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Antibiotics > Fluroquinolones > Flashcards

Fluroquinolones Flashcards

0
Q

Fluoroquinolone resistance occurs through what mechanisms

A

Chromosomal gene mutations: alteration of gyrase or topoisomerase, drug efflux pumps, or outer membrane diffusion channels

Plasmids: proteins that block protect drug target or acetylate cipro

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1
Q

Fluoroquinolone moa

A

Directly inhibit dna synthesis by inhibiting dna gyrase and topoisomerase IV

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2
Q

Why are fluoroquinolones not approved in children?

A

Joint cartilage injury due to chelation of mg++ damaging chondrocyte interactions

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3
Q

Adverse events of fluoroquinolones

A

Use in children
Hyper/hypoglycemia
Cns toxicity - light headedness to seizures and psychosis (worse with nsaids sue to gaba receptor interference)
Myasthenia gravis - increased muscle weakness
Tendonopathy (60+ steroid, renal disease post transplant are highest risk)
Opiod screen false positives
Elongated qtc interval (torsades and vfib, highest risk: women, decreased K+, decreased Mg++, bradycardia, other drugs)
Gi upset
C. Diff
Chelation with metals
Retinal detachment

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4
Q

Which fluoroquinolone has the greatest potentency against aerobic gram neg bacilli

A

Ciprofloxacin

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5
Q

Brand name of ciprofloxcin?

A

Cipro

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7
Q

Adult Dose of ciprofloxacin for cutaneous anthrax

A

500 mg po q12h x 60 days

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8
Q

Adult Dose of ciprofloxacin for inhalated anthrax post exposure anaphylaxis

A

50 mg po q12h x 60 days

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9
Q

Adult Dosage of ciprofloxacin for active disease of inhaled, gi, or oropharyngeal anthrax

A

400 mg iv q12h x 60 days

With clindamycin or rifampin

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10
Q

Adult Dose of ciprofloxacin for arthritis or osteomyelitis

A

400 mg iv q 8-12h x 6 weeks

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11
Q

Adult Dose of ciprofloxacin for infectious diarrhea caused by salmonella

A

500 mg po bid x 7 days

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12
Q

Adult Dose of ciprofloxacin for infectious diarrhea caused by shigella (travelers diarrhea)

A

750 mg po bid x 3 days

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13
Q

Adult Dose of ciprofloxacin for infectious diarrhea caused by vibrio cholerae

A

1000 mg po once

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14
Q

Adult dose of ciprofloxacin for Intra-abdominal infection (peritonitis)

A

400 mg IV q12h

with metronidazole IV

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15
Q

Adult dose of ciprofloxacin for Typhoid Fever

A

500 mg po q12h x 10 days

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16
Q

Adult dose of ciprofloxacin for UTI, acute uncomplicated cystitis, urethritis

A

250 mg po q12h x 3 days, or 500 mg Extended release once daily x 3 days

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17
Q

Adult dose of ciprofloxacin for UTI, polynephritis

A

500 mg po q12h x 7-10 days, or 1000 mg extended release once daily x 7-10 days

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18
Q

adult dose of ciprofloxacin for P. aeruginosa infections

A

for parenteral therapy, increase dose to 400 mg IV q8h

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19
Q

pediatric dose of ciprofloxacin for anthrax, cutaneous

A

10-15 mg/kg po q12h x 60 days (max 1000 mg/day)

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20
Q

pediatric dose of ciprofloxacin for anthrax, inhalational post exposure prophylaxis

A

15 mg/kg po q12h X 60 days (max 500 mg/dose)

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21
Q

pediatric dose of ciprofloxacin for active disease anthrax (inhalational, GI, or oropharyngeal)

A

10-15 mg/kg IV q12h x 60 days (max 500 mg/dose switch to po when stable)

22
Q

pediatric dose (5-17 years) of ciprofloxacin for cystic fibrosis

A

30 mg/kg/day IV divide q8h x 1 week or 40 mg/kg/day po divided q12h x 1 week

23
Q

pediatric dose of ciprofloxacin for complicated UTI or pyelonephritis

A

IV: 6-10 mg/kg IV q8h x 10-21 days (max 400 mg/dose)
PO: 20-30 mg/kg/day in 2 divided doses q12h x 10-21 days (max 1500 mg/day)

