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INTRODUCTION

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doxycycline* (dox-i-sye-kleen)

Apo-Doxy, Doryx, Doxy, Doxy Caps, Image not available.Doxycin, Monodox, Novo-Doxylin, Oracea, Periostat, Vibramycin, Vibra-Tabs

Classification

Therapeutic: anti-infectives

Pharmacologic: tetracyclines

*As the recommendations for treating/preventing anthrax are still evolving, all health care professionals are urged to check the most current recommendations at the Centers for Disease Control and Prevention Web site (www.bt.cdc.gov).

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Indications
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Treatment of various infections caused by unusual organisms, including Mycoplasma, Chlamydia, Rickettsia, Borrelia burgdorferi. Treatment of inhalational anthrax (postexposure) and cutaneous anthrax. Treatment of gonorrhea and syphilis in penicillin-allergic patients. Prevention of exacerbations of chronic bronchitis. Treatment of acne. Treatment of inflammatory lesions associated with rosacea (Oracea only). Malaria prophylaxis.

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Action
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Inhibits bacterial protein synthesis at the level of the 30S bacterial ribosome. Low-dose products used in the management of periodontitis inhibit collagenase. Therapeutic Effects: Bacteriostatic action against susceptible bacteria. Spectrum: Includes activity against some gram-positive pathogens: Bacillus anthracis (anthrax), Clostridiumperfringens, C. tetani, Listeria monocytogenes, Nocardia, Propionibacterium acnes, Actinomyces israelii. Active against some gram-negative pathogens: Haemophilus influenzae, Legionella pneumophila, Yersinia enterocolitica, Y. pestis, Neisseria gonorrhoeae, N. meningitidis. Also active against several other pathogens, including Mycoplasma, Treponema pallidum, Chlamydia, Rickettsia, Borrelia burgdorferi.

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

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PHYSICAL THERAPY IMPLICATIONS

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Examination and Evaluation
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  • Monitor signs of pseudomembranous colitis, including diarrhea, abdominal pain, fever, pus or mucus in stools, and other severe or prolonged GI problems (nausea, vomiting, heartburn). Notify physician or nursing staff immediately of these signs.

  • Monitor signs of hypersensitivity reactions or anaphylaxis, including pulmonary symptoms (tightness in the throat and chest, wheezing, cough dyspnea) or skin reactions (rash, angioedema, pruritus, urticaria). Notify physician or nursing staff immediately if these reactions occur.

  • Monitor signs of leukopenia (fever, sore throat, signs of infection), thrombocytopenia (bruising, nose bleeds, and bleeding gums), or unusual weakness and fatigue that might be due to anemia or other blood dyscrasias. Report these signs to physician or nursing staff.

  • Monitor and report signs of benign intracranial hypertension, especially in children. signs include dizziness, headache, tinnitus, nausea, and disturbed vision (e.g., blurry or double vision).

  • Monitor IV injection site for pain, swelling, and irritation. Report prolonged or excessive injection-site reactions to the physician.

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Interventions
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  • Always wash hands thoroughly and disinfect equipment (whirlpools, electrotherapeutic devices, treatment tables, and so forth) to help prevent the spread of infection. Employ universal precautions or isolation procedures as indicated for specific patients.

  • Because of the risk of intracranial hypertension, avoid activities that might increase intracranial pressure such as elevating the feet above the head (Trendelenburg's position) or holding breath and straining during a bowel ...

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