Fluoroquinolone's Flashcards
Exam 1 List
Fluoroquinolone’s should NOT be taken with:
Dairy, or oral supplements which contain Mag, zinc, calcium, or iron
Is Ciprofloxacin part of the older or newer generation?
Older
Which Fluoroquinole has significant activity against Staphylococcus, Enterococcus, and Streptococcus?
Levofloxacin
Ciprofloxacin and Levofloxacin are the only two fluoroquinoles that have activity against this organism:
P. aeruginosa.
Can ciprofloxacin & Levofloxacin cross the blood brain barrier?
Poorly in uninflammed meninges, but to a moderate extent under inflammation
Does ciprofloxacin enter breast milk?
Yes
What is the bioavailability of ciprofloxacin vs levofloxacin?
Cipro: 70%
Levo: 99%
How does ciprofloxacin get eliminated?
40-50% excreted unchanged in urine; remainder in feces
How does levofloxacin get eliminated?
87% unchanged in urine; remained eliminated by tubular secretion
What are the black box warnings for fluoroquinolone?
- Tendonitis & tendon rupture
- Exacerbation of muscle weakness; avoid in patients with myasthenia graves
Fluoroquinoles should be dosed for:
Impaired renal function: CrCl <50mL/min
Can Ciprofloxacin be given safely & confidently to pregnant mothers?
No. There is conflicting evidence & the FDA recommends alternative medications unless the organism is solely susceptible to Cipro (inhalation anthrax)
Ciprofloxacin is used as first-line treatment for:
typhoid fever
What are the primary indications for levofloxacin?
Bronchitis
Community acquired pneumonia
pyelonephritis/
uncomplicated UTI’s
Sinusitis
What are the primary indications for Ciprofloxacin?
-Bacterial diarrhea
-Inhalation anthrax
-Severe or complicated UTI’s
-Meningococcal carriers
-Intra-abdominal infections
Both Ciprofloxacin & Levofloxacin require special dosing in these types of patients. State the lab value as well.
Renal impairment
Creatinine clearance of <50mL/min
Levofloxacin should not be given concurrently with these drugs. State why:
NSAIDS
Dairy
Antacids
Ciprofloxacin should not be given concurrently with these drugs/foods:
Caffeine
Dairy
Phenytoin
Probenecid
Theophylline
Antacids
What effect does the fluorine molecule have on fluoroquinolone activity?
Provides increased potency against gram-negative organisms and broadens the spectrum to include gram-positive organisms as well.
How is resistance mediated against fluoroquinolones?
By mutations in the quinolone-binding region of the target enzyme or by a change in the permeability of the organism
Fluoroquinolones have notable activity against which types of organism?
gram-negative bacteria
What is the age recommendations for fluoroquinolones?
not recommended for children younger than 18 years
What are three possible adverse effects of fluoroquinolones?
- C. Diff
- hypersensitivity reactions
- Phototoxicity
Generally speaking, Fluoroquinolones are first-line therapy in the treatment of?
Traveler’s diarrhea and severe diarrhea not associated with antibiotic therapy
Fluoroquinolones undergo metabolism by which enzymes?
CYP3A4
Fluoroquinolones can increase risk of toxicity of these two drugs which are metabolized by the sam enzymes:
Theophylline and Warfarin
What is the MOA?
Prevent transcription of supercoiled DNA by inhibiting DNA Gyrase
Fluoro’s can cause these adverse effects:
Tendon rupture
Prolonged QTC
Increased risk of aortic dissection
Phototoxicity; STJ
