Guest guest Posted July 4, 2004 Report Share Posted July 4, 2004 Hi J, Could you direct me to the place where you found this information about TCN? A couple of months ago we had a patient with a TCN allergy and no one could find a way to enter it in the computer b/c no one knew the drug class. We had 3 RPh's on that day (Pharmacy Manager, District Scheduler and Pharmacist in Charge) and I listened as each one stumbled over the question. We used the Facts & Comparisons which listed TCN as a drug class in itself. If its a subclass of macrolides do the allergies follow 100% or are the allergies more like PCN and Cephalosporins? Thanks, Trade= Achromycin, Sumycin Generic - tetracycline, aka TCN for short Classification - Antibiotic Subclass = macrolide Use - Severe acne (oral and topical), Tick Fevers (Rocky Mnt Spotted and Q), Amebic infections adjunctively (techs should know this word = along with or in addition to other treatment for it to work best), Some Urinary and Respiratory infections,. This is to name a few of the most popular uses. Techs in various parts of the US know the common uses for their given area more than not. But the PTCB is a National Exam, and therefore would most likely zero in on a use that is common in all territory (ie Skin). -- To love what you do and feel that it matters - how could anything be more fun? -- Graham .. . . for my heart rejoiced in all my labour . . . Ecclesiastes 2:10 Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 4, 2004 Report Share Posted July 4, 2004 Dear , you got to remember I am an old tech who self studied and asked many many questions to the pharmacists I worked with ( drove half crazy i am sure! . somuch of what I wrote is from my own knowledge base. However did check on the rxlist site for use,and allergies were on there as I wrote them from that site. TCN is not a subclas of macrolides. But rather Macrolides are a subclass of antibiotic/ antibacterials. I have neverknown a pharmacist who did not know this! but then I worked in hospital only, where more clinical stuff comes into play. The new FACTS and Comparisons DOES list TCN as its own class. The OLD Facts listed it as a subclass of antibiotics as a Macrolide. I do not understandyour questions about allergies following 100 % or like PCN Cephalosporins. Please be more specific and I will answer. I am going to do a search and get back to you .... Love ya J > Hi J, > Could you direct me to the place where you found this information about TCN? A couple of months ago we had a patient with a TCN allergy and no one could find a way to enter it in the computer b/c no one knew the drug class. We had 3 RPh's on that day (Pharmacy Manager, District Scheduler and Pharmacist in Charge) and I listened as each one stumbled over the question. We used the Facts & Comparisons which listed TCN as a drug class in itself. If its a subclass of macrolides do the allergies follow 100% or are the allergies more like PCN and Cephalosporins? > Thanks, > > > Trade= Achromycin, Sumycin > Generic - tetracycline, aka TCN for short > Classification - Antibiotic > Subclass = macrolide > Use - Severe acne (oral and topical), Tick Fevers (Rocky Mnt Spotted > and Q), Amebic infections adjunctively (techs should know this word = > along with or in addition to other treatment for it to work best), > Some Urinary and Respiratory infections,. This is to name a few of > the most popular uses. Techs in various parts of the US know the > common uses for their given area more than not. But the PTCB is a > National Exam, and therefore would most likely zero in on a use that > is common in all territory (ie Skin). > > > -- > To love what you do and feel that > it matters - how could anything > be more fun? -- Graham > > . . . for my heart rejoiced in > all my labour . . . Ecclesiastes > 2:10 > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 4, 2004 Report Share Posted July 4, 2004 Hi J, It's not that they didn't know it. I was trying to enter the allergy in the patient profile and I need to enter by class (most of the time) not actual drug. Our computer does not pick up a DUR when macrolides are listed as the allergy and TCN is entered as the Rx. I guess what I was trying to say is that our computer data base does not match the " old knowledge " from school and we were trying to find a way to enter the allergy in the computer so a DUR would alert. What I remember from the conversations was a group surprise that TCN has its own class. It was sort of like " Really? " " Are you sure? " " I don't remember that. " " I never knew that. " Which is why a technician needs to be educated about pharmacology and not learn it in a book or OTJ. This is just one example of many where a possible mistake was averted because 3 educated pharmacists and 1 technician needed to collaborate to find an answer. We rely too much on computers to do our jobs for us and we forget much of what we learned. So if a tech never learned it all they wouldn't even know they made a mistake. Anyway, thanks for the info. -- To love what you do and feel that it matters - how could anything be more fun? -- Graham .. . . for my heart rejoiced in all my labour . . . Ecclesiastes 2:10 -------------- Original message -------------- Dear , you got to remember I am an old tech who self studied and asked many many questions to the pharmacists I worked with ( drove half crazy i am sure! . somuch of what I wrote is from my own knowledge base. However did check on the rxlist site for use,and allergies were on there as I wrote them from that site. TCN is not a subclas of macrolides. But rather Macrolides are a subclass of antibiotic/ antibacterials. I have neverknown a pharmacist who did not know this! but then I worked in hospital only, where more clinical stuff comes into play. The new FACTS and Comparisons DOES list TCN as its own class. The OLD Facts listed it as a subclass of antibiotics as a Macrolide. I do not understandyour questions about allergies following 100 % or like PCN Cephalosporins. Please be more specific and I will answer. I am going to do a search and get back to you .... Love ya J > Hi J, > Could you direct me to the place where you found this information about TCN? A couple of months ago we had a patient with a TCN allergy and no one could find a way to enter it in the computer