14. Quinolones and fluoroquinolones

Question 1

Quinolones

Answer 1

Nalidixic acid​ (non fluorinated quinolone)

• Too rapid excretion into the urine → use in lower UTIs-Spectrum: G-ive aerobic
• Adverse effect: GI and CNS

Question 2

Fluoroquinolones

Answer 2

• *Nor** floxacin
• *Cipro** floaxcin
• *Levo** floxacin
• *Moxi** floxacin
• mainly indicated for gram negatives
• Unwinding braid: inhibit bacterial DNA gyrase (Topoisomerase)
• treat gram negative UTI’s (E. coli and proteus)
• elevating (levo) and sipping (cipro) from Bladder cup: Complicated UTI’s, levofloxacin and ciprofloxacin treat UTI caused by Pseudomonas
• empiric treatment for pyelonephritis
• treat acute prostatitis
• treat gram negative causes of gastroenteritis (shigella, E. Cola, Salmonella)
• treat salmonella gastroenteritis
• treat anthrax caused by B. Anthracis
• treat gram negative salmonella osteomyelitis
• respiratory quinolones treat community acquired pneumonia (s. Pneumonia)
• respiratory quinolones treat atypical “walking “ pneumonia caused by mycoplasma pneumonia (levofloxacin and moxifloxacin)
• respiratory quinolones treat atypical pneumonia caused by Legionella
• *-not recommended for children under 10 years of age
• ——————————————————————————**

-sickle cell patients are at increased risk of Salmonella osteomyelitis

-divalent and trivalent cations
(calcium, iron, magnesium, decrease absorption

• risk of prolonged QT interval
• GI Side effects N/V
• risk of tendon and cartilage damage in the elderly
• risk of tendon rupture in steroid users
• teratogenic – damage to growing cartilage