Tetracycline hepatotoxicity

Tetracyclines inhibit P. acnes, reduce the amount of keratin in sebaceous follicles, and have antiinflammatory properties (inhibiting chemotaxis, phagocytosis, complement activation, and cell-mediated immunity). Drawbacks to tetracyclines include hepatotoxicity and predisposition to infections (e.g., vaginal candidiasis). Other adverse effects include GI disturbances, photosensitivity, tooth discoloration in children, and inhibition of skeletal growth in the developing fetus. Tetracyclines must not be combined with systemic retinoids because of an increased risk of intracranial hypertension. / Tetracycline is the least expensive agent in this class and is often... 

Hepatic function impairment Doses more than 2 g/day IV can be extremely dangerous. In the presence of renal dysfunction, and particularly in pregnancy, IV tetracycline more than 2 g/day has been associated with death secondary to liver failure. Hepatotoxicity has been reported with minocycline. Administer with caution reduce the recommended dosage and/or extend the dosing interval. 

Buffering agents that are compounded with didanosine to counteract its degradation by gastric acid may interfere with the absorption of other drugs that require acidity (e.g., indinavir, delavirdine, ketoconazole, fluoroquinolones, tetracyclines, dapsone). An enteric-coated formulation Videx EC) that dissolves in the basic pH of the small intestine is not susceptible to these interactions. Ganciclovir and valganciclovir can increase blood levels of didanosine. The use of zalcitabine with didanosine is not recommended because that combination carries an additive risk of peripheral neuropathy. The combination of didanosine with stavudine increases the risk of pancreatitis, hepatotoxicity, and peripheral neuropa-... 

Tetracycline Prevents bacterial protein synthesis by binding to the 30S ribosomal subunit Bacteriostatic activity against susceptible bacteria Infections caused by mycoplasma, chlamydiae, rickettsiae, some spirochetes malaria H pylori acne Oral mixed clearance (half-life 8 h) dosed every 6 h divalent cations impair oral absorption Toxicity Gastrointestinal upset, hepatotoxicity, photosensitivity, deposition in bone and teeth... 

Tetracycline Tetracycline injections have an acid pH. Incompatibility may reasonably be expected with alkaline preparations or with drugs unstable at low pH. Care should be taken when administering tetracyclines, since chelation takes place with metal ions. Tetracyclines interact with inorganic metal ions. They should not be used with drugs that cause hepatotoxicity and nephrotoxicity (e.g., digoxin, theophylline, ergot alkaloids, methotrexate, oral contraceptives, and penicillins). 

Fatal hepatotoxicity This side effect has been known to occur in pregnant women who received high doses of tetracyclines, especially if they are experiencing pyelonephritis. 

CICLOSPORIN TETRACYCLINES -DOXYCYCLINE t levels of ciclosporin leading to risk of nephrotoxicity, hepatotoxic-ity and possible neurotoxicity such as hallucinations, convulsions and coma The mechanism is not known, but doxycydine is thought to t ciclosporin levels Concomitant use in transplant patients should be well monitored, with frequent ciclosporin levels. In non-transplant patients, renal function should be monitored closely and patients warned about potential side-effects such as back pain, flushing and gastrointestinal upset. The dose of ciclosporin should be 1 appropriately... 

Tetracyclines can cause gastric irritation, particularly in large doses, and can also cause tooth discoloration in children. Hepatotoxicity may be seen with large doses (> 2g), as well as nephrotoxicity. Hypersensitivity reactions can also be seen. 

Patients who receive tetracycline may also experience nephrogenic diabetes insipidus, hepatotoxicity, pancreatitis, dizziness, syncope, and their skin might be increasingly sensitive to sunlight. 

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