Search your Drugs Here

Monday, February 7, 2011

minocycline hydrochloride

Posted by Sampil 5:57 PM, under | No comments

minocycline hydrochloride
(mi noe sye' kleen)
ArestinDynacin, Gen-Minocycline (CAN), Minocin IV, Novo-Minocycline (CAN)

Pregnancy Category D

Drug classes
Antibiotic
Tetracycline

Therapeutic actions
Bacteriostatic: Inhibits protein synthesis of susceptible bacteria, causing cell death.

Indications
·        Infections caused by rickettsiaeMycoplasma pneumoniae; agents of psittacosis, ornithosislymphogranuloma venereum and granuloma inguinaleBorreliarecurrentisHemophilus ducreyiPasteurella pestisPasteurella tularensisBartonella bacilliformisBacteroidesVibrio comma; Vibrio fetus;Brucella; Escherichia coli; Enterobacter aerogenesShigellaAcinetobacter calcoaceticus; H. influenzaeKlebsiellaDiplococcus pneumoniae; Staphylococcus aureus
·        When penicillin is contraindicated, infections caused by Neisseria gonorrhoeaeTreponema pallidumTreponema pertenueListeria monocytogenes, Clostridium, Bacillus anthracis. As an adjunct to amebicides in acute intestinal amebiasis
·        Oral tetracyclines are indicated for treatment of acne, uncomplicated urethral, endocervical, or rectal infections in adults caused by Chlamydia trachomatis
·        Oral minocycline is indicated in treatment of asymptomatic carriers of N. meningitidis (not useful for treating the infection); infections caused byMycobacterium marinumuncomplicated urethral, endocervical, or rectal infections caused by Ureaplasma urealyticum; uncomplicated gonococcalurethritis in men due to N. gonorrhoeae
·        Arestin: Adjunct to scaling and root planing to reduce pocket depth in patients with adult periodontitis
·        Unlabeled use: Alternative to sulfonamides in the treatment of nocardiosis

Contraindications and cautions
·        Contraindicated with allergy to tetracylines.
·        Use cautiously with renal or hepatic dysfunction, pregnancy, lactation.

Available forms
Capsules—50, 75, 100 mg; pellet-filled capsules—50, 100 mg; oral suspension—50 mg/5 mL; powder for injection—100 mg; tablets—50, 75, 100 mg; sustained-release microsphere—1 mg

Dosages
ADULTS
200 mg followed by 100 mg q 12 hr IV. Do not exceed 400 mg/day. Or 200 mg initially, followed by 100 mg q 12 hr PO. May be given as 100–200 mg initially and then 50 mg qid PO.
·        Syphilis: Usual PO dose for 10–15 days.
·        Urethral, endocervical, rectal infections: 100 mg bid PO for 7 days.
·        Gonococcal urethritis in men: 100 mg bid PO for 5 days.
·        Gonorrhea: 200 mg PO followed by 100 mg q 12 hr for 4 days; get post-therapy cultures within 2–3 days.
·        Meningococcal carrier state: 100 mg q 12 hr PO for 5 days.
·        Adult peridontitis: Unit dose cartridge discharged in subgingival area.
PEDIATRIC PATIENTS > 8 YR
4 mg/kg IV followed by 2 mg/kg q 12 hr IV or PO.
GERIATRIC PATIENTS OR PATIENTS WITH RENAL FAILURE
IV doses of minocycline are not as toxic as other tetracyclines in these patients. Decrease recommended dosage; increase dosing interval with renal impairment. Do not exceed 200 mg Minocin in 24 hr in patients with renal impairment.

Pharmacokinetics
Route
Onset
Peak
Oral
Rapid
2–3 hr
IV
Immediate
End of infusion

Metabolism: Hepatic; T1/2: 11–26 hr
Distribution: Crosses placenta; enters breast milk
Excretion: Feces, urine

IV facts
Preparation: Dissolve powder and then further dilute to 500–1,000 mL with sodium chloride injection, dextrose injection, dextrose and sodium chloride injection, Ringer's injection, or lactated Ringer's injection; administer immediately.
Infusion: Infuse slowly over 6 hr; discard any diluted solution not used within 24 hr.
Incompatibilities: Avoid solutions with calcium; a precipitate may form.
Y-site incompatibilities: Do not inject with hydromorphonemeperidinemorphine.

Adverse effects
·        Dental: Discoloring and inadequate calcification of primary teeth of fetus if used by pregnant women; discoloring and inadequate calcification of permanent teeth if used during period of dental development
·        Dermatologic: Phototoxic reactions, rash, exfoliative dermatitis (more frequent, more severe with this tetracycline than with any others)
·        GI: Fatty liver, liver failure, anorexia, nausea, vomiting, diarrhea, glossitis, dysphagiaenterocolitis, esophageal ulcer
·        HematologicHemolytic anemia, thrombocytopenia, neutropeniaeosinophilialeukocytosisleukopenia
·        Local: Local irritation at injection site
·        Other: Superinfectionsnephrogenic diabetes insipidus syndrome

Interactions
·        Decreased absorption of minocycline with antacids, iron, alkali
·        Increased digoxin toxicity
·        Increased nephrotoxicity with methoxyflurane
·        Decreased activity of penicillin
·        Decreased absorption of minocycline if taken with food, dairy products

Nursing considerations
Assessment
·        History: Allergy to tetracyclines, renal or hepatic dysfunction, pregnancy, lactation
·        Physical: Skin status, orientation and reflexes, R and adventitious sounds, GI function and liver evaluation, urinalysis and BUN, LFTs, renal function tests; culture infected area

Interventions
·        Administer oral medication without regard to food or meals; if GI upset occurs, give with meals.

Teaching points
·        Take drug throughout the day for best results.
·        Take with meals if GI upset occurs.
·        Arestin: After treatment, avoid eating hard, crunchy, or sticky foods for 1 week and postpone brushing for a 12-hour period.
·        You may experience these side effects: Sensitivity to sunlight (wear protective clothing, use sunscreen); diarrhea, nausea (take with meals; eat frequent small meals).
·        Report rash, itching; difficulty breathing; dark urine or light-colored stools; severe cramps, watery diarrhea.

Adverse effects in Italic are most common; those in Bold are life-threatening.

0 comments:

Post a Comment

Tags

Blog Archive

Blog Archive