A-25. Fluoroquinolones, other antibacterial agents (nitroimidazoles, nitrofurans, fosfomycin)

Question 1

2nd generation Fluoroquinolones

Answer 1

Ciprofloxacin
Enrofloxacin
marbofloxacin

Question 2

3rd generation Fluoroquinilones

Answer 2

Levofloxacin
Sparfloxacin

Question 3

4th generation fluoroquinilones

Answer 3

Pradofloxacin
moxifloxacin

Question 4

AMEG Category of fluoroquinilones

Answer 4

3rd & 4th : Cat B

Question 5

Structure of Fluoroquinilones

Answer 5

5th carbon attachment affects toxicity
3 & 4th carbon attachement affects effectiveness

Question 6

3rd & 4th fluoroquinilones generation resistance

Answer 6

decreased efficacy or no efficacy against P. aeruginosa

Question 7

2nd generation fluoroquinilones generation resistance

Answer 7

Anaerobic
streptococcus
enterococcus

Question 8

2nd generation fluoroquinilones generation spectrum

Answer 8

P. aeruginosa (Ciprofloxacin, Enrofloxacin, marbofloxacin)
IC bacteria

Question 9

Spectrum of 1st generation Fluoroquinilones

Answer 9

Enterobacteriaceae
fastidious bacteria
Aeromonas

Question 10

Spectrum of 3rd generation Fluoroquinilones

Answer 10

Gram +
Streptococcus
IC bacteria

Question 11

Spectrum of 4th generation Fluoroquinilones

Answer 11

Gram +
Streptococcus
IC bacteria
Anaerobs

Question 12

mode of action of Fluoroquinilones

Answer 12

promotion of bacterial DNA cleavage : inhibition of DNA synthesis
Concentration dependent bactericidal
PAE : 2-5hrs

Question 13

Resistance of fluoroquinilones

Answer 13

chromosomal resistance (E.Coli, Salmonella & Campylobacter)
Plasmid mediated (Enterobacteriaceae)
cross resistance between all generations

Question 14

PK of fluoroquinilones

Answer 14

Abs: Excellent, PO (food delays) ; SC/IM : good
Distr: Excellent (special barriers, concentrated in phagocytic cells)
Met: Partially metabolized, metabolites may be active
Excr: Urine as active drug, partially bile

Question 15

Toxicity of Fluoroquinilones

Answer 15

very safe (1st G most toxic)
long lasting administration & large dose : more SE

Question 16

Side effects of Fluoroquinilones

Answer 16

Retinopathy in cats (enrofloxacin)
inhibition of cartilage dvlpmt
CNS seizures
Dysbacteriosis

Question 17

interactions with fluoroquinilones

Answer 17

synergistic: b-lactam, aminoglycosides, Vancomycin, Metronidazole
Antagonist: Chloramphenical, Rifampicin
increases: Warfarin, caffein, theophylline & cyclosporin effect
prolonged QT, use antiarrhythmics

Question 18

Indication of 2nd Generation Fluoroquinilones

Answer 18

UTI
Resp inf.
Dermatitis
sepsis
otitis
meningitis
1st choice: prostatitis

Question 19

indication of 3rd & 4th G fluoroquinilones

Answer 19

Meningitis
Anaerob infection
meningoencephalitis
peritonitis
periodontitis

Question 20

Enrofloxacin specie administration

Answer 20

Lactating cows
sus
poultry
smalls

Question 21

Ciprofloxacin specie administration

Answer 21

Human

Question 22

Danofloxacin specie administration

Answer 22

lactating cows
swine
poultry

Question 23

marbofloxacin specie administration

Answer 23

large (injection)

Question 24

orbifloxacin specie administration

Answer 24

smalls (orally)

Question 25

Pradofloxacin specie administration

Answer 25

smalls (orally)

Question 26

Nitroimidazoles drug

Answer 26

metronidazoles

Question 27

metronidazole mode of action

Answer 27

destroys DNA in anaerobic conditions (Bacteriacidal??)

Question 28

metronidazole spectrum

Answer 28

obligate anaerobic bacteria protozoa (trichomonas, histomonas, giardia, amoeba)

Question 29

PK of metronidazole

Answer 29

Abs: Excellent Distr: Excellent Met: liver excr: urine

Question 30

metronidazole indication

Answer 30

anal sacculitis gingivitis paradonditis oral cavity infection protozoal

Question 31

metronidazole banned from

Answer 31

Swine dysentery prevention

Question 32

Fosfomycin mode of action

Answer 32

inhibition of peptidoglycan, bactericidal

Question 33

spectrum of fosfomycin

Answer 33

Gram + Gram - (resistance develops rapidly)

Question 34

PK of fosfomycin

Answer 34

distr: moderate met: none excr: faeces & urine

Question 35

Administration and indication of fosfomycin

Answer 35

PO for UTI

Question 36

Nitrofurans drugs

Answer 36

nitrofurantoin

Question 37

mode of action of nitrofurantoin

Answer 37

bactericidal

Question 38

spectrum of nitrofurantoin

Answer 38

broad Gram - Enterobactericeae

Question 39

resistance of nitrofurantoin

Answer 39

proteus & pseudomonas

Question 40

PK of nitrofurans

Answer 40

abs: PO well Furasolidone : met by liver (for enteral infections) excr: Urine & nitrofurantoin

Question 41

nitrofurantoin indication & species

Answer 41

UTI, Ca & Fe

Question 42

Toxicity of nitrofurantoin

Answer 42

low TI GI irritation neurotoxicity NOT for FPA (mutagenic & carcinogenic)