La tétracycline, connue sous le nom commercial Sumycin, agit en bloquant la fixation de l’ARNt sur la sous-unité 30S ribosomale, interrompant l’élongation de la chaîne protéique bactérienne. Ce mécanisme confère une activité sur un spectre large, incluant bactéries Gram positives, Gram négatives, rickettsies et spirochètes. Sa biodisponibilité digestive varie selon la prise alimentaire et les interactions avec les ions divalents comme calcium et magnésium. Sa diffusion tissulaire est importante, notamment dans les voies respiratoires et génito-urinaires. L’élimination se fait par voie rénale et biliaire. Les effets indésirables incluent photosensibilisation, troubles digestifs et coloration dentaire en cas d’administration précoce. Les guides thérapeutiques mentionnent sumycin prix, en soulignant la nécessité de restreindre son utilisation afin de limiter les résistances acquises.

腎功能不全時應監測濃度，調整藥物劑量（但常被忽略）之藥物

腎功能不全時應監測濃度，調整藥物劑量（但常被忽略）之藥物
項次 藥物
ClCr <15 ml/min--2 mg on dailysis day <3 mg/min: 100 mg at extended intervals <10 ml/min-- in fast acetylators Q8-16H ClCr 30-50: 0.25 mg QD or 0.5 mg QOD (treatment-naive) ClCr <10: 0.05 mg QD or 0.5 Q7D (treatment-naive) 10-50 ml/min Q6-12H; <10 ml/min Q12-18H Clcr<25 ml/min:dosage adjustments may be necessary Clcr<25 ml/min:dosage adjustments may be necessary 1# QD in moderate renal impairment and in patients on 10-50 ml/min 75%; <10 ml/min 50% of the usual dose 10-50 ml/min <0.6 mg/day to every other day ClCr<30 ml/min not on hemodialysis: starting dose should be 5 milligrams (mg) once daily with titration not to lower dose and then increased gradually; not recommended for patients with end-stage renal disease (requiring dialysis) or severe renal impairment (ClCr<30 GFR 10 to 50 ml/min: 75% of the usual dose GFR <10 ml/min: 50% of the usual dose GFR >50 ml/min Q6H; 10-50 ml/min Q12H; <10 ml/min Clcr 5-29 ml/min: 5 mg ORALLY twice daily GFR 10 to 50 ml/min: Q24-36H; <10 ml/min Q48H GFR 10-70 ml/min: 75%; hemodialysis: 50% GFR 10-70 ml/min: 75%; hemodialysis: 50% Initial dose should be 50 mg QD in renal impairment Initial dose should be 50 mg QD in renal impairment Thiazides should not be used in patients with a serum creatinine or urea nitrogen level greater than 2.5 mg/Dl GFR <10 ml/min: 50%; 10-50 ml/min: 75% GFR 10 to 50 ml/mi: 75% ; <10 ml/min 50% Clcr<25 ml/min:dosage adjustments may be necessary Contraindicated in advanced renal impairment Adjustment for patients with a ClCr< 20 mL/minute <30 ml/min halved or the dosing interval doubled GFR 10 to 50 ml/min: 50 to 75%; <10 ml/min: 25 to 50% Initial dose should be 50 mg QD in renal impairment GFR 10 to 50 ml/min: 50%; <10 ml/min: 25% Initial dose should be 50 mg QD in renal impairment GFR10-50 ml/min: 50%; <10 ml/min: avoided The lower dose of 7.5 milligrams daily has been suggested GFR10-50 ml/min: 75%; <10 ml/min: 50% A reduction in daily dosage should be considered (Clcr<20 A reduction in daily dosage should be considered (Clcr<20 GFR> 50 ml/min: Q6H; 10 to 50 ml/min: Q12-18H; Potential need for dose adjustments in renal insufficiency Clcr 10 to 30 mL/min: 5 mg/day; < 10 mL/min: 2.5mg/day CrCl 20 to 40 ml/min: starting dose 0.5 mg ClCr>60 ml/min--4 mg/day; 30-60 ml/min--2 mg/day; 15-30 ml/min--2 mg/QOD; <15 ml/min--2 mg on dailysis GFR <10 ml/min: 50%; 10-50 ml/min: 75% Clcr<25 ml/min:dosage adjustments may be necessary < 40 ml/min (>2.5 mg/dL), oral dosing should be reduced Moderate: < 16 mg/day; severe (creatinine clearance < 9 Patients in renal failure may require higher than usual Dosage of sulfonamides be adjusted in patients with Serum creatinine is recommended to be maintained less ClCr 30 to 49 mL/min: 600 mg QOD; <30 mL/min: 600 mg Q72H; ESRD requiring hemodialysis: 600 mg Q96H, Clcr<50 ml/min: 50%; Clcr<25 ml/min: 25% > 50 mL/min Q6-12H; 10 to 50 mL/min Q12-24; <10 112 Superocin(Ciprofloxacin)250 mg 30-50 ml/min 250-500 mg Q12H; 5-29 ml/min 250-500 Slight reduction in the normal dose or by increasing the Clcr10-30 ml/min:treatment--75 mg/day; prophylaxis--75 > 50 ml/min Q8-12H; 10 to 50 ml/min Q12-24H; < 10 ml/min Q24H, but is best avoided in these patients One half of the usual adult dose is recommended Do not use extended-release tramadol in patients with severe renal impairment (creatinine clearance less than 30 < 30 ml/min: initiated at 300mg/day, one-half the usual starting dose, and increased at a slower rate than usual Clcr<30 ml/min: 25 mg (starting dose) Clcr 10 to 30 mL/min: 5 mg/day; < 10 mL/min: 2.5mg/day

Source: http://www.vhcy.gov.tw/vhcy/vhcy_dept5/code_upload/DHealthInfo1/file1_66_1714996.pdf