- group and viridans streptococci (limited) - Streptococcus pneumoniae (including PRSP) - enterococcus spp (limited) - staphylococcus aureus (MRSA) (only dela, ssti)

E2 Erdman FQs Flashcards by Cole O'Connor

all FQs today are structural derivatives of ?

nalidixic acid

How well did you know this?

Not at all

Perfectly

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

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

How well did you know this?

Not at all

Perfectly

what are the 4 FQs for us to know

Ciprofloxacin
Levofloxacin
Moxifloxacin
Delafloxacin

How well did you know this?

Not at all

Perfectly

FQ MOA

inhibit DNA synthesis by inhibiting bacterial topoisomerases

How well did you know this?

Not at all

Perfectly

the FQs target bacterial DNA ______ and topoisomerase ___

DNA gyrase (topo II)
IV

How well did you know this?

Not at all

Perfectly

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

stable
dna replication

How well did you know this?

Not at all

Perfectly

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

How well did you know this?

Not at all

Perfectly

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

How well did you know this?

Not at all

Perfectly

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

How well did you know this?

Not at all

Perfectly

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

How well did you know this?

Not at all

Perfectly

T or F:
FQs are time dependent with bactericidal activity

false, conc dependent

How well did you know this?

Not at all

Perfectly

4 mechs of resistance for FQs

altered binding sites
expression of active efflux
altered cell wall permeability
cross-resistance between FQs

How well did you know this?

Not at all

Perfectly

FQ SoA:
GP aerobes

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

How well did you know this?

Not at all

Perfectly

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

How well did you know this?

Not at all

Perfectly

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

How well did you know this?

Not at all

Perfectly

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

How well did you know this?

Not at all

Perfectly

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

enterobacteriaceae
pseudomonas aeruginosa ** (not moxi tho)

How well did you know this?

Not at all

Perfectly

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

How well did you know this?

Not at all

Perfectly

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

How well did you know this?

Not at all

Perfectly

FQ SoA:
anaerobes

moxi has limited activity against bacteroides spp

FQ SoA:
atypical bacteria

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

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

legionella

FQ SoA:
“other organisms” (2)

mycobacterium tuberculosis
Bacillus anthracis

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

what is PAE

post-antibiotic effect

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

true

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

D (59% F)

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

false, higher

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

T or F: FQs have excellent CSF penetration

false, minimal

5 highlighted body locations FQs distribute to

- lung - bone - prostate - sputum - bronchial mucosa

How are the FQs eliminated?

renally, except for moxi

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

Which FQs are removed during hemodialysis?

NONE **

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

B, C, D

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

B, D

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

B, C

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

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

B, C

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

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

B, C

FQ AEs: neurologic (highlighted)

peripheral neuropathy (a new box warning cool)

FQ AEs: hepatotoxicity

- LFT elevation - moxi has been associated with liver failure

FQ AEs: cardiac

prolongation of QT interval

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

all

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

pediatric pregnant/breastfeeding women

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

all

notable drug interactions for ALL FQs:

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

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