24
Q

Hepatic dose adjustments for ciprofloxacin extended release

A

No adjustments needed

25
Q

Renal dose adjustments for ciprofloxacin extended release

A

no adjustments needed

26
Q

dose adjustment for ciprofloxacin with CrCl > 50-90

A

500 -750 mg po q12 h

400 mg IV q12h

27
Q

dose adjustment for ciprofloxacin with CrCl 10-50

A

250-500 mg po q12h

400 mg IV q24h

28
Q

dose adjustment for ciprofloxacin with CrCl <10

A

250 mg po q12h
500 mg po q24h
400 mg IV q24h

29
Q

dose adjustment for ciprofloxacin on hemodialysis

A

500 mg po q24h
400 mg IV q24h
(dose after dialysis on dialysis days)

30
Q

dose adjustment for ciprofloxacin on continuous ambulatory peritoneal dialysis

A

500 mg po q12h

31
Q

dose adjustment for ciprofloxacin on continuous renal replacement therapy

A

250-500 mg po q12h

200-400 mg IV q12h

32
Q

hepatic dose adjustments for ciprofloxacin

A

none

33
Q

which organisms are usually susceptible to ciprofloxacin

A

Gram + : staph aureus (MSSA), staph epidermidis, L. monocytogenes
Gram - : N. gonorrhoeae, N. meningitidis, M. catarrhalis, H. influenzae, E.coli, Klebsiella sp. E.coli/ Klebs sp. ESBL+, enterobacter sp., serratia sp., salmonella sp, shigella sp, proteus mirabilis, proteus vulgaris, providencia sp. morganella sp. citrobacter sp. aeromonas sp. p. aeruginosa, y. enterocolitica, legionella sp, P. multocida
Misc: Chlamydophila sp. M. pneumoniae

34
Q

Ciprofloxacin pregnancy category

A

C

35
Q

Ciprofloxacin Cyp interactions

A

inhibits 1A2, 3A4

36
Q

Ciprofloxacin interacts with insulin, oral hypoglycemics in what way

A

CIPROFLOXACIN can increase or decrease blood sugar

37
Q

ciprofloxacin interacts with caffeine in what way

A

CIPROFLOXACIN increases levels of caffeine

38
Q

ciprofloxacin interacts with cimetidine in what way

A

cimetidine increases levels of CIPROFLOXACIN

39
Q

ciprofloxacin interacts with cyclosporine in what way

A

CIPROFLOXACIN increases levels of cyclosporine

40
Q

ciprofloxacin interacts with didanosine in what way

A

didanosine decrease absorption of CIPROFLOXACIN

41
Q

ciprofloxacin interacts with cations (Al+++, Ca+, Fe++, Mg++, Zn++, citrate/citric acid) in what way

A

cations decrease absorption of CIPROFLOXACIN

42
Q

ciprofloxacin interacts with methadone in what way

A

increased risk of CNS stimulation/seizures

43
Q

ciprofloxacin interacts with NSAIDs in what way

A

CIPROFLOXACIN can increase or decrease the concentration of NSAIDS

44
Q

ciprofloxacin interacts with phenytoin in what way

A

phenytoin decreases renal clearance of CIPROFLOXACIN

45
Q

ciprofloxacin interacts with probenecid in what way

A

CIPROFLOXACIN increases levels of probenecid

46
Q

ciprofloxacin interacts with rasagiline in what way

A

rasagiline decreases levels of CIPROFLOXACIN

47
Q

ciprofloxacin interacts with sucralfate in what way

A

sucralfate decreases absorption of CIPROFLOXACIN

48
Q

ciprofloxacin interacts with theophylline in what way

A

CIPROFLOXACIN increases levels of theophylline

49
Q

ciprofloxacin interacts with thyroid hormone in what way

A

CIPROFLOXACIN decreases levels of thyroid hormone

50
Q

ciprofloxacin interacts with tizanidine in what way

A

CIPROFLOXACIN increases levels of tizanidine

51
Q

ciprofloxacin interacts with warfarin in what way

A

Increases prothrombin time

Antibiotics (2 decks)

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