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PHRM 865 > E2 Erdman FQs > Flashcards

E2 Erdman FQs Flashcards

1
Q

all FQs today are structural derivatives of ?

A

nalidixic acid

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2
Q

what did the “fluorinated” quinolones do that made them a major therapeutic advance

A

improved PK properties, gave better oral absorption, tissue penetration, longer half lives

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3
Q

what are the 4 FQs for us to know

A

Ciprofloxacin
Levofloxacin
Moxifloxacin
Delafloxacin

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4
Q

FQ MOA

A

inhibit DNA synthesis by inhibiting bacterial topoisomerases

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5
Q

the FQs target bacterial DNA ______ and topoisomerase ___

A

DNA gyrase (topo II)
IV

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6
Q

FQs form ______ complex with DNA and DNA gyrase which blocks ______ _________

A

stable
dna replication

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7
Q

removes excess positive supercoiling in DNA helix
A. topo II
B. topo IV

A

A

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8
Q

essential for separation of interlinked daughter DNA molecules
A. topo II
B. topo IV

A

B

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9
Q

Primary target in GN bacteria:
A. Topo II
B. Topo IV

A

A

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10
Q

Primary target for many GP bacteria:
A. Topo II
B. Topo IV

A

B

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11
Q

T or F:
FQs are time dependent with bactericidal activity

A

false, conc dependent

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12
Q

4 mechs of resistance for FQs

A
  • altered binding sites
  • expression of active efflux
  • altered cell wall permeability
  • cross-resistance between FQs
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13
Q

FQ SoA:
GP aerobes

A
  • group and viridans streptococci (limited)
  • Streptococcus pneumoniae (including PRSP)**
  • enterococcus spp (limited)
  • staphylococcus aureus (MRSA) (only dela, ssti) ***
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14
Q

Has poor activity against GP bacteria:
A. Delafloxacin
B. Levofloxacin
C. Ciprofloxacin
D. Moxifloxacin

A

C

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15
Q

treat MRSA:
A. Delafloxacin
B. Levofloxacin
C. Ciprofloxacin
D. Moxifloxacin

A

A

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16
Q

does not cover streptococcus pneumoniae (including PRSP)
A. Delafloxacin
B. Levofloxacin
C. Ciprofloxacin
D. Moxifloxacin

A

C

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17
Q

FQ SoA:
GN aerobes
(highlighted in slides and doc)

A
  • enterobacteriaceae
  • pseudomonas aeruginosa ** (not moxi tho)
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18
Q

does not cover pseudomonas aeruginosa
A. Delafloxacin
B. Levofloxacin
C. Ciprofloxacin
D. Moxifloxacin

A

D

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19
Q

best option for pseudomonas aeruginosa
A. Delafloxacin
B. Levofloxacin
C. Ciprofloxacin
D. Moxifloxacin

A

C

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20
Q

FQ SoA:
anaerobes

A

moxi has limited activity against bacteroides spp

21
Q

FQ SoA:
atypical bacteria

A

ALL FQs have excellent activity against atypicals:
- Legionella
- Chlamydophila and Chlamydia spp
- Mycoplasma spp
- ureaplasma urealyticum
******* for all

22
Q

out of all atypical bacteria which are FQs “extremely” active against

A

legionella

23
Q

FQ SoA:
“other organisms” (2)

A

mycobacterium tuberculosis
Bacillus anthracis

24
Q

Correlates with efficacy for FQs:
A. Cmax/MIC
B. AUC/MIC
C. MIC/AUC
D. Cmax x MIC

25
Q

what is PAE

A

post-antibiotic effect

26
Q

T or F:
FQs display a PAE against GN and GP bacteria

27
Q

least oral bioavailability:
A. Delafloxacin
B. Levofloxacin
C. Ciprofloxacin
D. Moxifloxacin

28
Q

T or F:
FQs have a lower conc-time profile than B-lactams

A

false, higher

29
Q

NOT good for infections of urinary tract and prostate:
A. Delafloxacin
B. Levofloxacin
C. Ciprofloxacin
D. Moxifloxacin

30
Q

T or F:
FQs have excellent CSF penetration

A

false, minimal

31
Q

5 highlighted body locations FQs distribute to

A
  • lung
  • bone
  • prostate
  • sputum
  • bronchial mucosa
32
Q

How are the FQs eliminated?

A

renally, except for moxi

33
Q

Hepatically eliminated:
A. Delafloxacin
B. Levofloxacin
C. Ciprofloxacin
D. Moxifloxacin

34
Q

Which FQs are removed during hemodialysis?

35
Q

which of the following can be used for upper RTIs?
A. Delafloxacin
B. Levofloxacin
C. Ciprofloxacin
D. Moxifloxacin

36
Q

which of the following are used for lower RTIs
A. Delafloxacin
B. Levofloxacin
C. Ciprofloxacin
D. Moxifloxacin

37
Q

which of the following are used for nosocomial pneumonia
A. Delafloxacin
B. Levofloxacin
C. Ciprofloxacin
D. Moxifloxacin

38
Q

which of the following is used in bacterial exacerbations in cystic fibrosis
A. Delafloxacin
B. Levofloxacin
C. Ciprofloxacin
D. Moxifloxacin

39
Q

Which of the following are used for UTIs?
A. Delafloxacin
B. Levofloxacin
C. Ciprofloxacin
D. Moxifloxacin

40
Q

which of the following is used for skin and skin structure infections
A. Delafloxacin
B. Levofloxacin
C. Ciprofloxacin
D. Moxifloxacin

41
Q

which of the following is used for chronic bacterial prostatitis
A. Delafloxacin
B. Levofloxacin
C. Ciprofloxacin
D. Moxifloxacin

42
Q

FQ AEs:
neurologic
(highlighted)

A

peripheral neuropathy (a new box warning cool)

43
Q

FQ AEs:
hepatotoxicity

A
  • LFT elevation
  • moxi has been associated with liver failure
44
Q

FQ AEs:
cardiac

A

prolongation of QT interval

45
Q

which of the following should be used with caution in pts with hypokalemia, taking antiarrhythmics, or a preexisting QTc prolongation
A. Delafloxacin
B. Levofloxacin
C. Ciprofloxacin
D. Moxifloxacin

46
Q

FQ AEs:
articular cartilage damage leads to a CI in what 2 populations of patients

A

pediatric
pregnant/breastfeeding women

47
Q

which of the following can cause tendonitis and tendon rupture
A. Delafloxacin
B. Levofloxacin
C. Ciprofloxacin
D. Moxifloxacin

48
Q

notable drug interactions for ALL FQs:

A
  • divalent and trivalent cations (this is for ALL PO FQs), ZICAM, antacids, sucralfate, enteral feeds
  • warfarin -> idiosyncratic, also all FQs
49
Q

which of the following has drug interactions with cyclosporine and theophylline
A. Delafloxacin
B. Levofloxacin
C. Ciprofloxacin
D. Moxifloxacin

PHRM 865 (32 decks)

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