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Test > Fluoroquinalones, Other ABX > Flashcards

Fluoroquinalones, Other ABX Flashcards

1
Q

Are fluoroquinalones bacteriostatic or icidal?

A

Bactericidal

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2
Q

Are Fluoroquinalones concentration or time dependent?

A

Concentration dependent

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3
Q

What is fluoroquinolone’s MOA?

A

They inhibit protein synthesis by binding to DNA gyrase, inhibiting the relaxation of the supercoiled DNA, promoting breaking of the DNA strands

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4
Q

Which fluoroquinolones cover pseudomonas?

A

Cipro, high dose levo, norfloxacin, and ofloxacin

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5
Q

What is fluoroquinolones’ relationship with atypicals?

A

They provide good atypical coverage, ex. Mycoplasma pneumonia
- provide good intracellular penetration to atypicals

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6
Q

What are the general uses for fluoroquinolones?

A

CAP, nosocomial pneumonia, acute sinusitis, complicated and uncomplicated UTIs (except not gemifloxacin and moxifloxacin), prostatitis, some soft tissue infections and osteo, Crohn’s, campylobacter, legionella, brucella, salmonella, mycobacterium
- cipro, levo, and ofloxacin for eyes
- ofloxacin for ears

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7
Q

Is cipro a good choice for strep pneumonia?

A

No, cipro is generally not great for gram +

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8
Q

Where are cipro’s SE?

A

GI, QT prolong, tendon rupture, increased seizure frequ, renal dose required
- CYP1A2 inhibitor

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9
Q

Which fluoroquinolone is good for MRSA

A

Only Delafloxacin

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10
Q

Which fluoroquinolones are not good for peds?

A

Norfloxacin, ofloxacin, moxifloxacin, and levo

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11
Q

Which fluoroquinolone does not require renal dosing?

A

Moxifloxacin

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12
Q

What pregnancy and lactation category are fluoroquinolones?

A

Category C, L3

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13
Q

General Fluoroquinolone SE

A

QT prolong (mostly with other meds or if you have prolongation syndrome
- seizure risk, mostly related to taking cipro with NSAID and used off label
- tendon rupture if organ transplant and taking steroids, and over 60y

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14
Q

Which fluoroquinolone is good for CF?

A

Cipro

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15
Q

What are the mechanisms of resistance to fluoroquinolones?

A
  • change the structure of the DNA gyrase
  • reduced abx uptake by the bacteria
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16
Q

Which fluoroquinolone eye drop does not have a preservative?

A

Moxifloxacin

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17
Q

Which otic solution is not sterile?

A

Cipro 0.2% and hydrocortisone suspension, don’t use if tympanic membrane is ruptured

18
Q

Which otic solution is appropriate for acute otitis media externa from pseudomonas?

A

Cipro

19
Q

Do bi and tri valent cations interact with fluoroquinolones?

A

Yes, Ca, Fe AL, and Mg interact with them, reducing the bioavailability of abx

20
Q

What drug class is Daptomycin?

A

Cyclic Lipopeptide, a concentration dependent bactericidal against Gram +

21
Q

What is Daptomycin mainly used for?

A

Gram + MRSA of skin/soft tissue infections
- also vanc sensitive enterococcus, s. Aureus endocarditis

22
Q

Can Daptomycin be used for CAP

A

No. Broken down by surfactant

23
Q

What are the SE of Daptomycin?

A

Increased CK and myopathy, caution with statins, fibrates, colchicine

24
Q

What is the MOA of Trimethoprim/Sulfamethoxazole (TMP/SMX [Bactrim])?

A

Inhibits folic acid synthesis causing cell div to stop or slow, can cause bone marrow suppression and anemias dt cross over to effects on human cells

25
Q

What is TMP/SMX prescribed for?

A

Drug of choice for PJP/PCP*
Only drug for ventilator associated Stenotrophomonas maltophilia*
-otitis media, UTIs, travelers diarrhea, shigella, cholera, prostatitis, nocardiosis
- Gram +: CA S. Aureus (MRSA), S. Epidermidis, S. Pneumoniae, S. pyogenes, s. Viridans
- Gram -: H. Influenzae, enterobacteriaceae, salmonella, shigella
- poor strep coverage

26
Q

What are the TMP/SMX SE?

A

-increased bili/kernicterus (avoid in last trimester and breastfeeding)
- sulfa allergy (SJS)
- Major inhibitor of CYP2C9 (will increase effects of warfarin)
- renal dosing
- avoid in G6PD
- crystalluria
- hyperkalemia (dt K sparing)
- bone marrow suppression (TMP=Treats Marrow Poorly)

27
Q

What type of drug is Dapsone?

A

Bacteriostatic, Sulfone, similar in action to sulfonamides

28
Q

What is Dapsone used for?

A

Leprosy and alternative for PJP

29
Q

What are the SE for Dapsone?

A

Anemia and increased bili if G6PD, N/V, HAs, neuropathy

30
Q

What is the MOA of Nitrofurantoin (Macrobid, macrodantin)

A

Bactericidal, interferes will cell wall synthesis

31
Q

What is nitrofurantoin (macrobid) prescribed for?

A

Gram + and gram - UTIs

32
Q

What are the SE of nitrofurantoin (macrobid?)

A

Hemolytic anemia with G6PD(don’t give near term), caution with folate def, pulm tox with prolonged use, CNS effects, brownish urine, peripheral neuropathy, false + urine glucose, avoid with renal impairment since it needs to make to the urine for UTI treatment

33
Q

Fluuroquinalones are the ________ line treatment for chlamydia and epididymitis, the ______ line therapy for traveler’s diarrhea, and no longer recommended for __________.

A

First line treatment for chlamydia and epididymitis
Second line therapy for diarrhea
No longer rec for gonorrthea

34
Q

Which drug is a first line treatment for typhoid fever?

A

Cipro

35
Q

Linezoilid is what type of abx?

A

Oxazolidinones

36
Q

What is Linezolid used for?

A

Most effective against Gram +:
-also includes gram - and anaeorbic
- main ones are group A and B strep, S. Pneumoniae, E. Faecalis, E. Faecium, S. Aureus (both MSSA and MRSA), S. Epidermis is, C. Perfringens, Peptostreptococcus, Corynebacterium jeikeium, L. Monocytogenes, Enterococcus including VRE

37
Q

What are the contraindications and SE for Linezolid?

A

Contra: concomitant use with MAOI, SSRIs, tricyclics, QT prolonging meds
- an cause serotonin syndrome, myelosupression, lactic acidosis, neuropathy, with long term use

38
Q

What is Linezolid typically used for?

A

Group A and B strep, , esp MRSA pneumonia as alternative to vanc, Vanc resistant Enterococcus faecium (VRE)

39
Q

Sulfonamides, TMP-SMZ, trimethoprim, nitrofurantoin, and fosfomycin can be used for what?

A

UTIs specifically cystitis
-TMP-SMZ can also be used for community acquired MRSA

40
Q

Sulfanimides should be used cautiously in pts with which deficiency?

A

G6PD def and folate def
Use cautiously w renal impairment
Can also cause kernicterus, crystalluria unless urine alkaline and not enough water, TEN/SJS, hepatitis, photosens, increased K-, neuropathy, CNS changes, aseptic meningitis, increased QT
-Preg D

41
Q

Trimethoprim should be used cautiously in pts with which deficiency?

A

Folate, renal impairment, pregnancy category C, although TMP-SMZ is Category D

Test (13 decks)

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