Quinolones Flashcards
(18 cards)
What are the quinolone drugs?
Ciprofloxacin, Levofloxacin, Moxifloxicin
What is the MOA of the quinolones?
Inhibit DNA gyrase, inhibit topoisomerase IV. Quinolones trap or stabilize the enzyme-DNR complexes after strand breakage and before resealing DNA
What gram positive organisms are quinolones effective against?
- In-vitro activity against S. aureus
- S. pneumonia: Levo/Moxi
- Enterococus: poor, may be effective for UTI
What gram negative organisms are quinolones effective against?
- Enteric GNR’s: E. coli, Klebsiella, Proteus
- H. influenza
- P. aeruginose: Cipro/Levo
True/False: Quinolones are not effective against atypical bacteria
False. quinolones are effective against atypical bacteria
True/False: Quinolones are effective against mycobacterium bacteria
True
Which quinolone is effective against anaerobes?
Moxifloaxin
What UTI disorders are quinolones used for? Except which drug?
• Cystitis
• Pyelonephritis
• Prostatitis
NOT Moxifloaxin
What GI/Abdominal Infections are quinolones used for?
- Traveler’s diarrhea
* Intra-abdominal infection: moxifloxacin alone, Cipro or Levo + Metronidazole
What respiratory infections are quinolones used for?
- CAP: moxi/levo (activity against S. pneumoniae)
- HAP: cipro/levo (activity against P. aeruginosa); high dose
- Cystic fibrosis
What bone and joint infections are quinolones used for?
- Osteomyelitis
* Prosthetic joint infection: retained joint: quinolone + rifampin
True/false: quinolones are used to treat osteomyelitis?
True
True/false: quinolones are used as an adjunct to treat MDR in pulmonary TB?
true
What are the SE of quinolones?
o GI: usually mild; higher association with C. difficile than other agents
o Central nervous system: HA, dizziness, confusion
o Tendinitis, tendon rupture (rare)
• Risk increased in older patients, pts on steroids
o QT prolongation
• Moxifloxacin > cipro or levo
• Risk increased in patients:
o Receiving Class III or Class IA antiarrhythmics or other agents that prolong QT (erythromycin, haloperidol)
o With hypokalemia, hypomagnesemia, bradycardia
What is the MOA of Metronidazole?
o Interacts with DNA to cause a loss of helical DNA structure and strand breakage resulting in inhibition of protein synthesis
What organisms does metronidazole cover?
o Anaerobes • B. fragilis • Clostridium including difficile • Note a good choice for Actinomyces o Trichomonas
What are the clinical uses of metronidazole?
o C. difficile diarrhea
o Intra-abdominal infections in combination with other agents
o Surgical prophylaxis in colon surgery (with other agents)
o Trichomoniasis
What are the SE of metronidazole?
o Metallic taste
o GI disturbances
o Peripheral neuropathy (long term use or high doses)
o Disulfiram reaction with alcohol
