Quinolone Antimicrobial Agents Flashcards

(46 cards)

1
Q

Name the four quinolone core structures

A

Quinolone
Cinnolone
1,8-Naphthyridone
Pyridopyrimidone

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2
Q

First generation quinolones are used to treat

A

Gram Negative Bacteria

Only useful for lower urinary tract infections

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3
Q

Two examples of first generation quinolones?

A

Oxolinic acid

Nalidixic acid

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4
Q

Defining characteristics of second generation quinolones

A

Fluorine substituent at C6

Heterocyclic ring at C7

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5
Q

Three common examples of second generation quinolones

A

Norfloxacin
Ciprofloxacin
Levofloxcin

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6
Q

Second generation quinolones are much more effective against…

A

G- species (including Pseudomonas)

Extended activity against G+ organisms and mycoplasma

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7
Q

The most potent flouroquinolone

A

Ciprofloxacin

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8
Q

How are 3rd and 4th generation quinolones different from 2nd?

A

Multiple Fluorine atoms

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9
Q

3rd/4th Generation quinolones are more effective against…

A

G+ organisms (esp. strep pneumo)

None as good as Cipro against Gram negatives

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10
Q

Two examples of 3/4th generation quinolones

A

Sparfloxacin

Moxifloxacin

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11
Q

Moxifloxacin is considered a drug…

A

of last resort

Severe Side Effects

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12
Q

How do DNA topoisomerases and gyrases cleave DNA?

A

A Nucleophilic attack on a phosphodiester linkage

One strand becomes free, the other enzyme linked

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13
Q

The nucleophile targeted by DNA topiosomerases and gyrases?

A

the phenolic hydroxyl group of a tyrosine residue

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14
Q

Decribe the method of DNA transport by bacterial topoisomerases and gyrases?

A
  1. G-segment DNA binds a high affinity CAP region site
  2. CAP regions remain in closed conformation
  3. 2 ATP bind ATPase domains
  4. N gate closure with T seg trapped in the DNA capture domain
  5. G-sgement DNA gate opens, T seg passes through
  6. G-segment DNA religates. C-gate opens
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15
Q

G-segment binding requires what enzyme conformation

A

An open N gate and an opening between the two B regions of the protein
Once bound, the CAP regions remain closed

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16
Q

What is likely assoiciated with ATP hydrolysis of topiosomerases? Why?

A

A conformational change

To help squeeze the T segment through the open gate

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17
Q

How is the cycle of Topisomerase activity ended?

A

Rapid closure of the C gate

Release of hydrolysis products and open N gate

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18
Q

The dimeric enzyme binds _____ and cleaves the strands with ______

A

duplex DNA

A Four Base Stagger

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19
Q

Clevage involves covalent attachment of…

A

Each subunit of the dimer through a phosphotyrosine linkage to the 5’ end of the DNA

20
Q

When would the gyrase/topisomerase mechanism be used within the same molecule? From different ones?

A

Same – Relaxation, Knotting, Unknotting

Different – Catenation, Decatenation

21
Q

Requirements for topisomerase/gyrases to be active?

A

Mg++

ATP hydrolysis

22
Q

How is the phosphodiester backbone rejoined/ligated?

A

Nucleophliic Displacement of the Protein Tyrosine residue

23
Q

Quinolone antibiotics bind to…

A

the Cleavage complex that exists after a strand is broken

24
Q

What happens after the quinolone antibiotic has bound?

A

The clevage comlex is stabilized and the religation reaction is inhibited. This blocks progression of the replication fork and the DS breaks will lead to apoptosis.

25
Most common therapeutic uses of quinolones? | Which ones?
UTIs | Norfloxacin, Ciprofloxacin, ofloxacin, and nalidixic acid
26
Treatment for prostatitis?
Norfloxacin, Ciprofloxacin, Ofloxacin
27
STDS treatable with quinolones?
Neisseria gonorrhoeae Chlamydia Ducreyi
28
Treatments for gonorrhea and ducreyi?
Ciprofloxacin
29
Treatments for Chlamydia?
Ofloxacin | Sparfloxacin
30
First line treatment against gonorrhea
Ceftriaxone | Too much resistance to quinolones
31
Quinolones can be used to treat what GI illness? | Which drugs?
Traveler's Diarrhea, Reduces time for cholera | Norfloxacin, Ciprofloxacin, Ofloxacin
32
Quinolones effective against Strep pneumo
Moxifloxacin
33
______ as a sole therapy is effective in 50% of diabetic foot infections
Ciprofloxacin
34
______ and ______ are effective against intracellular bacteria
Norfloxacin | Ciprofloxacin
35
Fluoroquinolone resistance mechanisms include...
Decreased cellular permeability Efflux Pumps Mutation of the target enzymes
36
Two specific types of mutations that might alter quinolone efficacy
1. Mutation of a-subunit of DNA gyrase that inhibits binding affinity for the drug 2. B-subunit mutations Especially if these mutations are additive
37
Floroquinolone penetration of G- bacteria depends on...
diffusion through porin channels
38
Bioavailability of fluoroquinolones?
Readily absorbed orally | high bioavailability
39
Which flurorquiolone isn't dependent on renal and hepatic clearance?
Oxafloxacin (almost entirely renal)
40
Quinolones should not be distributed with foods/drugs containing...
heavy metals | They form insoluble chelates
41
The major inactive metabolite of quinolones
the glucuronide at the 3 carboxyl position
42
Most common side effects of quinolones?
Nausea, Vomiting, and Diarrhea
43
CNS reactions associated with quinolones?
Headache and Dizziness | Hallucinations, Delirium, Seizures
44
Why don't you give quinolones to patients under 18? | Exception?
Damage to growing cartilage, arthropathy | Exception - CF patients
45
Photosensitivity has been reported with...
Lomefloxacin
46
Uncontrolled sugar in diabetic patients is associated with...
Gatifloxacin