ID I: QUINOLONES

Question 1

Quinolones are normally what line…

Answer 1

LAST BRUH

due to tendon inflammation/rupture, and peripheral neuropathy

Question 2

MOA: quinolone inhibit bacterial DNA topoisomerase IV and…

Answer 2

gyrase (topoisomerase II) inside the bacteria

prevents supercoiling of DNA and promote breakage

Question 3

Quinolones have what kind of coverage?

Answer 3

broad! against gram negative and gram positive and ATYPICAL

Question 4

What are the respiratory quinolones? (ie pneumonia)

Answer 4

My Good Lungs – used for pneumonia

Gemifloxacin

Levofloxacin

Moxifloxacin

Question 5

Brand: Cipro

Answer 5

generic: ciprofloxacin

Question 6

Which quinolones have enhanced gram negative activity including coverage of pseudomonas?

Answer 6

ciprofloxacin and levofloxacin

*typically used in combo with another agent (beta lactam) when treating pseudomonas infections empirically

Question 7

This quinolone has enhanced gram POSITIVE and ANAEROBIC activity and can be used alone for mixed infection (intra-abdominal)?

Answer 7

moxifloxacin

Question 8

which quinolone cannot be used to treat urinary tract infections?

Answer 8

moxi

*no renal adjustment!

Question 9

this is a newer quinolone approved for skin infections and is active against MRSA

Answer 9

Delafloxacin

*other quinolones are also active against MRSA but advised not to use because of rates of resistance

Question 10

Brand: Ciprodex

Answer 10

generic: ciprofloxacin + dexamethasone (ear drops)

Question 11

Brand: Avelox

Answer 11

generic: moxifloxacin

Question 12

Brand: Levaquin

Answer 12

generic: levofloxacin

Question 13

Brand: Ocuflox

Answer 13

generic: ofloxacin (eye drops)

Question 14

What are Quinolones boxed warnings?

Answer 14

tendon inflammation/rupture
Peripheral neuropathy, even years after discontinued

Seizures!!!! use caution in patients with CNS disorders or drugs that treat – can lower threshold

Question 15

Quinolones can be used last line in…

Answer 15

acute bacterial sinusitis

acute exacerbation of chronic bronchitis

uncomplicated UTI

Question 16

What are the warnings of quinolones?

Answer 16

QT prolongation (highest with moxi) **caution with CVD, dec KMg

hypoglycemia and hyperglycemia

psych disturbances

avoid in children due to musculoskeletal issues

photosensitivity

Question 17

Your patient is receiving cipro oral suspension.. how to administer? and what are notes?

Answer 17

shake intensely for 15 seconds before each use

do NOT put it through an NG to another tube

Question 18

Your patient needs cipro but they are NPO how can we administer?

Answer 18

can crush IR tablets, mix with water, give via feeding tube.

Question 19

What are the antipseudomonal quinolones?

Answer 19

ciprofloxacin and levofloxacin

used for pseudomonas, UTIs, intra-abdominal, travels diarrhea (without blood)

Question 20

Which quinolones are IV:PO 1:1

Answer 20

Levo and moxi

Question 21

Your patient is receiving an antipsychotic, methadone and an anti fungal… what’s the concern?

Answer 21

QT PROLONGATION!!!!

Check KMg to

Question 22

Who should you avoid quinolones in?

Answer 22

seizure history, seizure drugs

children

Question 23

What counseling points?

Answer 23

avoid sun exposure

separate from cations

monitor BG

Question 24

Quinolone + Warfarin =

Answer 24

inc INR