Tetracycline Phenytoin

The product labeling states that the simultaneous administration of sucralfate may reduce the bioavailability of certain agents (e.g.. tetracycline, phenytoin. digoxin. orcimelidine). It further recommends restoration of bioavailability by separating administration of the.se agents from that of sucralfate by 2 hours. Presumably, sucralfate binds these agents in the GI tract. 

There is an increased risk of toxicity of MTX when administered with the NSAIDs, salicylates, oral antidiabetic drugs, phenytoin, tetracycline, and probenecid. There is an additive bone marrow depressant effect when administered with other drug known to depress the bone marrow or with radiation therapy. There is an increased risk for nephrotoxicity when MTX is administered with other drug that cause nephrotoxicity. When penicillamine is administered with digoxin, decreased blood levels of digoxin may occur. There is a decreased absorption of penicillamine when the dmg is administered with food, iron preparations, and antacids. 

The following drugp have a decreased pharmacologic effect when administered with an antacid corticosteroids, digoxin, chlorpromazine, oral iron products, isoniazid, phenothiazines, ranitidine, phenytoin, valproic acid, and the tetracyclines. 

Allopurinol, barbiturates, carbamazepine, cephalosporins, cyclophosphamide, ethambutol, fluconazole, ibuprofen, lamotrigine, macrolides, nitrofurantoin, penicillins, phenytoin, propranolol, quinolones, sulfonamide antimicrobials, sulindac, tetracyclines, thiazides, valproic acid, and vancomycin... 

Allopurinol, barbiturates, benzodiazepines, captopril, carbamazepine, erythromycin, fluoroquinolones, isoniazid, NSAIDs, penicillins, phenothiazines, phenytoin, rifampin, sulfonamides antimicrobials, and tetracyclines... 

Drugs that may affect tetracyclines include antacids containing aluminum, calcium, or magnesium iron salts zinc salts barbiturates bismuth salts carbamazepine cholestyramine colestipol phenytoin rifamycins urinary alkalinizers (eg, sodium lactate, potassium citrate). 

Calcium Acetate (PhosLo) [Calcium Supplement/ Anti arrhythmic/Mmeral/ Electrolyte] Uses ESRD-associated hyper-phos-phatemia Action Ca " supl w/o aluminum to X P04 absorption Dose 2-4 tabs PO w/ meals Caution [C, ] Contra t Ca Disp Gelcap SE Can t Ca, hypophosphatemia, constipation Interactions t Effects OF quinidine X effects W/ large intake of dietary fiber, spinach, rhubarb X effects OF atenolol, CCB, etidronate, tetracyclines, fluoroquinolones, phenytoin, Fe salts, thyroid hormones EMS Pts have reduced renal Fxn, monitor ECG for signs of electrolyte disturbances OD S/Sxs of hypercalcemia (confusion, weakness, GI upset, constipation, N, V, and cardiac arrhythmias) give IV fluid for diuresis symptomatic and supportive Calcium Carbonate (TumS/ Alka Mints) [Antacid/ Calcium Supplement/Mineral/ Electrolyte] [OTC] Uses Hyperacidity associated w/ peptic ulcer Dz, hiatal hernia, etc Action Neutralizes gastric acid Dose 500 mg—2 g PO PRN -1- in renal impair Caution [C, ] Disp Chew tabs, susp SE t -1- PO constipation Interactions X Effect OF tetracyclines, fluo-... 

Side effects include dry mouth, constipation, nausea, vomiting, rash, pruritus, dizziness. It adsorbs and interferes with absorption of tetracycline, cimetidine, digoxin and phenytoin. 

Cimetidine Phenytoin Ciprofloxacin Ranitidine Digoxin Tetracycline Norfloxacin Theophylline... 

Doxycydine (Adoxa, Periostal-, Oracea, Vibramycin, Vibra-Tabs) [Anribiotic/Tetracycline] Uses Broad-spectrum antibiotic acne vulgaris, uncomplicated GC, Chlamydia sp, PID, Lyme Dz, skin Infxns, anthrax, malaria prophylaxis Action Tetracycline bacteriostatic X- protein synth Dose Adults. 100 mg PO ql2h on 1st d, then 100 mg PO daily bid or 100 mg IV ql2h acne daily dosing, Chlamydia 7d, Lyme Dz 14—21 d, PID 14 d Peds >8 y 5 mg/kg/24 h PO, to a max of 200 mg/d - daily-bid Caution [D, +] Hepatic impair Contra Children <8 y, severe hepatic dysfxn Disp Tabs, caps, syrup, susp, inj SE D, GI disturbance, photosens Interactions T Effects OF digoxin, warfarin 1 effects W/ antacids, Fe, barbiturates, carbamazepine, phenytoins, food 4-effects OF penicillins EMS Monitor for signs of electrolyte disturbances and hypovolemia d/t D monitor for S/Sxs of super Infxn T risk of photosensitivity Rxns antibiotic of choice for the Tx and prophylaxis of anthrax exposure expired tetracyclines have been known to cause nephrotox OD May cause adverse GI effects symptomatic and supportive... 

Pethidine Hydrochloride Pethidine hydrochloride solutions are not compatible with barbiturates, aminophylline, morphine sulfate, sulfadiazine sodium, methicilline sodium, nitrofurantoin, phenytoin sodium, heparin sodium, sodium iodide, diethanolamine, sulfafurazol, acyclovir sodium, liposomal doxorubicin hydrochloride, frusemide, imipenem, and idarubicin. Visual incompatibilities are reported with mixtures of pethidine hydrochloride and cefoperazone sodium or mezlocillin sodium, nafcillin sodium and minocycline hydrochloride or tetracycline hydrochloride in 5% glucose injection.82 83... 

Molindone tablets contain calcium sulfate, which may interfere with absorption of phenytoin sodium or tetracyclines... 

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