liver functions
• may worsen the condition of patients with myasthenia gravis.

tetracycline:

• special precaution should be taken with for those with history or predisposition of oral candidiasis.
• to avoid oesophagal injury should be taken with a glass of water in an upright position.