Initials of patient: R.

A
Age: 48 y.o
Sex: Male
DRUG
Generic Name:
Doxycycline
Brand Name:
Vibramycin
Classification:
Anti-infective,
tetracycline

Dosage:
1 cap (100 mg)
Route:
Per orem
Frequency:
BID
Form:
Capsule
Color:
Sky blue

Date of Admission:
Diagnosis: Cerebral malaria
Date medication started:
MECHANISM OF
ACTION
Is
primarily
a
bacteriostatic. It enters
the gram negative
bacteria by passive
diffusion through the
porin channels and
gram positive channels
and gram positive
bacteriaand
other
organisms by energydependent
active
transport.
It
is
concentrated
intracellularly
by
vulnerable
cells.
Tetracyclines
after
entering the cell are
bound reversibly to the
30S subunit of the
ribosomes of bacteria.
Here the aminoacyltRNA is prevented
from attaching to the
acceptor site which is
present
on
the
ribosomal complex of
mRNA. This leads to
inhibition
of
the
process
of
adding
amino acids to the
emerging peptide.

INDICATION
Doxycycline is drug of
choice for treatment of
suspected or proven
Rocky
Mountain
spotted
fever.
Doxycycline is used for
treatment of falciparum
malaria resistant to
chloroquine,
acne
vulgaris, communityacquired pneumonia,
lymphogranuloma
venereum
etc.
Doxycycline can also
be used for prophylaxis
of
malaria
and
leptospirosis..

CONTRAINDICATION

Hypersensitivity to any
of the tetracyclines.
Children less than 8
years of age.
Pregnancy and lactation
Porphyria
Severe hepatic
dysfunction

EFFECTS
Adverse effects:
CNS: benign
intracranial
hypertension (higher in
children)
GI: esophagitis,
hepatotoxicity,
pancreatitis.
Derm: rashes
Hemat: blood
dyscrasias.
Local: phlebitis at IV
site.
Misc: hypersensitivity
reactions,
superinfection.
Side effects:
GI: diarrhea, nausea,
vomiting
Derm: photosensitivity

NURSING
RESPONSIBILITIES
Pre-administration
Check doctors order

Observe 10 Rs

Intra-administration
Administer 1 hr or 2
hrs after meals.
May be taken with
food if GI irritation
occurs
Administer with a
full glass of liquid
and at least 1 hr
before going to bed
to avoid esophageal
ulceration.
Avoid administration
of calcium, zinc,
antacids,
magnesiumor
aluminumcontaining
medications, sodium
bicarbonate, or iron
supplements within
1-3 hr of oral
tetracyclines.
Post administration:
Document
Observe for adverse
reactions

The carrier involved in

the active transport is
absent
in
the
mammalian cells and
also tetracyclines do
not bind to mammalian
60S or 30S ribosomes.
These two factors are
responsible for the
selective toxicity of
tetracyclines to the
microbes.
SUBMITTED BY: RHODEVA JOY T. BRAGA