Fluoroquinolones Flashcards
True or false
Topoisomerase II of mammalian cells is the same as the topoisomerase II in the bacteria
False
Topoisomerase II of mammalian cells is DIFFERENT from the topoisomerase II in bacteria.
Mammalian DNA is linear
Bacterial DNA is circular
Which of the following is not a bacterial resistnace to fluoroquinolones?
A. mutation of bacterial topoisomerase
B. Mutation of mammalian topoisomerase
C. insuffient accumulation of drug in bacteria
B
If a bacteria mutates gyrA gene, which of the following antibiotics won’t work?
A. beta-lactams
B. Protein synthesis inhibitors
C. cyclic peptide antibiotics
D. fluoroquinolones
D
Which of the following colors is the pharmacopohore required for activity?
A. Blue
B. Red
C. Black
A. Blue
Called a carboxy-4-pyridone nucleus
True or False
Reduction of the highlighed parts will cause interference with gyrase-DNA complexation
False
FQ will inactivate
if there is a substitution at C2 then there will interference with gyrase-DNA complexation
If there is substitution at the C2 carbon what features will the FQ have?
A. Increased antibacterial activity
B. Broadens activity
C. interferes with gyrase-DNA complexation
D. increased absorption
C. Increased with gyrase-DNA complexation
What does the F-group on the C6 Carbon do to the FQ?
A. Required for activity
B. Increases antibacterial activity
C. Increases absorption therefore activity
D. Broadens activity
B. Increases antibacterial activity
Increased cell penetration due to lipophilicity
What effects do the F in the C8 carbon have? (select all that apply)
A. photosensitivity
B. Increases antibacterial activity
C. Increases absorption therefore activity
D. Broadens activity
A,C
The group C8 can be substituted with a -OCH3. What does the -OCH3 do for the structure?
A. Better Absorption
B. Improved antibacterial
C. Decreased photosensitivity
D. Adverse side effects
C
At the C7 position there can be a hterocyclic ring, what is the purpose of the heterocyclic ring?
A. Better absorption
B. Photosensitivity
C. Improved antibacterial effect
D. Produces CNS effects
C.
Which of the following statements is true?
A. Piperazinyl ring has the best antibacterial effects, but it has CNS effects
B. Piperazinyl ring decreases CNS effects
C. Alkyl substitutions on the piperazinyl ring increase CNS effects
D. alkyl substiution on piperazynyl ring decrease CNS effects
A, D
Adding a cyclopropyl ring to the N-1 position does which of the following?
A. Improves antibacterial Activity
B. broadens activity
C. Increased CNS effects
D. Decreases CNS effects
B. Broadens Activity
The following structure covers what type of bacteria?
A. Gram Positive
B. Gram Negative
C. Atypical
D. A and B
E. B and C
F. All of the above
F. All of the above
Atypical bacteria have no cell wall examples include chlamydia, mycoplasma, and legionella
A third ring in the nucleus does what to the FQ?
A. Produces CNS effects
B. Increases Photosensitivity
C. Increases Absorption
D. Increases Activity
D
What activity does the highlighed arrow have?
A. Increased Activity
B. interferes with gyrase-DNA complexation
C. Increases photosensitivity
D. Increased absorption
A. Increased antibacterial activity
Which of the following statements is true about the arrow pointing at Norfloxacin? (select all that apply)
A. Alkyl susbtitution on piperazinyl ring increases CNS Effects
B. Piperazinyl causes CNS effects
C. piperazinyl decreases CNS Effects
D. Alkyl susbtitution on piperazinyl ring decreases CNS Effects
B, D
What activity doe the yellow do?
A. Broadens Activity
B. Improved Antibacterial Effects
C. Increased Activity
D. Increased Absorption
C
What does the yellow do for the activity?
A. Increase Photosensitivity
B. Decrease Photosensitivity
C. Increase CNS Effects
D. Decrease CNS Effects
D.
What does the yellow do for the activity?
A. Increased Photosensitivity
B. Decreased Photosensitivity
C. Decreased absorption
D. Increased Antibacterial Activity
A
What does the yellow do for its activity?
A. Decreases CNS Effects
B. Increases CNS Effects
C. Decrease Absorption
D. Increase Absorption
A. Decrease CNS effects
Remember that if there is an alkyl substitution on the piperazinyl ring then that will decrease the CNS effects
What does the blue arrow do for the drug’s activity?
