Fluoroquinolones Flashcards
What are the Fluoroquinolones?
**Ciprofloxacin
**Levofloxacin
Moxifloxacin
How do the Fluoroquinolones work?
All about DNA:
- Topoisomerase II (DNA gyrase) –> in gram negative
- Quinolones inhibit the relaxation of positively supercoiled DNA
- Topoisomerase IV –> in gram positive
- Quinolones interfere with separation of replicated chromosomal DNA
So the bacteria can’t replicate their DNA
Which Fluoroquinolone has the best bioavailability?
All have good bioavailability, but Levofloxacin has the best
How are the Fluoroquinolones excreted?
Renal excretion:
- Ciprofloxacin
- Levofloxacin
Nonrenal excretion:
- Moxifloxacin
What has strong Gram Positive Killing?
Strong:
- Gemifloxacin
- Levofloxacin
- Moxifloxacin
Moderate = Ciprofloxacin
What has strong Gram Negative Killing?
Strong:
- Ciprofloxacin –> even Pseudomonas
Moderate = Levofloxacin & Moxifloxacin
What has strong Anaerobe activity?
Strong:
- Gemifloxacin
- Moxifloxacin
Moderate: Levofloxacin
What are Fluoroquinolones used for?
- Urinary tract infection
- Sexually transmitted diseases
- Respiratory tract (community acquired pneumonia)
- Prostatitis
- Gastrointestinal and abdominal
- Bone, joint and soft tissue
- Anthrax
What are possible side effects of the Fluoroquinolones?
- Gastrointestinal
- Mild nausea, vomiting, diarrhea - Central nervous system
- Headache, dizziness - Tendonitis
- Achilles tendon rupture, tear - Use in pediatric patients
- QTc prolongation
Prescription for Ciprofloxacin?
500 mg
One tablet every twelve (12) hours
Not for gram positive.
Good for uncomplicated UTI, 3 days
For complicated UTI: 1-2 weeks treatment.
Bone/joint: 500 mg, 2x a day, for 4-6 weeks
Prescription for Levofloxacin?
500 mg
One tablet daily
Good for Gram positive and psuedomonas.
Community acquired pneumonia: 7-14 days
General rule for Ciprofloxacin & Levofloxacin with regard to the Diaphragm?
Above the diaphragm?
- Think LEVOFLOXACIN
Below the diaphragm?
-Think CIPROFLOXACIN
