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Infectious Disease > Fluoroquinolones > Flashcards

Fluoroquinolones Flashcards

1
Q

(T/F) - Fluoroquinolones have a broad-spectrum activity against gram (-) and (+) organisms

A

FALSE - Gram (-), (+), and atypical organisms

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2
Q

(T/F) - Fluoroquinolones display an excellent oral F

A

TRUE

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3
Q

(T/F) - Fluoroquinolones have a high incidence of adverse effects

A

FALSE - low incidence

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4
Q

What is the MOA of fluoroquinolones?

A

Inhibits DNA gyrase (bacterial topoisomerase) leading to DNA strand breaks and rapid bactericidal activity

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5
Q

What are the mechanisms of resistance for fluoroquinolones?

A
  • Mutation of target site (DNA gyrase)
  • Decreased permeability of outer cell wall membrane of gram (-) bacteria
  • Production of efflux proteins that actively trasnport fluoroquinolones out of bacteria
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6
Q

What are the drugs that fall under the fluoroquinolone class?

A
  • Ciprofloxacin
  • Moxifloxacin
  • Levofloxacin
  • Gemifloxacin
  • Delafloxacin
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7
Q

Which fluoroquinolones are also known as respiratory quinolones?

A
  • Gemifloxacin
  • Moxifloxacin
  • Levofloxacin
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8
Q

Ciprofloxacin has a good spectrum over which bacteria?

A
  • Enteric GNRs
  • Pseudomonas
  • H. influenzae
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9
Q

Respiratory quinolones have a good spectrum over which bacteria?

A
  • H. influenzae
  • Enteric GNRs
  • Pseudomonas
  • S. pneumoniae
  • Atypicals
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10
Q

Only one respiratory quinolone is active against pseudomonas, which one is it?

A

Levofloxacin

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11
Q

What adverse events could occur with fluoroquinolones?

A
  • CNS
  • CV
  • Musculoskeletal
  • Dermatologic
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12
Q

What type of CNS adverse events could occur?

A
  • Dizziness
  • Peripheral neuropathy
  • Hallucinations
  • Confusion
  • Insomnia
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13
Q

What type of CV adverse events could occur?

A

QT prolongation

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14
Q

What type of musculoskeletal adverse events could occur?

A
  • Arthralgias (uncommon)

- Achilles tendon rupture (black boxed warning)

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15
Q

Who is more likely to gain Achilles tendon rupture as an adverse event w/ fluoroquinolones?

A
  • Elderly
  • Renal dysfunction pts
  • Pts on corticosteroids
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16
Q

What type of dermatologic adverse event could occur?

A

Photosensitivity

17
Q

What is a contraindication of flouroquinolones?

A

Pregnant and children

18
Q

What is the dose of ciprofloxacin in pseudomonas?

A
  • 400 mg IV q 8 h
    OR
  • 750 mg PO q 12 h
19
Q

What is the dose of levofloxacin in pseudomonas?

A
  • 750 mg PO or IV q 24 h
20
Q

What is the percentage of bioavailability with fluoroquinolones?

A

80-100%

21
Q

(T/F) - ALL fluoroquinolones dose given PO are the same dose as IV

A

FALSE - all except ciprofloxacin (po = 1.25 x IV)

22
Q

(T/F) - ALL fluoroquinolones chelate cations which decrease the oral F of fluoroquinolones

A

TRUE

23
Q

Which cations chelate with fluoroquinolones?

A
  • Mg
  • Ca
  • Fe
  • Milk
  • MVIs
  • antacids
24
Q

What should be done if a patient is taking cations and flouroquinolones?

A

Separate by at least 2 hrs

25
Q

Fluoroquinolones are problematic with what else?

A

Tube feeds

26
Q

How are fluoroquinolones cleared?

A

Renally

27
Q

Which fluoroquinolone is not renally cleared?

A

Moxifloxacin

28
Q

Moxifloxacin is not best to be used in which indication?

A

UTIs

29
Q

The FDA has stated to use fluoroquinolones if risks outweigh benefits for which indications?

A
  • Sinusitis
  • Bronchitis
  • Uncomplicated UTIs
30
Q

Delafloxacin can be administered how?

A
  • IV

- PO

31
Q

Delafloxacin has a good spectrum in which bacteria?

A
  • Gram (+) including MRSA

- Gram (-) including pseudomonas

32
Q

What is delafloxacin FDA approved of?

A

Skin/soft tissue infections

33
Q

Should delafloxacin be used whenever for any infections?

A

No, it shouldn’t be used unnecessarily to avoid development of resistance

34
Q

What is the usual dose of delafloxacin given PO?

A

450 mg PO q 12 h

35
Q

What is the usual dose of delafloxacin given IV?

A

300 mg IV q 12 h

Infectious Disease (41 decks)

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