Prompt #3 Valerie Valerie is taking tetracycline to treat her cystic acne.

Prompt #3 Valerie
           Valerie is taking tetracycline to treat her cystic acne. Tetracycline is an oral antibiotic given to treat acne that is caused by inflammation from bacteria. Providers should “advise patients to take tetracycline on an empty stomach or with foods that are not high in calcium, aluminum, iron, or magnesium because the drug chelates with these minerals, thereby decreasing absorption” (Woo,2019). Since Valeria is taking the medication twice a day, I would recommend she take it in the morning before eating anything and then bed at night (assuming she does not eat a few hours before bed). This will ensure that she is taking the medication correctly and receiving the maximum benefit. This will be the only way to determine if it’s the way she is taking the medication or the medication itself that is not working for her. 
             Antacids are basic substances to nuetralize the acid in the gastrointestinal system. “changes in the pH from antacid or potassium therapy can reduce absorption of folic acid, iron, and vitamin B12” (Woo, 2019). Changes in the PH of the gastrointestinal system can interfere with the metabolism of other medications. Studies have also shown that, “antacids containing aluminium and magnesium hydroxides interfered with the intestinal absorption of tetracycline” (0gawa, 2011).Administration of these drugs together reduces the area under the concentration-time curves of tetracyclines by 90% (0gawa, 2011). This means that the area under the concentration-time curves take into account the maximum concentration, time of the maximum concentration and the half-life. This shows that there is a significant drug-drug interaction. I would recommend to Valeria that she evaluate what is causing the heartburn instead of treating it with over the counter medications. It appears that she has started taking the antacid soon after beginning the tetracycline. A common side effect of tetracylcine is gastrointestinal upset. 
Woo, T. M. (2019). Pharmacotherapeutics for Advanced Practice Nurse Prescribers with 3-yr access to Davis Edge. [VitalSource Bookshelf]. Retrieved from https://online.vitalsource.com/#/books/9781719641531/
Ogawa, R., & Echizen, H. (2011). Clinically significant drug interactions with antacids: an update. Drugs, 71(14), 1839–1864.