Pharm Fluroquinolones

Question 1

What are the 3 ways in which Anti-bacterial agents work?

Answer 1

Cell Wall Synthesis
Nucleic Acid Synthesis
Protein Synthesis

Question 2

Drug groups that effect cell wall synthesis

Answer 2

Beta Lactams- Penicillins, Cephalosporin, Carbapenems, monobactram
Vancomycin
Bacitracin
Cell Membrane- Polymyxin

Question 3

Drug groups that effect Protein Synthesis

Answer 3

30 subunit : Tetracyclin and aminoglycosides

50 subunit : Macrolides, Clindamycin, Linezolid, Chloramphenicol, Streptogramins

Question 4

MAO of Fluoroquinolones

Answer 4

Block bacterial DNA synthesis by inhibiting bacterial

1. ) Topoisomerase II (DNA gyrase)
2. ) Topoisomerase IV

Question 5

Topoisomerase II is responsible for?

Answer 5

relaxing the supercoiling

Question 6

Topoisomerase IV is responsible for?

Answer 6

separation of replicated chromosomal DNA into respective daughter cells during cell division

Question 7

Which bacteria is more susceptible at the Topoisomerase II location?

Answer 7

Gram Negative bacteria

Question 8

Which bacteria is more susceptible at the Topoisomerase IV location

Answer 8

Gram Positive bacteria

Question 9

Mechanism of Resistance

Answer 9

1. ) Mutation that alters drug target: DNA Gyrase (GyrA or GyrB or topoisomerase IV (ParC or ParE)
2. ) Mutation that reduces drug accumulation: Increase porins or make up efflux pumps
3. ) Plasmid-mediated resistance

Question 10

Describe Plasmid-mediated resistance

Answer 10

two bacteria one with the resistant gene come into close contact and the resistant gene (qnr) produces a protein that binds and protects DNA gyrase and topoisomerase IV against the fluoroquinolone actions

Plasmid containing a variant of aminoglycoside acetyltransferase that can modify fluoroquinolone and inhibit fluoroquinolone activity.

Question 11

Ciprofloxacin and Levofloxacin for gram

Answer 11

negatives

Question 12

Moxifloxacin and gemifloxacin for gram

Answer 12

positives

Question 13

NOT a respiratory fluoroquinolone because it has relatively high minimum inhibitory concentrations (MIC) against S. pneumoniae (gram positive)

Answer 13

ciprofloxacin

Question 14

This fluoroquinolone is metabolized by the liver.

All the others are metabolized renally and must be watched in people with renal insufficiency

Answer 14

Moxifloxacin; not a good agent for genito urinary tract infections

Question 15

This fluoroquinolone is given orally only

Answer 15

Gemifloxacin

Question 16

review the clinical uses slide

Answer 16

slide 16

Question 17

Side Effects for Ciprofloxacin, levofloxacin, moifloxacin, gemifloxacin

Answer 17

QT interval prolongation
photosensitiviety
tendonitis, rupture of tenden, arthropathy
peripheral neuropathy