A. Increases Activity
B. Decreases Activity
C. Increased antibacterial activity
D. Broadens Activity
D.
N-1 Cyclopropyl broadens activity
Which of the following is not covered by the first generation FQ? (select all that apply)
A. Gram Positive
B. Gram Negative
C. P. aeruginosa
D. S. pneumoniae
A, C, D
Which of the following is paired incorrectly?
A. First Generation: Cinoxin
B. Second Generation: Levofloxacin
C. Third Generation: Gemifloxacin
D. Fourth Generation: Moxifloxacin
B.
Which of the following medications is first generation FQ?
A. Norfloxacin
B. Cinoxin
C. Moxifloxacin
D. Gemifloxacin
B.
Which of the following FQ generation has poor serum and tissue concentration?
A. Fourth Generation
B. Third Generation
C. Second Generation
D. First Generation
A
Which of the following medications is second generation FQ? (select all that apply)
A. Levofloxacin
B. Ofloxcin
C.Sparfloxacin
D. Enoxacin
B, D
Second Generation Spells out CLONE
Ciprofloxacin
Lomefloxacin ( m comes before v on loMefloxacin and leVofloxacin)
Ofloxcin
Norfloxacin
Enoxxacin
Which of the following medications is third generation FQ? (select all that apply)
A. Lomefloxacin
B. Levofloxacin
C. Sparfloxacin
D. Gemifloxacin
B, C, D
Third Generation FQ Spell out
GLasS
Gemifloxacin
Levofloxacin
as
Sparfloxacin
IDK
Which of the following FQ generations have a PK of adequate serum and tissue concentration?
A. first generation
B. second generation
C. third generation
D. Fourth generation
B
What is the antibacterial spectrum of the second generation FQ?
A. Gram Positive
B. Gram Negative
C. Anaerobes
D. Atypical Bacteria
B
What is the PK of the third generation FQ?
A. tissue concentration exceeds plasma concentration
B. high serum and tissue concentration
C. adequate serum and tissue concentration
D. poor serum and tissue concentraion
B
What is the antibacterial coverage of the third generation FQ? (select all that apply)
A. P. aeruginosa
B. S. pneumoniae
C. Atypical
D. Gram Positive
E. Gram Negative
B, C
Which of the following is a fourth generation FQ?
A. Levofloxacin
B. Norfloxacin
C. Moxifloxacin
D. Lomefloxacin
C. Moxifloxacin
What generation has a PK of tissue concentration exceeds plasma concentration?
A. First Generation
B. Second Generation
C. Third Generation
D. Fourth Generation
D
What antibacterial coverage does Moxifloxacin have? (select all that apply)
A. Aerobic Bacteira
B. Anaerobic Bacteria
C. Gram Positive
D. Gram Negative
E. Atypical Bacteria
A, B, C, D
Which of the following FQ are used for UTI?
A. First generation
B. Second generation
C. third generation
D. fourth generation
B.
What can Ciprofloxacin treat?
A. Community Aquired Pneumonia
B. Hospital Acquired Pneumonia
C. UTI
D. Conjuntivitis
C
Which of the following can treat Community acquired pneumonia?
A. Lomefloxacin
B. Levofloxacin
C. Norfloxacin
D. Cinoxin
B
Which of the following antibiotics is eliminated heptically?
A. Levofloxacin
B. Lomefloxacin
C. Moxifloxacin
D. Norfloxacin
C.
Frank is at the counseling window waiting for you to counsel on Norfloxacin. What counseling points are important that you mention?
A. Don’t take with antacids
B. Take Norfloxacin one hour before or 2 hours after your multivitamin
C. Do not take on an empty stomach
D. Take it with milk or food
A, B
patient is to take on an empty stomach and not to take with food or milk becasue of the Ca++ that will cause chelation
Look Frank is reading the pamphlet with you
Which of the follwoing are Adverse effects of FQ? (select all that apply)
A. Cardiotoxicity: Prolonged QT interval
B. Tendonitis
C. Muscle weakness
D. Ototoxicity
A,B,C
Which of the following patient should avoid FQ? (select all that apply)
A. 24 yo pregnant Lupita
B. Jasmine’s nursing mother
C. John Smith with Renal Failure
D. 70 yo healthy patient
A, B, C
