ch 78

Question 1

Fluoroquinolones can all cause what major adverse effect

Answer 1

tendinitis and tendon rupture of achilles tendon

Question 2

ciprofloxacin is ____ spectrum and ______

Answer 2

broad spectrum

bactericidal

Question 3

drug for preventing anthrax in people who have inhaled

Answer 3

Ciprofloxacin

Question 4

fluoroquinolones in kids

Answer 4

no due to tendon rupture

Question 5

ciprofloxacin adverse effects

Answer 5

tendinitis
rupture of achilles tendon
n/v/d
abd pain
dizziness
headache
restlessness
confusion
candida infections of the pharynx, vagina, 
confusion
somnolence 
psychosis
visual disturbances
phototoxicity (severe sunburn) - characterized by erythema, exudate, vesicles, blistering and edema - which can occur with direct sun, indirect sun and sunlamps even with sunscreen - wear protective clothing on top of sunscreen - d/c cipro at first sign of phototoxic rash
c.diff

Question 6

cipro should be stopped at the first sign of

Answer 6

tendon injury
discontinue at the first sign of tendon pain swelling or inflammation

refrain from exercise until tendon injury is r/o

Question 7

which fluoroquinolones are approved in children

Answer 7

Ciprofloxacin and levofloxacin

however generally avoided in kids

Question 8

pregnancy fluoroquinolones

Answer 8

no

Question 9

breast feeding fluoroquinolones

Answer 9

no

Question 10

fluoroquinolones older adults

Answer 10

well tolerated, creatinine clearance should be calculated

Question 11

fluoroquinolones - high risk group

Answer 11

glucocorticoids
pt 60 and older
history of heart, lung or kidney transplant

Question 12

education on ciprofloxacin for sun tox

Answer 12

characterized by erythema, exudate, vesicles, blistering and edema - which can occur with direct sun, indirect sun and sunlamps even with sunscreen - wear protective clothing on top of sunscreen - d/c cipro at first sign of phototoxic rash

Question 13

ciprofloxacin and MG

Answer 13

can exacerbate weakness. Should not get this drug

Question 14

cipro and food reaction

Answer 14

can be reduced by the following

aluminum or mag containing antacids
iron salts
zinc salts
sucralfate
calcium supplements
milk
dairy products

these cationic agents should be administered at least 6 hours before cipro or 2 hours after

Question 15

drug interactions ciprofloxacin

Answer 15

increase plasma levels of the following drugs

theophylline
warfarin
tinidazole

for pt taking warfarin - prothrombin time should be monitored and dose of warfarin reduced as appropriate

Question 16

fluoroquinolone used for infections of the resp tract, GI, bones, joint, skin, soft tissue and anthrax

Answer 16

Ciprofloxacin (Cipro)

Question 17

used to treat protozoal infections and infections by obligate anaerobic bacteria

Answer 17

metronidazole (Flagyl)

Question 18

Bacteroides fragilis and other Bacteroides, c diff and other clostridium species, fusobacterium, gardnerella vaginalis, peptococcus species and peptostroptococcus species

Answer 18

Metronidazole (flagyl)

Question 19

flagyl is employed for prophylaxis in surgical procedures associated with a high risk for infection by

Answer 19

anaerobes such as colorectal surgery, abd surgery, gynecologic surgury

Question 20

H.Pylori treatment for someone with PUD

Answer 20

Metronidazole (flagyl) with a tetracycline and bismuth subsalicylate to eradicate

Question 21

black box for flagyl

Answer 21

carcinogenic risk

Question 22

cyclic lipopeptides drug

Answer 22

Daptomycin

Question 23

what bad bug can daptomycin target

Answer 23

MRSA

Question 24

adverse effect daptomycin

Answer 24

muscle injury - ckmb will be elevated
constipation
n/d
headache
insomnia 
rash

Question 25

can you use daptomycin for community acquired pneumonia

Answer 25

no

Question 26

2 approved indications daptomycin

Answer 26

1) bloodstream infection to include endocarditis) 2) complicated skin and skin structures by susceptible strains of the following gram pos bacteria: ``` S aureus (to include MRSA) strep pyoges strep agalactiae strep dysgalactiae subspecies equisimilis E.faecalis (vanc susceptible strains only) ```

Question 27

Daptomycin and renal

Answer 27

renal dosing must be used for GFR less than 30 or risk tox

Question 28

what labs should be done weekly for pt taking daptomycin

Answer 28

CPK levels - if levels rise more than 10 times the upper limit, d/c med if also having muscle pain or weakness

Question 29

drug interactions and daptomycin

Answer 29

when you combine daptomycin and tobramycin - increased daptomycin levels and moderate decrease in tobramycin levels statin inhibitor (simvastatin)- both can cause myopathy

Question 30

Treatment in hospital for MRSA

Answer 30

Vanc Daptomycin Zyvox

Question 31

outpatient treatment for MRSA

Answer 31

Bactrim minocycline doxycycline clindamycin

Question 32

what fluoroquinolone will treat MRSA

Answer 32

Daptomycin

Question 33

what fluoroquinolone has risk of QT

Answer 33

Moxifloxacin (Avelox)

Question 34

which fluoroquinolone is approved for Community acquired pneumonia

Answer 34

Gemifloxacin

Question 35

which fluoroquinolones have sun toxicity

Answer 35

Levofloxacin Gemifloxacin Delafloxacin