Fluoroquinolones

Question 1

Why should fluoroquinlones be avoided in MRSA?

Answer 1

Because many staphylococci are resitant to quinolones

Question 2

What is the interaction with NSAIDs and quinolones?

Answer 2

Risk of convulsions- even when no history of convulsions apparent

Question 3

MHRA alerts associated with quinolones

Answer 3

• Tendonitis risk
• Aortic aneurysm risk
• Potential risk of irreversible serious side effects
• Heart valve reguritation risk
• Must only prescribe when other abx are inappropriate

Question 4

When is the risk of tendon damage with quinolones increased?

Answer 4

Concomittant use of corticosteroids

Question 5

When is tendon damage likley to occur?

Answer 5

Can occur within 48 hours but

Question 6

CI of fluoroquinolones

Answer 6

History of tendon disorder

Question 7

Cautions of fluuoroquinolones

Answer 7

History of epilepsy, QT prolongation, heart valve disorders, in children and adolescents due to atrophy risk

Question 8

SEs of fluoroquinolones

Answer 8

Seizures- lower seizure threshold and cause hallucinations

Muscle tendon ruptures

QT prolongation

GI upset

Skin reactions

Hypoglycaemia

C diff risk

Question 9

Key interactions of fluoroquinolones

Answer 9

NSAIDs- increase seizure risk

Prednisolone- increases risk of tendon rupture

Drugs which prolong QT interval

Anticoagulants as it increases anticoagulant effect

Calcium- lower ciprofloxacin absorption

Theophylline- risk of theophylline toxicity and seizures

Question 10

Counselling points for fluoroquinolones

Answer 10

May impair performance of skill tasks such as driving

Leave 2 hours before or after taking a quinolone to have antacids, zinc, or iron

Protect skin from sunlight and avoid sunbeds