Dr. Ogbru received his Doctorate in Pharmacy from the University of the Pacific School of Pharmacy in 1995. He completed a Pharmacy Practice Residency at the University of Arizona/University Medical Center in 1996. He was a Professor of Pharmacy Practice and a Regional Clerkship Coordinator for the University of the Pacific School of Pharmacy from 1996-99.
Jay W. Marks, MD, is a board-certified internist and gastroenterologist. He graduated from Yale University School of Medicine and trained in internal medicine and gastroenterology at UCLA/Cedars-Sinai Medical Center in Los Angeles.
DRUG CLASS AND MECHANISM: Tetracycline is an antibiotic with a broad
spectrum, that is, it is active against many different bacteria. It is effective
against Hemophilus influenzae, Streptococcus pneumoniae, Mycoplasma pneumoniae,
Chlamydia psittaci, Chlamydia trachomatis, Neisseria gonorrhoeae, and many
others. Tetracycline prevents growth of bacteria by preventing the bacteria to
manufacture proteins that they need to survive. The first drug of the
tetracycline family, chlortetracycline, was introduced in 1948.
PRESCRIPTION: Yes
GENERIC AVAILABLE: Yes
PREPARATIONS: Capsules: 250 and 500mg; Oral Suspension: 125 mg/5 ml
(teaspoon).
STORAGE: Tetracycline should be stored below 30 C (86 F).
PRESCRIBED FOR: Tetracycline is used for treating several types of
infections caused by susceptible bacteria. Some examples include infections of
the respiratory tract, urinary tract, and skin. It also is prescribed for
nongonococcal urethritis, Rocky Mountain spotted fever,
typhus,
chancroid,
cholera, brucellosis, anthrax,
syphilis, and acne. It is used in combination
with other medications to treat Helicobacter pylori, the bacteria associated
with ulcers and inflammation of the stomach and duodenum.
DOSING: Food reduces the absorption of tetracycline. Therefore,
tetracycline should be taken at least two hours before or after meals. For most
infections, tetracycline is taken two to four times daily for 7 to 14 days. The
usual adult dose is 1-2 g/day in 2 or 4 divided doses.
DRUG INTERACTIONS: Tetracycline should not be taken at the same time
as aluminum, magnesium, or calcium-based antacids [for example,
aluminum with magnesium hydroxide-oral
(Mylanta, Maalox), calcium
carbonate (Tums, Rolaids)]; iron supplements;
bismuth subsalicylate (Pepto-Bismol), and dairy products. These agents bind
tetracycline in the intestine and reduce its absorption into the body.
Tetracycline may enhance the activity of the blood thinner, warfarin
(Coumadin), and result in excessive "thinning" of the blood, necessitating a
reduction in the dose of warfarin. Phenytoin (Dilantin), carbamazepine
(Tegretol), and barbiturates (such as phenobarbital) may enhance the elimination
of tetracycline. Tetracycline may reduce the effectiveness of
oral
contraceptives.
PREGNANCY: Tetracycline antibiotics can impair development of bone in
the fetus. Therefore, tetracycline is not recommended during
pregnancy unless
there is no other appropriate antibiotic.
NURSING MOTHERS: Tetracycline is secreted into breast milk. Since
tetracycline can impair the development of bone in infants,
nursing mothers
should not use tetracycline.
SIDE EFFECTS: Tetracycline is generally well-tolerated. The most
common side effects are diarrhea or loose stools, nausea, abdominal pain, rash,
and vomiting. Headache and dizziness may also occur. Tetracycline may cause
discoloration of teeth if used in patients below 8 years of age. Exaggerated
sunburn can occur with tetracycline
(photosensitivity). Therefore, sunlight or sunlamp exposure
should be minimized during treatment.
Urinary tract infection (UTI) is an infection of the kidney, ureter, bladder, and/or urethra. Not
everyone with a UTI has symptoms. Common symptoms include a frequent urge to
urinate and a painful, burning when urinating.
A boil is a skin abscess, a collection of
pus localized deep in the skin. There are several different types of boils. Among them are the following: furuncle or
carbuncle, Cystic acne, Hidradenitis suppurativa, and Pilonidal cyst.
Pink eye, also called conjunctivitis, is redness or irritation of the conjunctivae, the membranes on the inner part of the eyelids and the membranes covering the whites of the eyes. These membranes react to a wide range of bacteria, viruses, allergy-provoking agents, irritants, and toxic agents.
Acne is a localized skin inflammation as a result of overactivity of oil glands at the
base of hair follicles. This inflammation, depending on its location, can take the form
of a superficial pustule (contains pus), a pimple, a deeper cyst, congested pores, whiteheads, or blackheads. Treatments vary depending on the severity of the acne.
Sexually transmitted diseases, or STDs,
are infections that are transmitted during any type of sexual exposure,
including intercourse (vaginal or anal), oral sex, and the sharing of sexual
devices, such as vibrators. Women can contract all of the STDs, but may have no symptoms, or have different symptoms than men do.
