Tetracyclines

Author: Prof. Dr. med. Peter Altmeyer

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Last updated on: 13.04.2021

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Definition
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Broad-spectrum antibiotics. A distinction is made between short-term tetracyclines and long-term tetracyclines.

Half-life
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  • 10 h: tetracycline-HCl, oxytetracycline
  • Long term tetracyclines (15-18 h): Doxycycline, Minocycline

Pharmacodynamics (Effect)
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Inhibition of the protein biosynthesis of bacteria by disturbing the translation in the ribosomes (30S subunit), bacteriostatic

Spectrum of action
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Acinetobacter spp., Actinomyces spp., Bacillus anthracis, Bordetella pertussis, Borrelia burgdorferi, Brucella spp., Campylobacter spp., Chlamydia spp., Corynebacterium spp., Coxiella burneti, Enterococcus spp., E. coli, Francisella tularensis, Haemophilus spp., Klebsiella spp, Leptospira spp., Listeria monocytogenes, Mycoplasma spp., Nocardia spp., Pasteurella multocida, Pseudomonas mallei, Pseudomonas pseudomallei, Rickettsia, Salmonella spp., Shigella spp., Staphylococcus spp., Streptococcus spp., Treponema pallidum, Vibrio cholerae, Yersinia spp.

Indication
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Among other things in chlamydia and mycoplasma infections, rickettsialpox, brucellosis, tularaemia. Acne vulgaris, actinomycosis, borreliosis, chron. bronchitis, typhus, gonorrhoea and syphilis in penicillin allergy, mixed ENT infections, interstitial peumonia, leptospirosis, melioidosis, plague, prostatitis, Q-fever, rosacea, dysentery.

Undesirable effects
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Bronchospasm, pulmonary infiltrates, tooth discoloration, gastrointestinal disorders, cholestasis, hepatitis, pancreatitis, allergic reactions, purpura, nail discoloration, photosensitization, pericarditis, depression, headaches, intracranial hypertension, visual disorders, arthralgias, myopathies, vulvovaginitis, drug-induced lupus erythematosus.

Interactions
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See Table 1.

Contraindication
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Pregnancy, lactation, children < 8 years, severe liver dysfunction, renal insufficiency, tetracycline intolerance, myasthenia gravis.

Tables
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Essential interactions of tetracyclines

Alcohol abuse, chron.

Tetracyclinabbau↑

Methoxsalen

Photosensitization ↑

Antacids

Tetracycline-Spiegel↓

Antidiabetics, oral

Blood glucose lowering ↑

Anticoagulants, oral

Bleeding tendency ↑

Cephalosporins

Cephalosporin effect ↓

Ciclosporin A

Toxicity of Ciclosporin ↑

Didanosine

Tetracycline-Wirkung↓

Digoxin

Digoxin plasma levels ↑

Enzyme inductors

Tetracyclinabbau↑

Ergotamins

Vasospasm ↑

Insulin

Insulin action ↑

Contraceptives, oral

contraceptive effect ↓

Lithium salt

Lithium mirrors ↑

Methotrexate

Methotrexate toxicity ↑

Methoxyflurane

Renal failure

Milk and dairy products

Tetracyclinresorption↓

Retinoids

intracranial pressure increase, combination contraindicated

Theophylline

Theophylline plasma levels ↑

Thiomersal

Conjunctivitis when using thiomersal-containing contact lens cleaner

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Last updated on: 13.04.2021