Fluroquinolones Flashcards
fluoroquinolone drugs
ciprofloxacin - old
levofloxacin
moxifloxacin
delafloxacin
MOA of fluroquinolones
inhibit DNA synthesis by inhibiting topoisomerases
DNA gyrase (topo II) works on what type of bacteria
gram negative
topo IV works on what type of bacteria
gram positive
fluroquinolones bacteriocidal or static
cidal
fluroquinolones time or concentration dependent
concentration dependent
AUC/MIC
fastest killers
mechanisms of resistance fluoroquinolones
alteration in binding site / affinity
efflux
decreased permeability and porins
general spectrum of activity fluroquinolones
cipro: pos and neg and anaerobes
moxi, dela, levo: pos (better) and neg and anaerobes
ciprofloxacin target organisms
MSSA (not used)
pseudomonas
legionella
moxifloxacin target organisms
PRSP
MSSA (not used)
legionella
delafloxacin target organisms
PRSP
MSSA (not used)
MRSA
pseudomonas
legionella
levofloxacin target organisms
PRSP
MSSA (Not used)
pseudomonas
legionella
what are FQs the primary drug for
legionella
advantage of FQs against pseudomonas
only oral agents
which fluroquinolone targets MRSA
delafloxacin
which fluroquinolones target PRSP
moxifloxacin
delafloxacin
levofloxacin
which fluroquinolones target pseudomonas
ciprofloxacin
levofloxacin
delafloxacin
which fqs target legionella
All!
do the fluroquinolones penetrate CSF
no
which fqs do not require renal dose adjustment
moxifloxacin
adverse effects fluoroquinolones
peripheral neuropathy
hepatotoxicity
QT prolongation
tendonitis
articular damage
drug interactions with fluroquinolones
oral agents: chelation with ZICAM, give 2 hours before these agents
warfarin - increased bleeding
can we use FQs in pregnancy
no, contraindicated
can we use FQs in children
no, contraindicated
PK characteristics of FQs
excellent oral bioavailability
fastest working
risks for Torsades in fluroquinolones
hypokalemia
preexisting QT
amiodarone, sotalol use
