Chapter 95: Miscellaneous Antibacterial Drugs: Fluoroquinolones, Metronidazole, Rifampin, and Rifaximin

Question 1

Fluroroquinolones

Answer 1

broad spectrum antibiotics with wide variety of clinical applications
Ciprofloxacin
Gemifloxacin
Levofloxacin
Moxifloxacin
Ofloxacin

Question 2

MOA for Ciprofloxacin (Cipro)

Answer 2

broad spectrum antibiotic (gram positive and gram negative)
inhibits bacterial DNA replication
IV or PO form

Question 3

Uses for Ciprofloxacin (Cipro)

Answer 3

wide variety of infections
Respiratory Infections
GI infections
Infections in the bone, skin, soft tissue
UTI
prevents anthrax formation

Question 4

Adverse Effects for Ciprofloxacin (Cipro)

Answer 4

Gastrointestinal (N/V/D, abdominal pain)
Headache
Tendon Rupture in adults >60, children <18 (discontinue at the first sign of tendon pain, swelling, or inflammation)
Increased risk of clostridium difficile infection (CDI)**

Question 5

Fluoroquinolones (ciprofloxacin) drug and food interactions

Answer 5

resistance increasing due to overuse
Absorption reduced by:
Aluminum and magnesium antacids
Iron and zinc salts
Sulcrafate
Milk and dairy products
Theophylline - plasma levels increased by Cipro
Warfarin - warfarin levels can be elevated
give 6 hours before or 2 hours after cipro

Question 6

Metronidazole (Flagyl) MOA

Answer 6

bacteriacidal, anaerobes only
inhibits nucleic acid synthesis

Question 7

Metronidazole (Flagyl) Uses

Answer 7

very common for abdominal infections
protozoal infections
infections caused by obligate anaerobes
H. Pylori
C-diff colitis

Question 8

Metronidazole (Flagyl) Drug Interaction

Answer 8

inhibits warfarin metabolism
no alcohol (during and 3 days after)

Question 9

Metronidazole (Flagyl) Adverse Effects

Answer 9

Neurotoxicity
Nausea
Disulfram-type reaction
Phototoxicity
St. Johnson Syndrome

Question 10

Metronidazole (Flagyl) nursing considerations

Answer 10

1 drug to treat C. diff infection

Treats STI
Avoid ETOH (during and 3 days after completion of treatment - severe vomiting & cramps)

Question 11

Metronidazole (Flagyl) side effects

Answer 11

Report - rash –>Stevens Johnson Syndrome
No need to report –> metallic taste and urine discoloration (brown color urine)

Question 12

METRonidazole pneumonic

Answer 12

M - metallic taste and dark urine
E - ETOH - avoid
T - treats - c-diff and STI
R - rash - stevens johnson syndrome

Question 13

Rifampin

Answer 13

broad spectrum antibacterial used primarily for tuberculosis (TB)
also used for meningitis; not monotherapy
prophylaxis of meningitis due to Haemophilus influenza
turns urine, sweat, tears, bright orange/red