Fluoroquinolone's Flashcards

Exam 1 List

1
Q

Fluoroquinolone’s should NOT be taken with:

A

Dairy, or oral supplements which contain Mag, zinc, calcium, or iron

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2
Q

Is Ciprofloxacin part of the older or newer generation?

A

Older

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3
Q

Which Fluoroquinole has significant activity against Staphylococcus, Enterococcus, and Streptococcus?

A

Levofloxacin

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4
Q

Ciprofloxacin and Levofloxacin are the only two fluoroquinoles that have activity against this organism:

A

P. aeruginosa.

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5
Q

Can ciprofloxacin & Levofloxacin cross the blood brain barrier?

A

Poorly in uninflammed meninges, but to a moderate extent under inflammation

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6
Q

Does ciprofloxacin enter breast milk?

A

Yes

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7
Q

What is the bioavailability of ciprofloxacin vs levofloxacin?

A

Cipro: 70%
Levo: 99%

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8
Q

How does ciprofloxacin get eliminated?

A

40-50% excreted unchanged in urine; remainder in feces

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9
Q

How does levofloxacin get eliminated?

A

87% unchanged in urine; remained eliminated by tubular secretion

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10
Q

What are the black box warnings for fluoroquinolone?

A
  1. Tendonitis & tendon rupture
  2. Exacerbation of muscle weakness; avoid in patients with myasthenia graves
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11
Q

Fluoroquinoles should be dosed for:

A

Impaired renal function: CrCl <50mL/min

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12
Q

Can Ciprofloxacin be given safely & confidently to pregnant mothers?

A

No. There is conflicting evidence & the FDA recommends alternative medications unless the organism is solely susceptible to Cipro (inhalation anthrax)

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13
Q

Ciprofloxacin is used as first-line treatment for:

A

typhoid fever

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14
Q

What are the primary indications for levofloxacin?

A

Bronchitis
Community acquired pneumonia
pyelonephritis/
uncomplicated UTI’s
Sinusitis

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15
Q

What are the primary indications for Ciprofloxacin?

A

-Bacterial diarrhea
-Inhalation anthrax
-Severe or complicated UTI’s
-Meningococcal carriers
-Intra-abdominal infections

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16
Q

Both Ciprofloxacin & Levofloxacin require special dosing in these types of patients. State the lab value as well.

A

Renal impairment
Creatinine clearance of <50mL/min

17
Q

Levofloxacin should not be given concurrently with these drugs. State why:

A

NSAIDS
Dairy
Antacids

18
Q

Ciprofloxacin should not be given concurrently with these drugs/foods:

A

Caffeine
Dairy
Phenytoin
Probenecid
Theophylline
Antacids

19
Q

What effect does the fluorine molecule have on fluoroquinolone activity?

A

Provides increased potency against gram-negative organisms and broadens the spectrum to include gram-positive organisms as well.

20
Q

How is resistance mediated against fluoroquinolones?

A

By mutations in the quinolone-binding region of the target enzyme or by a change in the permeability of the organism

21
Q

Fluoroquinolones have notable activity against which types of organism?

A

gram-negative bacteria

22
Q

What is the age recommendations for fluoroquinolones?

A

not recommended for children younger than 18 years

23
Q

What are three possible adverse effects of fluoroquinolones?

A
  1. C. Diff
  2. hypersensitivity reactions
  3. Phototoxicity
24
Q

Generally speaking, Fluoroquinolones are first-line therapy in the treatment of?

A

Traveler’s diarrhea and severe diarrhea not associated with antibiotic therapy

25
Q

Fluoroquinolones undergo metabolism by which enzymes?

A

CYP3A4

26
Q

Fluoroquinolones can increase risk of toxicity of these two drugs which are metabolized by the sam enzymes:

A

Theophylline and Warfarin

27
Q

What is the MOA?

A

Prevent transcription of supercoiled DNA by inhibiting DNA Gyrase

28
Q

Fluoro’s can cause these adverse effects:

A

Tendon rupture
Prolonged QTC
Increased risk of aortic dissection
Phototoxicity; STJ