Tetracyclines should not be administered with
milk, milk products, antacids or iron preparations; they
combine with metal ions to form nonabsorbable
Examples of tetracyclines in common use are
listed in appendix IV, page 6.
a group of drugs that share chemical, antimicrobial,
pharmacologic, and toxic characteristics, and that are
effective against most gram-positive and gram-
Their method of action is by
inhibiting protein synthesis. Aminoglycosides can
cause varying degrees of ototoxicity and nephro-
toxicity, depending on the particular agent and the
dose. Toxicity is more prevalent in the very young or
old, in the presence of renal impairment or
dehydration, or with the use of diuretics. Because of
their high toxicity, aminoglycosides are not
recommended when the infective organism is
susceptible to less toxic preparations.
Examples of several aminoglycosides are listed in
appendix IV, page 7.
MACROLIDES.Macrolide antibiotics constitute
a large group of bacteriostatic agents that inhibit protein
They are effective against gram-positive
cocci, Neisseria, Hemophilus, and mycobacteria. All are
similar to penicillin in their antibacterial spectra, and are
often used in patients who are sensitive to penicillin. (See
appendix IV, pages 7 and 8.)
ANTIFUNGALS.Antifungal agents inhibit or
suppress the growth systems of fungi, dermatophytes,
or Candida. Antifungals have not been developed to
the same degree as antibacterial agents. Most fungi are
completely resistant to the action of chemicals at
concentrations that can be tolerated by the human cell.
Since there are only a few available for internal use,
most antifungal agents are topical. The antifungal
agents that are available for systemic use generally
produce hepatic or renal dysfunction or other serious
side effects. Because of these side effects, systemic
antifungals should be limited to serious or potentially
Therapy that includes topical
preparations may be provided in conjunction with oral
or parenteral antifungal agents.
Examples of several antifungal agents are listed in
appendix IV, page 8.
ANTIPARASITICS.Antiparasitics are agents that
are destructive to parasites. Parasitic infections or
infestations account for the largest number of chronic
disabling diseases known. They are especially prevalent in
the tropics or subtropics and in lesser-developed countries
where overcrowding and poor sanitation exist. Parasitic
infections include protozoal infections (malaria, amebiasis,
and to a lesser extent, trichomoniasis), helminthic infections
(intestinal worms), and ectopara- sites. Ectoparasites, such
as head lice and crab lice, although not disabling, are
considered a nuisance and can transmit disease.
Examples of antiparasitics in common use are
listed in appendix IV, page 9.
LAXATIVES.Laxatives are drugs that facilitate
the passage and elimination of feces from the colon and
rectum. They are indicated to treat simple constipation
and to clean the intestine of any irritant or toxic
substances (catharsis). Laxatives may also be used to
soften painfully hard stools and to lessen straining of
certain cardiac patients when defecating.
contraindicated in certain inflammatory conditions of
the bowel, bowel obstruction, and abdominal pain of
unknown origin, and should not be used in the presence
of nausea and vomiting. Laxatives are classified as
irritant, bulk, emollient, or stool softeners. Frequent or
prolonged use of any laxative may result in dependence.
(See appendix IV, pages 9 and 10.)
ANTIDIARRHEALS.Antidiarrheals are drugs
that are effective in combating diarrhea. Diarrhea is
defined as an abnormal frequency and liquidity of fecal
This condition may result from food
poisoning, parasitic infestation of the bowel, and
gastrointestinal diseases. (See appendix IV, page 10.)
DIURETICS.The kidney is the primary organ
that excretes water-soluble substances (urine) from the
body. Diuretics are agents that increase the rate of
urine formation. These agents are useful in treating
hypertension and edematous conditions, such as
congestive heart failure and acute pulmonary edema.
However, loss body fluids due to use of diuretics can
seriously deplete electrolytes from the system, and
care should be taken to monitor and replenish lost
sodium and potassium through diet and supplement
therapy. (See appendix IV, page 10 and 11)
NON-NARCOTIC ANALGESICS, ANTI-
PYRETICS, AND ANTI-INFLAMMATORY
AGENTS.Non-narcotic analgesics are drugs that
relieve pain without producing unconsciousness or
impairing mental capacities. Antipyretics relieve or
reduce fevers. Anti-inflammatory agents counteract
or suppress inflammation or the inflammatory process.
Many of the drugs discussed in appendix IV, page 11,
were developed with two or more of these properties.