Ingrown hairs may be caused by improper shaving, waxing or blockage of the hair follicle. Symptoms and signs of ingrown hairs include itching, tenderness, and small red pus bumps. Ingrown hairs usually heal on their own, but topical antibiotics, chemical depilatories, and hair-removal laser may be used in the treatment of ingrown hairs.
Clostridium difficile (C. difficile) is a bacterium, and is one of the most common causes of infection of the colon. C. difficile spores are found frequently in hospitals, nursing homes, extended care facilities, and nurseries for newborn infants. They can be found on bedpans, furniture, toilet seats, linens, telephones, stethoscopes, fingernails, rings, floors, infants' rooms, and diaper pails. They even can be carried by pets. Antibiotic-associated (C. difficile) colitis is an infection of the colon caused by C. difficile that occurs primarily among individuals who have been using antibiotics. Treatment for C. difficile colitis hydration, replenishment of electrolyte deficiencies, discontinuing the antibiotic that caused the colitis, and using antibiotics to eradicate the C. difficile bacterium.
Rosacea is a skin disease that causes redness of the forehead, chin, and lower half of the nose. In addition to inflammation of the facial skin, symptoms include dilation of the blood vessels and pimples (acne rosacea) in the middle third of the face. Oral and topical antibiotics are treatments for rosacea. If left untreated, rhinophyma (a disfiguring nose condition) may result.
Chlamydia, a type of bacteria that causes an infection, is spread through sexual contact. Most of the time, women with chlamydia have no symptoms. Antibiotics are an effective treatment for chlamydia.
Helicobacter pylori (H. pylori) is a bacterium that causes chronic inflammation (gastritis) of the inner lining of the stomach in humans. This bacteria also is the most common cause of ulcers worldwide.
Jock itch is an itchy red rash that appears in the groin area. The rash may be caused by a bacterial or fungal infection. People with diabetes and those who are obese are more susceptible to developing jock itch. Antifungal shampoos, creams, and pills may be needed to treat fungal jock itch. Bacterial jock itch may be treated with antibacterial soaps and topical and oral antibiotics.
Folliculitis is a skin condition that causes small red bumps to form around the hair follicles. Skin bacteria such as Staphylococcus and Pseudomonas my infect the follicles. Treatment involves over-the-counter bacterial washes, topical antibiotics, and/or topical steroids.
COPD (chronic obstructive pulmonary disease) is a disorder that persistently obstructs bronchial airflow. COPD mainly involves three related conditions, chronic bronchitis, chronic asthma, and emphysema. Symptoms of COPD include chronic cough, shortness of breath, frequent respiratory infections, wheezing, morning headaches, and pulmonary hypertension. Treatment of COPD is focused on the related condition(s).
Scleroderma is an autoimmune disease of the connective tissue. It is characterized by the formation of scar tissue (fibrosis) in the skin and organs of the body, leading to thickness and firmness of involved areas. Scleroderma is also referred to as systemic sclerosis, and the cause is unknown. Treatment of scleroderma is directed toward the individual features that are most troubling to the patient.
Malaria is an infectious disease transmitted by the bite of an infected Anopheles mosquito. Symptoms of malaria include chills, pain, fever, and sweating. Though mild cases of malaria can be treated with oral medication, severe cases require intravenous drug treatment and fluids.
Pleurisy, an inflammation of the lining around the lungs, is associated with sharp chest pain upon breathing in. Cough, chest tenderness, and shortness of breath are other symptoms associated with pleurisy. Pleurisy pain can be managed with pain medication and by external splinting of the chest wall.
Sexually transmitted diseases, or STDs, are infections that are transmitted during any
type of sexual exposure, including intercourse (vaginal or anal), oral sex, and
the sharing of sexual devices, such as vibrators. Although treatment exists for many STDs, others currently are
usually incurable, such as those caused by HIV, HPV, hepatitis B and C, and HHV-8.
Canker sore is a small ulcer crater in the lining of the mouth. Canker sores are one of the most
common problems that occur in the mouth. Canker sores typically last for
10-14 days and they heal without leaving a scar.
Vancomycin-resistant enterococci (VRE) infection is the most common type of infection acquired by patients while hospitalized. Patients at risk for VRE are those who are already ill, and hospitalized, including individuals with diabetes, elderly, ICU patients, kidney failure patients, or patients requiring catheters. Enterococci can survive for months in the digestive tract and female genital tract. Other risk factors for acquiring VRE include those how have been previously treated with vancomycin and combinations of other antibiotics. Treatment of VRE is generally with other antibiotics other than vancomycin. Prevention of VRE can be achieved by proper hand hygiene.
Pleural effusion is an excess fluid between the two membranes that envelop the lungs. There are two classifications of causes of pleural effusion; transudate and exudate. The treatment of pleural effusion depends on the cause.
