Flouroquinolones/UTI Flashcards
Flouroquinolones
Ciprofloxacin Ofloxacin levofloxacin moxifloxacin Gatifloxacin gemifloxacin
Flouroquinolones mech
Inhibits DNA gyrase which precents relaxation of coiled DNA so it can never uncoil enough for replication
-secondaryily transcription and replication
Bacericidal!
Flouroquinolones spectrum
- aerobic G- and goof G+
- anaerobic for moxi and gemifoxacin
Ciproflocacin
UTI and anthrax prophylaxis and P. aerunginosa
Ofloxacin
Prostatitis
Levofloxacin
CAP
Moxifloxacin
Anaerobes
Gatifloxacin
ocular application only
Gemifloxacin
anaerobes
Flouroquinolones Pharm
Well absorbed orally but iron/mg/ca/ alum absorbtion decrease
- poor CNS peneteation
- excreted by kidney
Flouroquinolones Adverse
GI disturbances All increase QT interval Tendon rupture!! Cartilage erosions photsensitivity Contra: preg or nursing women and children
Metronidazole mech
Oral, IV, Top
- liver metabolisms and elinated by kideys
taken up by bacteria which conerts it to active drug by ferredoxin! Only present in the ECC of anaerobes!
- take up into DNA making it unstabel so Cydal!
Metronidazole spectrum
anaerobes!
G- and G+
good for mixed infections
H. Pylori, mixed intraabdom inf, vaginitis, RTI, pseudomembranous colitis
Metronidazole reactions
Disulfiram like reaction- so dont drink alch
Disgeusia- metallic taste
UTI specific Drugs
Nitrofuranotoin
Methenamine
Properties of UTI drigs
Renally excreted
will achieve therapuetic concetrantions in the urine > cidal activity in the urine
-acid pH will also activate drug
Nitrofurantoin mech
Damaged bacterial DNA
wide spectrum except Proteus or Pseudomonas ( because they elevate pH in the urin)
- rapid absorptions after oral use
- should not be given if creatine clearance less then 50mL/min becuase abx wont reach high enough concentration in urin
*urine will be brown!
Nitrofurantoin toxicity
Hemolytic anemia in G6PD def
Pulmonary fibrosis- in elderly
N/V/D
Conta: preg(38-42), less than one month of age, impared renal function, allergy
Methenamine mech
begins as prodrug which decomposes to formaldehyde and ammonia in the acid medium
- it needs to go through Urea cycel ( so if poor liver function can get liver encepalopathy)
Methenamine spect and toxi
Nearly all bacteria are sensitiv except proteus( will raise pH) so can add hippuric acid
Tox: really not toxic but most with decompose in urinary tract
Methenamine contra
Hepatic insufficientcy becuase you need to be able to process ammonia
