Hi. Welcome to our video on bacteriostatic
inhibitors of protein synthesis.
So, in other words, we're
talking about antibiotics.
But want to start with a question.
What is the difference between
bacteriostatic and bactericidal?
Pause the video, take a minute, and
write some notes in the margin.
Welcome back. The difference between
bacteriostatic and bactericidal is
bactericidal, the antibiotic
actually kills the bacteria.
With bacteriostatic, it just does something
that stops the replication of the bacteria,
but it doesn't actually kill the bacteria.
But think of static as kind of even,
but cidal definitely means killer.
Let's take a look at tetracyclines. Here's
4 examples of tetracyclines:
tetracycline -- of course -- demeclocycline,
doxycyxline, and minocycline.
Okay, those are just 4 examples
that fall into the same drug category
known as the tetracyclines.
Now, I recommend when you are
that you think about the side effects
by families or categories.
So, in this case, the family or category
name would be tetracycline.
For examples are individual drugs that
represent that family or category.
So what you do not want to do is try
to memorize each drug
individually by itself.
You want to look for the common
side effects and adverse effects
and cautions that we're looking for,
for the group as a family.
Now, in the upper right hand corner, you'll
see that there's a different icon.
That's to help you remember
this mechanism of action.
This tetracycline family is a bacteriostatic
inhibitor of protein synthesis.
Now they've created a special icon for
each one of the mechanisms of action.
And that is so cool, because if you
keep looking at that icon
and reminding your brain, it'll
make it much easier for you
to remember the mechanism of action.
Now, tetracyclines are very broad spectrum.
They're bacteriostatic, and
they are broad spectrum.
Now, we've used less and less
of these over the years
because we have more selective drugs.
Remember, broad spectrum means it knocks out
plenty or more than one
type of bug or bacteria,
and so that puts us at an increased
risk for things like
superinfections or resistance.
So we've used these tetracyclines
less and less over the years
because we have drugs that are better,
they're more selective, and they have
fewer of the nasty toxicities
that tetracyclines can have.
Now we use tetracyclines to treat acne,
peptic ulcer disease, or periodontal disease.
So those are 3 categories that
we still use this drug for.
But we use it with caution with patients
who have known renal disease,
because someone who has kidneys that
are struggling and not really effective
at doing what kidneys are supposed to do,
filter and excrete things,
they have an increased risk
for tetracycline toxicity.
So keep that in mind with these patients.
They're broad spectrum,
but the same time, I want
to be really careful
in using with patients who have
known renal disease.
Now, one of the nastiest possible
side effects of tetracycline
is we know that they have a risk
of the patient developing
C. difficile-associated diarrhea.
Whew. Remember we talked about that?
That has a phenomenal odor,
one you will never forget.
The other risk is thrush, Candida albicans.
It's like a yeast infection in your mouth.
You can also have it in very personal
places, as you see listed there.
So a yeast infection is particularly
uncomfortable for your patient
no matter what orifice it involves.
So remember, we talked about it because
tetracyclines are broad spectrum,
they go after lots of different
types of bacteria,
that's why we have a risk for these other
superinfection kind of things
like C. diff and thrush.
If you've ever been a patient
who's had thrush,
especially oral thrush, it's extremely
painful for the patient.
So you want to watch and see if
your patient is developing any
of those signs and symptoms that
we immediately intervene.
Now, here's one of the really weird
ones about tetracycline.
It can involve your teeth,
because tetracyclines bind to the
calcium in developing teeth
in kids 4 months to 8 years.
So, we rarely would give a tetracycline
to a pediatric patient.
That's because we know what it does to their
teeth and how it damages their teeth.
It's also got the regular things
like the GI irritation
and the esophageal erosion if they lay down.
Now, we talked about that in the
Adverse Drug Effects video,
but want to hit it again here,
that all of these drugs can cause
severe esophageal erosion,
or erosive esophagitis is another
term that we use to describe it.
It is an excruciating sore throat
if the patient takes this medication
and then lays down.
That's why you want to educate your
patient to not take the medication
and then lay down, or take it at night time
because we usually lay down at nighttime.
And again, we already talked about
the C. diff and thrush.
We brought that back a couple
times just to remind you
that the tetracyclines are really
known for causing those.
It will also suppress long bone growth
in premature infants,
which is another reason we don't
give it to pediatric patients.
When it comes to toxicity,
tetracyclines have an increased
risk for hepatotoxicity
if you're having to give it IV
route in higher doses.
So, the higher the dose,
the longer the period of time the
patient is on a tetracycline,
the bigger the risk is for them to
Remember that's the toxicity of
the liver. Hepat means liver.
Also, there's a risk for nephrotoxicity,
or renal damage.
The last one is photo sensitivity.
That means if you're taking a tetracycline,
if you go out in the sun, you're really at
an increased risk to get sunburn.
So you want to educate your patients
to wear a hat when they go out,
wear lots of sunblock, because this
particular medication will make them
photosensitive. Really at an increased
risk to be sunburned,
even if they're someone who's not
usually at risk for sunburn.