Plague is an infectious disease caused by the Yersinia pestis bacteria, which is primarily found in rodents the fleas that feed off of them. The bacteria are passed to humans through flea or rodent bites. There are three forms of plague: bubonic, septicemic, and pneumonic. The symptoms and method of transmission vary with each form of plague. Plague can be treated with antibiotics.
Cholera is an infectious disease characterized by intense vomiting and profuse watery diarrhea and that rapidly lease to dehydration and often death. Cholera is caused by infection with the bacteria Vibrio cholerae, which may be transmitted via infected fecal matter, food, or water.
Syphilis, a sexually transmitted disease, is caused by a microscopic, wormlike bacterial organism called a spirochete. There are three stages of syphilis. The first involves the formation of the chancre. The second stage often includes hair loss, a sore throat, white patches in the nose, mouth, and vagina, fever, headaches, and a skin rash. The third stage can cause extensive damage to the internal organs and the brain, and can lead to death. Though early infection often resolves on its own, treatment usually varies based on the stage of the infection at the time of diagnosis.
Pregnancy planning is important to help prevent exposure of the mother and fetus to potentially harmful medications and substances during the early days, and throughout the pregnancy. Nutritional planning, prevention of birth defects, conditions such as high blood pressure, heart disease, diabetes, and kidney disease need careful monitoring. Gestational diabetes, preeclampsia, and pregnancy induced hypertension are conditions that may arise during pregnancy. Immunizations, inherited disorders, exercise, air travel, intercourse, and birth control are important factors to consider when planning a pregnancy.
Anthrax is a deadly infectious disease that may be transmitted to humans by infected animals or by biological warfare. There are three types of anthrax: cutaneous, inhalation, and gastrointestinal. Symptoms of cutaneous anthrax include a swollen glands, muscle ache, headache, fever, nausea, vomiting, and a red-brown raised spot that enlarges, blisters, and hardens, forming an ulcer crater with black crust. Symptoms of inhalation anthrax are flulike and may progress to respiratory distress, shock, coma, and death. Symptoms of gastrointestinal anthrax include loss of appetite, bloody diarrhea, and abdominal pain. Treatment for cutaneous anthrax involves penicillin, tetracycline, erythromycin, and ciprofloxin. Inhalation anthrax necessitates treatment with IV therapy with antibiotics.
Sun sensitivity (photosensitivity) is an inflammation of the skin induced by the combination of medications or substances and sunlight. The affect on the skin is redness, which looks similar to a sunburn. Generally, these reactions are either phototoxic or photoallergic. Phototoxic drugs are more common than photoallergic drugs. Symptoms of phototoxic reactions are a burning and stinging sensation and then redness. Symptoms of photoallergic reactions are itching, redness, swelling, blisters of the affected area. Treatment generally is discontinuation of the medication and topical application of creams.
Drug resistance (antimicrobial resistance) is the ability of bacteria, fungi, parasites, and viruses to grow, even in the presence of a drug that would normally kill it (or limit it's growth). Drug resistance is a growing problem, particularly for infections such as MRSA, VRE (vancomycin-resistant enterococci), tuberculosis, HIV, STDs, gonorrhea, flu, pneumonia, malaria, E. coli, salmonella, Campylobacter, which causes diarrhea and gastroenteritis. Learn how to protect yourself from resistance to drugs.
Rocky Mountain spotted fever (RMSF) is an infectious disease that's transmitted by the bite of a tick infected with the Rickettsia rickettsii bacterial organism. Initial symptoms of RMSF include fever, nausea, vomiting, muscle pain and severe headache. Later symptoms include rash, abdominal pain, joint pain, and diarrhea. Treatment usually involves a tetracycline antibiotic.
Pseudotumor Cerebri (intracranial hypertension) is a condition where there is an increase in pressure of fluid surrounding the brain and spinal cord (cerebrospinal fluid or CSF) mimicing a brain tumor. The cause is unknown. The most common symptom is headache but also include eye-pain, vision loss and double vision. Pseudotumor cerebri is diagnosed with MRI or CAT scans and treated by discontinuing offending medications (if applicable), weight loss and diuretic medications. The condition can also be helped by repeated drainage of spinal fluid using the lumbar puncture.
Jock itch is a common, itchy rash of the groin. It can be a very intense itch
with or without a visible red or pink rash in the groin folds and genitals. Jock
itch is primarily a skin condition in men.
The symptoms of jock itch may come and go, and many cases of jock itch resolve
spontaneously without any treatment. Jock itch is primarily seen in the groin,
although it may spread to the inner thighs, genitals (including penis, scrotum,
labia, and vaginal opening), and anus.
While jock itch is frequently noted in otherwise healthy patients, patients
with diabetes and/or obesity are more susceptible. Possible causes of this
common groin itch include irritation from tight or abrasive underwear, excess
moisture, sweating, skin rubbing or friction, allergic problems, fungal
infection, Candida (yeast) infection, and bacterial overgrowth or skin
infection.