c. Renal--rise in BUN (blood urea nitrogen) reported which is dose- related.
d. Hypersensitivity reactions--urticaria, angioedema, anaphylaxis, etc.
e. Bulging Fontanels--reported in young infants following full therapeutic
f. Hematological--blood dyscrasias only rarely reported.
g. Bone Lesions and Staining and Deformity of Teeth--in children up to 8
years old and in the newborn when given to pregnant women after fourth month of
h. Liver Damage--parenteral doses may cause serious liver damage, especially
in pregnant women and clients with renal disease receiving 1 gram or more daily.
5-26. CAUTIONS AND WARNINGS
a. The tetracyclines are contraindicated in clients who have shown
hypersensitivity to these antibiotics.
b. Tetracycline drugs should not be used during tooth development (last half of
pregnancy, infancy, and childhood to 8 years of age) unless other drugs are
contraindicated or are likely to be ineffective. The use of the tetracyclines in this age
group may cause permanent discoloration of the teeth (yellow, gray, brown). Enamel
hypoplasia has been reported also.
c. Reduce oral and parenteral doses of tetracyclines if renal impairment exists.
d. Photosensitivity reactions may develop as an exaggerated sunburn; thus,
clients who will be exposed to direct sunlight or ultraviolet light should be warned.
e. In pregnant women, tetracyclines cross the placenta and can have direct toxic
effects (usually related to retardation of skeletal development) on the developing fetus.
f. Tetracyclines will occur in the milk of lactating women.
g. Since bacteriostatic drugs may interfere with the bactericidal action of the
penicillins, avoid the use of a tetracycline in conjunction with a penicillin.
h. Superinfections may result due to overgrowth of nonsusceptible organisms
Using outdated and deteriorated tetracyclines may cause renal damage.