Flouroquinolones

Question 1

Fluoroquinolines

Mechanism

Answer 1

Inhibit DNA gyrase

Question 2

Fluoroquinolones

Spectrum

Answer 2

G -ve bacilli
Salmonella
Shigella
Campylobacter
Haemophilus
Neisseria

Question 3

Fluoroquinolones

Indications

Answer 3

Norfloxacin:
UTI
Uncomplicated Gonococcal inf.
Prostatitis

Cipro, ofloxacin, levofloxacin:
UTIs
Lower respiratory tract inf
Sinusitis
Bone, joint, skin inf.
Prostatitis

Levofloxacin, :
UTIs
Lower resp

Moxifloxacin: intra abdominal inf. + Lower resp

Gemifloxacin: lower resp inf. + Oral dose only

Question 4

Fluoroquinolones

Side effects

Answer 4

Nausea, dyspepsia, 
Headache
Dizziness
Insomnia
Cardiac QT prolongation
Arthropathy
Tendonitis & tendon rupture (black box warning by FDA)
CNS effects
Photosensitivity
Hypoglycemia

Rash urticaria
Leukopenia
Increased LFT
Crystalluria (high dose at alkaline pH)

Question 5

Fluoroquinolones

Interactions

Answer 5

Theophylline levels increase with tetracycline admin
Antacids & sucralfate & iron decrease absorption of fluoroquinolones
Fqs may increase prothrombin time in patients receiving warfarin
NSAIDs risk of seizure
Prolonged QT with antiarrhythmic
Antidiabetic + FQs (Plasma glucose levels fluctuate (hypo & hyper))

Question 6

Spectrum & Indications gen wise

Answer 6

1 gen:
Cinoxacin G -ve , UTIs
Nalidixic Acid
Norfloxacin

2 gen:
Cipro: G -ve , systemic, UTI
Ofloxacin: G +ve

3 gen:
Levo: G +ve, G-ve, Atypicals
Gemi: G -ve , systemic
Moxi: G +ve, Atypicals