Fluoroquinolones Flashcards
(35 cards)
(T/F) - Fluoroquinolones have a broad-spectrum activity against gram (-) and (+) organisms
FALSE - Gram (-), (+), and atypical organisms
(T/F) - Fluoroquinolones display an excellent oral F
TRUE
(T/F) - Fluoroquinolones have a high incidence of adverse effects
FALSE - low incidence
What is the MOA of fluoroquinolones?
Inhibits DNA gyrase (bacterial topoisomerase) leading to DNA strand breaks and rapid bactericidal activity
What are the mechanisms of resistance for fluoroquinolones?
- Mutation of target site (DNA gyrase)
- Decreased permeability of outer cell wall membrane of gram (-) bacteria
- Production of efflux proteins that actively trasnport fluoroquinolones out of bacteria
What are the drugs that fall under the fluoroquinolone class?
- Ciprofloxacin
- Moxifloxacin
- Levofloxacin
- Gemifloxacin
- Delafloxacin
Which fluoroquinolones are also known as respiratory quinolones?
- Gemifloxacin
- Moxifloxacin
- Levofloxacin
Ciprofloxacin has a good spectrum over which bacteria?
- Enteric GNRs
- Pseudomonas
- H. influenzae
Respiratory quinolones have a good spectrum over which bacteria?
- H. influenzae
- Enteric GNRs
- Pseudomonas
- S. pneumoniae
- Atypicals
Only one respiratory quinolone is active against pseudomonas, which one is it?
Levofloxacin
What adverse events could occur with fluoroquinolones?
- CNS
- CV
- Musculoskeletal
- Dermatologic
What type of CNS adverse events could occur?
- Dizziness
- Peripheral neuropathy
- Hallucinations
- Confusion
- Insomnia
What type of CV adverse events could occur?
QT prolongation
What type of musculoskeletal adverse events could occur?
- Arthralgias (uncommon)
- Achilles tendon rupture (black boxed warning)
Who is more likely to gain Achilles tendon rupture as an adverse event w/ fluoroquinolones?
- Elderly
- Renal dysfunction pts
- Pts on corticosteroids
What type of dermatologic adverse event could occur?
Photosensitivity
What is a contraindication of flouroquinolones?
Pregnant and children
What is the dose of ciprofloxacin in pseudomonas?
- 400 mg IV q 8 h
OR - 750 mg PO q 12 h
What is the dose of levofloxacin in pseudomonas?
- 750 mg PO or IV q 24 h
What is the percentage of bioavailability with fluoroquinolones?
80-100%
(T/F) - ALL fluoroquinolones dose given PO are the same dose as IV
FALSE - all except ciprofloxacin (po = 1.25 x IV)
(T/F) - ALL fluoroquinolones chelate cations which decrease the oral F of fluoroquinolones
TRUE
Which cations chelate with fluoroquinolones?
- Mg
- Ca
- Fe
- Milk
- MVIs
- antacids
What should be done if a patient is taking cations and flouroquinolones?
Separate by at least 2 hrs
