T3-Fluoroquinolones Flashcards Preview

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Flashcards in T3-Fluoroquinolones Deck (25)
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1
Q

What is the MOA of fluoroquinolone?

A

Block the enzymes of bacterial cells (mess up the bacteria’s DNA). Those enzymes are needed for DNA replication and cell division

Note: Humans have these enzymes, but they are a little different; our DNA/enzymes are not affected by the antibiotic

2
Q

What are the two enzymes that are affected by fluoroquinolone?

A

DNA gyrase

Topoisomerase IV

3
Q

What are the major fluoroquinolone?

A

Ciprofloxacin
Levofloxacin
Moxifloxacin

4
Q

What are the four common uses for fluoroquinolone?

A

Travelers Diarrhea
UTIs (complicated: fever, chills)
Respiratory infections
Anthrax (give cipro, even for a child)

5
Q

What is travelers diarrhea and what fluoroquinolone do we give for it?

A

When you forget not to drink the water in foreign places; give ciprofloxacin

6
Q

What kind of UTIs are fluoroquinolone given for? What drug specifically?

A
Complicated UTIs (fever, chills, etc)
Give cipro!
7
Q

What respiratory infections would we give a fluoroquinolone for? What specific fluoroquinolone would we give?

A

Pneumonias and bacterial sinusitises; give Levofloxacin or moxifloxacin can treat pneumonias and bacterial sinusitises

8
Q

What are the COMMON adverse effects with fluoroquinolones?

A

GI upset
Photosensitivity
Altered mental status (older adults)

9
Q

COMMON adverse effects: Do all antibiotics cause GI upset?

A

Yes

10
Q

COMMON adverse effects: Photosensitivity- what happens if there is a reaction to sunlight?

A

STOP DRUG and CALL DOC

11
Q

COMMON adverse effects: Altered mental status-explain what happens?

A

This is in older adults and it isn’t super common but is significant enough to be in COMMON adverse effects. The altered mental status can involve CONFUSION and HALLUCINATIONS

12
Q

What are the RARE adverse effects of fluoroquinolone?

A
QT prolongation
Seizures
Peripheral neuropathy
Superinfection
Tendon rupture
13
Q

RARE adverse effects: Why can fluoroquinolone cause seizures?

A

The drug decreases the seizure threshold

14
Q

RARE adverse effects: What happens with peripheral neuropathy? Should we call the doc?

A

Tingling, numbness-this is A BIG DEAL. CALL THE DOC!!!

15
Q

RARE adverse effects: What kind of superinfection may be caused?

A

C. diff!

*Clidamycin and 3rd generation cephalosporins can also cause C. diff!!!

16
Q

RARE adverse effects: What tendon is usually affected? Can all tendons be affected? Who are most at risk? Who should avoid and why?

A
  • Achilles
  • Yes
  • Most at risk: >60 year old, people taking corticosteroids, people with an organ transplant (prob bc they are taking steroids too)
  • Preg. women and children (bc they are still forming their tendons and joints)
17
Q

Fluoroquinolones have a RARE adverse effect of tendon rupture, especially in children since they are still forming their tendons and joints. What are the exceptions for giving a fluoroquinolone for children and which one specifically?

A

Exceptions: If child has a COMPLICATED UTI or if the child has anthrax (the benefits outweigh the risk–the risk of this is 1 in 10,000 people)
Give CIPRO!

18
Q

What are the food/drug interactions that occur with fluoroquinolone?

A
Don't take with:
Ca2+ (milk or milk products, supplements)
Fe3+ (iron) (supplements)
Mg+2 (laxatives)
Al+3 (antacids)
Zn+2
19
Q

If a patient must take one of those cationic compounds, when should they take it in relation to the fluoroquinolone?

A

Cationic compounds 6 hours before the Fluor. OR 2 hours after they take their Fluor.

It is best to take the Fluor. first, then 2 hours later take the cationic compound!

20
Q

What is the client education regarding fluoroquinolone?

A
  1. Avoid direct sunlight
  2. Report unexplained joint pain
  3. Avoid dairy products, antacids
  4. Complete the whole course
  5. Call the doc. if you don’t get better!
21
Q

What should we teach about avoiding direct sunlight?

A

Avoid direct sunlight, cover up, wear sunscreen!

If you have a reaction, CALL THE DOC

22
Q

What should we teach our client if the report unexplained joint pain and they are waiting to be seen by the doc (i.e their appt. is in 3 days)?

A

DON’T GO RUNNING, the unexplained joint pain may be due to the tendon being close to rupturing!

23
Q

We should teach our patients to avoid dairy products and antacids for the time being. But if they must take them, they should space them out. What is the best option?

A

Take the fluoroquinolone first!! Then wait 2 hours before taking the supplement! (taking them together or not spacing them out enough will cause NEITHER drug to be absorbed!)

24
Q

T/F. The patient needs to complete the entire course of the antibiotic–even if they start feeling better.

A

TRUE

25
Q

When do you STOP the drug and call the doc with fluoroquinolones? (4)

A
  • Reaction to sunlight
  • Unexplained joint pain
  • Numbness/tingling in periphery
  • If you aren’t feeling better after being on the antibiotic for a few days!