Never give to pregnant women, nursing mothers, or children under 8 years.
Before you read
Test yourself first: 3 questions
Question 1 of 3
A client taking a tetracycline antibiotic should receive which teaching about food and drug interactions?
Answer: B. Tetracyclines bind to calcium and other multivalent cations, so they should not be taken with dairy products, antacids, or iron, which reduce absorption. The client should also avoid sun exposure due to photosensitivity. Taking it with milk is incorrect.
Question 2 of 3
A nurse is administering an oral antibiotic that must be taken on an empty stomach for proper absorption. Which medication requires this instruction?
Answer: A. Penicillin V and other penicillins (and tetracyclines) are best absorbed on an empty stomach, taken about 1 hour before or 2 hours after meals. Many other drugs are taken with food to reduce GI upset, but the classic teaching for optimal absorption applies to oral penicillin. Amoxicillin can be taken with or without food; metronidazole and nitrofurantoin are taken with food to reduce GI distress.
Question 3 of 3
A client is prescribed both a fluoroquinolone antibiotic and oral calcium and iron supplements. What teaching prevents reduced antibiotic absorption?
Answer: B. Multivalent cations (calcium, iron, magnesium, aluminum, zinc) chelate fluoroquinolones and tetracyclines, reducing absorption. The client should separate the antibiotic from these products by at least 2 hours, not take them together.
Keep the streak going with more questions like these, each with a full rationale.
What is tetracyclines?
They are well known for staining developing teeth and causing photosensitivity. Memory aid: tetracyclines stain Teeth and are Teratogenic, so avoid in pregnancy and young children.
Key points to remember
- Tetracyclines are bacteriostatic and inhibit bacterial protein synthesis.
- They are contraindicated in pregnancy, breastfeeding, and children under 8 due to permanent tooth discoloration and bone effects.
- Dairy products, antacids, iron, and calcium bind the drug and reduce absorption (chelation).
- Photosensitivity is common, so sun exposure should be limited.
- Expired tetracyclines can become toxic and cause Fanconi-like kidney damage.
- Doxycycline is preferred in renal impairment because it is eliminated mainly by the GI tract.
Nursing priorities
- Verify the patient is not pregnant and is over 8 years old before giving.
- Administer on an empty stomach and separate from dairy, antacids, and iron by 2 to 3 hours.
- Instruct the patient to use sunscreen and protective clothing.
- Have the patient take the drug with a full glass of water and remain upright to prevent esophageal irritation.
- Discard any outdated medication and check expiration dates.
Labs & values
Patient teaching
- Do not take with milk, cheese, yogurt, antacids, or iron supplements.
- Wear sunscreen and avoid tanning beds because your skin will burn easily.
- Use an additional birth control method since effectiveness of oral contraceptives may drop.
- Take with a full glass of water and stay sitting or standing for 30 minutes afterward.
Red flags: report now
- Never give to pregnant women, nursing mothers, or children under 8 years.
- Severe sunburn after minimal sun exposure should be reported.
- Signs of intracranial pressure such as severe headache or blurred vision must be reported.
References
Clinical references for this topic
