ID I: QUINOLONES Flashcards
Quinolones are normally what line…
LAST BRUH
due to tendon inflammation/rupture, and peripheral neuropathy
MOA: quinolone inhibit bacterial DNA topoisomerase IV and…
gyrase (topoisomerase II) inside the bacteria
prevents supercoiling of DNA and promote breakage
Quinolones have what kind of coverage?
broad! against gram negative and gram positive and ATYPICAL
What are the respiratory quinolones? (ie pneumonia)
My Good Lungs – used for pneumonia
Gemifloxacin
Levofloxacin
Moxifloxacin
Brand: Cipro
generic: ciprofloxacin
Which quinolones have enhanced gram negative activity including coverage of pseudomonas?
ciprofloxacin and levofloxacin
*typically used in combo with another agent (beta lactam) when treating pseudomonas infections empirically
This quinolone has enhanced gram POSITIVE and ANAEROBIC activity and can be used alone for mixed infection (intra-abdominal)?
moxifloxacin
which quinolone cannot be used to treat urinary tract infections?
moxi
*no renal adjustment!
this is a newer quinolone approved for skin infections and is active against MRSA
Delafloxacin
*other quinolones are also active against MRSA but advised not to use because of rates of resistance
Brand: Ciprodex
generic: ciprofloxacin + dexamethasone (ear drops)
Brand: Avelox
generic: moxifloxacin
Brand: Levaquin
generic: levofloxacin
Brand: Ocuflox
generic: ofloxacin (eye drops)
What are Quinolones boxed warnings?
tendon inflammation/rupture
Peripheral neuropathy, even years after discontinued
Seizures!!!! use caution in patients with CNS disorders or drugs that treat – can lower threshold
Quinolones can be used last line in…
acute bacterial sinusitis
acute exacerbation of chronic bronchitis
uncomplicated UTI
What are the warnings of quinolones?
QT prolongation (highest with moxi) **caution with CVD, dec KMg
hypoglycemia and hyperglycemia
psych disturbances
avoid in children due to musculoskeletal issues
photosensitivity
Your patient is receiving cipro oral suspension.. how to administer? and what are notes?
shake intensely for 15 seconds before each use
do NOT put it through an NG to another tube
Your patient needs cipro but they are NPO how can we administer?
can crush IR tablets, mix with water, give via feeding tube.
What are the antipseudomonal quinolones?
ciprofloxacin and levofloxacin
used for pseudomonas, UTIs, intra-abdominal, travels diarrhea (without blood)
Which quinolones are IV:PO 1:1
Levo and moxi
Your patient is receiving an antipsychotic, methadone and an anti fungal… what’s the concern?
QT PROLONGATION!!!!
Check KMg to
Who should you avoid quinolones in?
seizure history, seizure drugs
children
What counseling points?
avoid sun exposure
separate from cations
monitor BG
Quinolone + Warfarin =
inc INR
