Test 3 - Flouroquinolones (Josh)

Question 1

MOA: Fluoroquinolones (-floxacin)

Answer 1

messing up the DNA by destroying the enzymes needed for DNA replication & cell division

Question 2

What enzymes do Fluoroquinolones target?

Answer 2

DNA Gyrate
Topoisomerase IV

These are needed for DNA replication & cell division

Humans have these, but they are a little different and are NOT targeted by fluoroquinolones

Question 3

Common uses for Fluoroquinolones

Answer 3

• Traveler’s Diarrhea (Ciprofloxacin)
• Complicated UTIs (Ciprofloxacin)
• Respiratory Infections like pneumonia & bacterial sinusitis (Levofloxacin & Moxifloxacin)
• Anthrax (Ciprofloxacin)

Question 4

Common adverse effects of Fluoroquinolones (-floxacin)

Answer 4

• GI upset (N/V, diarrhea like all antibiotics)
• Photsensitivity
• Altered Mental Status (confusion, hallucinations in older adults)

Question 5

Rare adverse effects of Fluroquinolones (-floxacin)

Answer 5

• QT elongation
• Seizures
• Peripheral Neuropathy
• Superinfection (C. diff)
• Tendon Rupture (esp. Achilles)

Question 6

Which clients who are at higher risk for tendon rupture w/ Fluoroquinolones (-floxacin)?

Answer 6

• > 60 yrs old
• clients on corticosteroids
• clients w/ organ transplant (b/c they’re taking corticosteroids)

Question 7

Which clients should AVOID Flouroquinolones (-floxacin)?

Answer 7

• Pregnant women
• Children

Exceptions for kids is if the have a complicated UTI or they are exposed to Anthrax… give them Ciprofloxacin

Question 8

Avoid which type of foods when taking -floxacin?

Answer 8

• Calcium (milk products)
• Iron (supplements)
• Magnesium (laxatives, MOM)
• Aluminum (antacids)
• Zinc

Question 9

When should we hold the -floxacin and call the doc?

Answer 9

• Allergy to sunlight (due to photosensitivity issue)
• unexplained join pain (tendon rupture)
• numbness/tingling in periphery (peripheral neuropathy)
• if you’re not getting better (wrong drug wrong bug)

Question 10

Overview of Antibiotics:

1) —- break down cross-links in bacterial cell wall
2) —- bind to ribosomes preventing them from making protein
3) —- block the formation of folic acid and used mainly for UTIs
4) — is a Trojan Horse that is nice on outside but destroys once absorbed into bacteria
5) —- mess up bacterial DNA

Answer 10

1) Beta-Lactams (-cillin, ceph- or cef-)
2) Protein Synthesis Inhibitors (tetracycline, Macrolide, Clindamycin, Linezolid, Aminoglycosides)
3) TMP/SMZ
4) Nitrofurantoin
5) Flouroquinolons (-floxacin)

Question 11

If taking supplements and then prescribed -floxacin, what is best method of taking?

Answer 11

Take drug first, then wait couple of hours to take supplement