Quinolones, Folic acid antagonists and Urinary antiseptics Flashcards

1
Q

Fluoroquinolone targets _________ in Gram negatives and _________ in Gram positive bacteria

A

DNA gyrase, topoisomerase IV

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2
Q

Name 3 fluoroquinolones

A

ciprofloxacin, levofloxacin, moxifloxacin

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3
Q

Fluroquinolones should be administered at least _________ hours before consumption of dairy products or substances that contain divalent cations

A

2 hours

Best on empty stomach

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4
Q

Name the two respiratory quinolones

A

Levofloxacin and moxifloxacin

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5
Q

Name at least 3 adverse effects associated with the use of fluroquinolones.

A
  1. Phototoxicity
  2. Tendinitis or tendon rupture
  3. Prolong QT interval
  4. Peripheral Neuropathy
  5. GI distress
  6. Arthropathy
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6
Q

Which antibiotics are known to cause phototoxicity?

A

Tetracyclines, fluoroquinolones

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7
Q

Fluoroquinolones are contraindicated in _________

A
  1. Children < 18 years old

2. Pregnant women

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8
Q

Can fluoroquinolones be used when breastfeeding?

A

No

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9
Q

Name 3 folate synthesis inhibitors

A

Sulfonamides, trimethoprim, cotrimoxazole

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10
Q

Folic acid is vitamin B9 that is needed in humans to produce healthy ___________

A

red blood cells

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11
Q

Which enzyme does sulfonamide inhibit?

A

Dihydropteroate synthase

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12
Q

Sulfonamides are only effective in bacteria that synthesize their own __________?

A

folic acid

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13
Q

Sulfonamides can cause nephrotoxicity as a result of __________?

A

crystalluria

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14
Q

G6PD deficient patients using sulfonamides can suffer from __________

A

hemolytic anemia

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15
Q

Usage of sulfonamides in last trimester can cause __________ in newborns

A

kernicterus

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16
Q

Which enzyme does trimethoprim inhibit?

A

Dihydrofolate reductase

17
Q

Trimethoprim can cause __________ deficiency in humans

A

folic acid

18
Q

Folic acid deficiency caused by trimethoprim can be managed by giving the patients _____________ .

A

Folinic acid

19
Q

Cotrimoxazole is a combination of which 2 antibiotics, and in what ratio?

A

Trimethoprim and sulfamethoxazole, 1:5 respectively

20
Q

Name an antibiotic which is used as the choice of drug for the management of pneumocystis pneumonia

A

Cotrimoxazole

21
Q

Cotrimoxazole is contraindicated in which trimester(s) of pregnancy?

A

First and last trimester

22
Q

Name at LEAST two indications for cotrimoxazole

A
  1. Uncomplicated UTI

2. Pneumocystis pneumonia

23
Q

Name at LEAST 3 adverse effects related to the use of cotrimoxazole

A
  1. GI related adverse effects like nausea, vomitting, CDAD
  2. Rash
  3. Photosensitivity
  4. Blood disorders including megaloblastic anemia, leukopenia, and thrombocytopenia
  5. Haemolytic anaemia in G6PD deficient patients
24
Q

What is nitrofurantoin’s mechanism of action?

A

It is converted by the bacteria to a highly active intermediate, which disrupts the synthesis of DNA, RNA and metabolic processes.

25
Q

Nitrofurantoin is effective in treatment of _________ .

A

lower UTI

26
Q

Nitrofurantoin can cause urine colour to turn _________ .

A

brown

27
Q

How is nitrofurantoin cleared?

A

Renal clearance

28
Q

G6PD deficient patients using nitrofurantoin are susceptible to ___________ .

A

Hematologic disturbances such as hemolytic anemia, leukopenia

29
Q

What is G6PD, and why is it important in red blood cells?

A

The glucose-6-phosphate dehydrogenase (G6PD) enzyme is the central factor of the antioxidant defense system in red blood cells, which helps maintain high levels of reduced glutathione (GSH) and nicotine adenine dinucleotide phosphate (NADPH), to protect the RBC from oxidative damage caused by reactive oxygen species.

30
Q

Name 3 groups of patients in whom nitrofurantoin may be contraindicated.

A
  1. Patients with impaired renal function
  2. Pregnant women (at term > 37 weeks)
  3. Infants <1 mth of age
31
Q

What would be examples of recommended treatment options for simple UTI in healthy women of reproductive age?

A
  1. Cotrimoxazole

2. Nitrofurantoin

32
Q

Name an antibiotic that can be administered orally for the management of Pseudomonas aeruginosa

A

Ciprofloxacin

33
Q

Can ciprofloxacin be used in the management of MRSA infections?

A

No, due to high rates of resistance.