b/c no one knew the drug class. We had 3 RPh's on that day (Pharmacy Manager, District Scheduler and Pharmacist in Charge) and I listened as each one stumbled over the question. We used the Facts & Comparisons which listed TCN as a drug class in itself. If its a subclass of macrolides do the allergies follow 100% or are the allergies more like PCN and Cephalosporins? > Thanks, > > > Trade= Achromycin, Sumycin > Generic - tetracycline, aka TCN for short > Classification - Antibiotic > Subclass = macrolide > Use - Severe acne (oral and topical), Tick Fevers (Rocky Mnt Spotted > and Q), Amebic infections adjunctively (techs should know this word = > along with or in addition to other treatment for it to work best), > Some Urinary and Respiratory infections,. This is to name a few of > the most popular uses. Techs in various parts of the US know the > common uses for their given area more than not. But the PTCB is a > National Exam, and therefore would most likely zero in on a use that > is common in all territory (ie Skin). > > > -- > To love what you do and feel that > it matters - how could anything > be more fun? -- Graham > > . . . for my heart rejoiced in > all my labour . . . Ecclesiastes > 2:10 > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 4, 2004 Report Share Posted July 4, 2004 Dearest , Okay to my understanding the most commonly thought of macrolide is in the Erythromicin family. Erythromycin oral (EES®, EryPed®, Ery-Tab®, PCE Dispertab®, Pediazole®) Erythromycin topical (A/T/S®, Akne-Mycin®, Erygel®, Erycette®, Eryderm®, Erygel®) Azithromycin (Zithromax®) Clarithromycin (Biaxin®) Dirithromycin (Dynabac®) and new: Troleandomycin (Tao®) However if my memory serves me well, (I hope I have not steered you wrong here) TCN is in this macroide fam also. NOT an erythromicin, but part of the macrolides. I hope I am not wrong. Memory and fact need to be correlated on my part. Stopped here to do a search! Boy was I wrong! Okay here is my new and improved stance; All macrolides are primarily bacteriostatic and bind to the 50S subunit of the ribosome, thus inhibiting bacterial protein synthesis. But if given in large doses they can be bacteriocidal. The above drugs are macrolides and you can also add Lincomycin and Clindamycin. My error! TCN are NOT macrolides. But they ARE a class among them selves. They do however exhibit bacteriostatic ONLY behavior. They bind to the 30S subunit of the ribosome and thus inhibit bacterial protein synthesis. This is what I got confused in my head: since they both have subribosomal unit binding and they are both have bacteriostatic behavior; I mistook those two pieces of information that they were both macroides. In fact TCN is it's own class. Please forgive me, my error and my confusion to you. Let's try this you are forgetting that you are netting with an old tech with an old brain and old memory who needs to double check her statements. Now all other information that I placed about TCN is true and correct as I know it and have researched it. What I would suggest is that you place TCN or tetracycline in the allergy line. However you will find that they do not necessarily cross over on the pathogen coverage. Now as for macrolides, they can be used in place of PCN allergy as the spectrum is very close or near. Erythromicins or macrolides do not have the same 5 – 15 % ( what we teach in school, but varies from book to book) cross-hypersensitivity (allergy) as do PCN and cephalosporins. In other words if you are allergic to PCN or Cephalosporins you are not necessarily allergic to macrolides or EES. Mainly because the MOA is so different. PCN and Cephalosporins work on negating the enzyme that helps to make protein synthesis in the bacterial cell membrane wall. There are a few people who may be allergic to PCN and EES but this would be idiosyncratic or unusual to the individual. PCN, EES and TCN can all cause pseudomembranous colitis. I also forgot to mention that because of the robbing of calcium in the teeth that teeth can become `mottled' or spotted. Usually a grey/yellow spotting (staining). Macrolides may cause N/V/D and cholestatic jaundice with erythromycin estolate and not so much with EES. I should have also mentioned that Mg++ antacids should alsonot be given with TCN, due to the chelating factor (ngeating the ability of TCN). Still true is never give a bacteriocidal drug with a bacterostatic drug and for the same reasons I had outlined. I do hope this clears up the misinformation. Mea culpa, Mea culpa. Rest assured I never knew a pharmacist that did not know that EES is bacterostatic at low doses, cidal at high does, and a macrolide. PCN and Cephalosporins have been known to cause anaphylactic shock/anaphylaxis. TCNs cause rash GI uspet and kidney problems. There is usually no cross-over allergy from EES (macrolide ) and TCN or PCN or Cephalosporins. Macrolides cause GI upset and possible jaundice (liver/bile). Okay that should do it. All other items regarding Pharmacology of TCN are correct. Thanks Jeanetta Mastron CPhT BSChem F/O > Hi J, > It's not that they didn't know it. I was trying to enter the allergy in the patient profile and I need to enter by class (most of the time) not actual drug. Our computer does not pick up a DUR when macrolides are listed as the allergy and TCN is entered as the Rx. I guess what I was trying to say is that our computer data base does not match the " old knowledge " from school and we were trying to find a way to enter the allergy in the computer so a DUR would alert. What I remember from the conversations was a group surprise that TCN has its own class. It was sort of like " Really? " " Are you sure? " " I don't remember that. " " I never knew that. " > Which is why a technician needs to be educated about pharmacology and not learn it in a book or OTJ. This is just one example of many where a possible mistake was averted because 3 educated pharmacists and 1 technician needed to collaborate to find an answer. We rely too much on computers to do our jobs for us and we forget much of what we learned. So if a tech never learned it all they wouldn't even know they made a mistake. > Anyway, thanks for the info. > > > > Quote Link to comment Share on other sites More sharing options...
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