Doxycycline Monohydrate (Monodox)
1. Description: a broad spectrum antibiotic with bacteriostatic
activity against wide range of gram positive and gram negative organism. They
are readily absorbed and bounded to plasma proteins in varying degree. Doxycyclin
is virtually completely absorbed after oral administration. Doxycycline is
effective against actinomyces and fusobacterium strain and thus are applicable
in dental treatment of periodontitis.
2. Instruction of administration: when taking doxycycline, patient needed
to be advise
- The use of tetracyclines drug (doxycycline) should not be used in tooth
development age (last half of pregnancy, infancy, and childhood to the age
of 8 years) unless other drug are not likely to be effective or are contraindicated.
- All tetracyclines drug formed a stable calcium complex in any bone forming
tissue. This could be a positive effect in treatment of periodontitis due
to its availability in bone and in crevicular fluid.
- Photosensitivity manifested by exaggerated sunburn reaction can occur
3. Mechanism of action: bacteriostatic by inhibition of protein
synthesis.
4. Dosage: (applicable in dentistry)
- Adult (more than 80 lbs): 200mg loading dose (100mg b.i.d.) the first day,
then 100mg once daily for the next ten days.
- Children (over eight years of age, weight less than 80 lbs): 2mg/lb/day
divided into two equal doses on the first day, then 1mg/lb/day given once
daily for the next ten days.
5. Warnings: The use of doxycycline (tetracycline class)
during tooth development (last half of pregnancy, infancy, and childhood to
the eight years of age) may cause permanent discoloration of the teeth (yellow-gray-brown).
This adverse reaction is more common during long term use of the drugs but
has been observed following repeated short term course. Anaphylactic reaction,
similar to other antibiotics, which cause difficulty breathing due to swelling
of smooth muscle in the airway may also happened followed administration of
doxycycline.
6. Contraindication: doxycycline is contraindicated in patient
who have shown hypersensitivity to any of the tetracyclines.
7. Precaution:
- pregnancy: tetracycline drugs cross the placenta, are found in fetal tissue
(animal study), and can have toxic effects on developing fetus. Avoid taking
tetracycline drugs during pregnancy or if become pregnant, the drug therapy
must be discontinue.
- nursing mother: because of potential for serious adverse reactions in nursing
infants from the tetracyclines, a decision should be made whether to discontinue
nursing or discontinue the drug, depending on the important of the drug to
the mother
- Exacerbation of SLE (systemic lupus erythematosus) may occur in individual
taking tetracycline drug.
- Renal toxicity (rise in BUN) may occur
- Blood disorder such as hemolytic anemias, neutropenia, thrombocytopenia,
and eosinophilia may also occur
8. Application in Dentistry:
- Adjunctive microbial therapy in treatment of periodontitis, specifically
juvenile periodontitis