C / 14 - Quinolones and fluoroquinolones

Question 1

Structure of quinolones and fluoroquinolones

Answer 1

• Quinolones : nalidixic acid : reaches high concentrations in urine to be antibacterial
• Fluoroquinolones : fluorinated so has systemic effect

Question 2

MOA of quinolones and fluoroquinolones

Answer 2

Inhibits topoisomerase II (gyrase) and topoisomerase IV : causes relaxation of supercoiled DNA and separation of replicated DNA

Question 3

1st, 2nd, 3rd and 4th generations of fluoroquinolones?

Answer 3

1 - Norfloxacin
2 - Ciprofloxacin, ofloxacin
3 - Levofloxacin
4 - Moxifloxacin

Question 4

Norfloxacin
Spectrum
Indications
Toxicity

Answer 4

• Gram (-) aerobe bacteria (proteus, e. coli)
• UTIs + prostatitis
• GI symptoms, CNS effects

Question 5

Ciprofloxacin, ofloxacin
Spectrum
Indications
ROA
Toxicity

Answer 5

• Gram (-) aerobe bacteria (including pseudomonas), and some gram (+) bacteria (b. anthracis)
• Abdominal infections, UTIs
• Oral, parenteral, topical
• GI symptoms, CNS effects

Question 6

Levofloxacin
Spectrum
Indications
ROA
Toxicity

Answer 6

• More active against gram (+) bacteria than gram (-) : staph, strep
• Community acquired pneumonia
• Oral, parenteral
• GI symptoms, QT prolongation

Question 7

Moxifloxacin
- Spectrum
- Indications
- ROA
- Toxicity

Answer 7

• Gram (+) bacteria and extended anaerobic coverage
• Respiratory tract infections
• Oral, parenteral
• GI symptoms