ch 78 Flashcards
Fluoroquinolones can all cause what major adverse effect
tendinitis and tendon rupture of achilles tendon
ciprofloxacin is ____ spectrum and ______
broad spectrum
bactericidal
drug for preventing anthrax in people who have inhaled
Ciprofloxacin
fluoroquinolones in kids
no due to tendon rupture
ciprofloxacin adverse effects
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
cipro should be stopped at the first sign of
tendon injury
discontinue at the first sign of tendon pain swelling or inflammation
refrain from exercise until tendon injury is r/o
which fluoroquinolones are approved in children
Ciprofloxacin and levofloxacin
however generally avoided in kids
pregnancy fluoroquinolones
no
breast feeding fluoroquinolones
no
fluoroquinolones older adults
well tolerated, creatinine clearance should be calculated
fluoroquinolones - high risk group
glucocorticoids
pt 60 and older
history of heart, lung or kidney transplant
education on ciprofloxacin for sun tox
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
ciprofloxacin and MG
can exacerbate weakness. Should not get this drug
cipro and food reaction
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
drug interactions ciprofloxacin
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
fluoroquinolone used for infections of the resp tract, GI, bones, joint, skin, soft tissue and anthrax
Ciprofloxacin (Cipro)
used to treat protozoal infections and infections by obligate anaerobic bacteria
metronidazole (Flagyl)
Bacteroides fragilis and other Bacteroides, c diff and other clostridium species, fusobacterium, gardnerella vaginalis, peptococcus species and peptostroptococcus species
Metronidazole (flagyl)
flagyl is employed for prophylaxis in surgical procedures associated with a high risk for infection by
anaerobes such as colorectal surgery, abd surgery, gynecologic surgury
H.Pylori treatment for someone with PUD
Metronidazole (flagyl) with a tetracycline and bismuth subsalicylate to eradicate
black box for flagyl
carcinogenic risk
cyclic lipopeptides drug
Daptomycin
what bad bug can daptomycin target
MRSA
adverse effect daptomycin
muscle injury - ckmb will be elevated constipation n/d headache insomnia rash
can you use daptomycin for community acquired pneumonia
no
2 approved indications daptomycin
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)
Daptomycin and renal
renal dosing must be used for GFR less than 30 or risk tox
what labs should be done weekly for pt taking daptomycin
CPK levels - if levels rise more than 10 times the upper limit, d/c med if also having muscle pain or weakness
drug interactions and daptomycin
when you combine daptomycin and tobramycin - increased daptomycin levels and moderate decrease in tobramycin levels
statin inhibitor (simvastatin)- both can cause myopathy
Treatment in hospital for MRSA
Vanc
Daptomycin
Zyvox
outpatient treatment for MRSA
Bactrim
minocycline
doxycycline
clindamycin
what fluoroquinolone will treat MRSA
Daptomycin
what fluoroquinolone has risk of QT
Moxifloxacin (Avelox)
which fluoroquinolone is approved for Community acquired pneumonia
Gemifloxacin
which fluoroquinolones have sun toxicity
Levofloxacin
Gemifloxacin
Delafloxacin
