Quinolone Antimicrobial Agents Flashcards

1
Q

What do first generation quinolones have limited activity against

A

gram (+) bacteria

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2
Q

What are first generation quinolones only useful for

A

treatment of lower urinary tract infections

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3
Q

Describe the activity of second generation quinolones

A

broader spectrum of bactericidal activity and are more potent

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4
Q

Most potent fluoroquinolone

A

Ciprofloxacin

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5
Q

What do second generation quinolones have activity against

A

extended activity against gram (+) organisms and mycoplasma

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6
Q

What do 3rd and 4th generation quinolones have improved activity against

A

gram (+) organisms, particularly Streptococcus pneumoniae

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7
Q

Moxifloxacin is considered?

A

a drug of last resort because of its severe side effects

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8
Q

What do gyrases and topoisomerases do?

A

untangle DNA by cutting one or two strands, and then allowing strand passage through the break or allowing the DNA to twist

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9
Q

How do different topoisomerases cleave DNA

A

so that either the 3’-hydroxyl or the 5’-hydroxyl of the DNA can become enzyme-linked

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10
Q

The topoisomerase-catalyzed reaction is?

A

reversible and usually equilibrium favors the uncleaved DNA, so cleavage complexes are present in very small amounts

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11
Q

How do bacterial/mammalian gyrases and topoisomerases cleave DNA

A

cleaves both opposing strands with a four-base stagger

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12
Q

What step is blocked by quinolones

A

DNA religation

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13
Q

Most common use of quinolones

A

urinary tract infections

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14
Q

Which quinolones are effective for urinary tract infections

A

Norfloxacin, ciprofloxacin, ofloxacin, and nalidixic acid

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15
Q

Which quinolones are effective for prostatitis?

A

Norfloxacin, ciprofloxcin, and ofloxacin

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16
Q

Which STDs are quinolones effective against

A

Neisseria gonorrhoeae, Chlamydia trachomatic, and Haemophilus ducreyi

17
Q

Which quinolones do you use for Chlamydia trachomatis

A

ofloxacin or sparfloxacin

18
Q

Which quinolone do you use for Haemophilus ducreyi

A

ciprofloxacin

19
Q

First line treatment of Neisseria gonorrhoeae

A

ceftriaxone (a cephalosporin)

20
Q

Effective quinolone treatments for shigellosis

A

Norfloxacin, ciprofloxacin, and ofloxacin

21
Q

Many of the newer fluoroquinolones, including moxifloxacin have excellent activity versus?

A

Streptococcus pneumoniae

22
Q

Respiratory tract exacerbations in cystic fibrosis patients are responded to?

A

fluoroquinolone therapy

23
Q

Sole therapy in 50% of diabetic foot infections

A

ciprofloxacin

24
Q

Treatment of bone, joint, and soft tissue infections with quinolones

A

fluoroquinolones (except norfloxacin)

25
Which quinolones have useful activity against intracellular bacteria
norfloxacin and ciprofoxacin
26
Clearance of fluoroquinolones?
renal and hepatic clearance (except oxafloxacin)
27
Why should quinolones not be administered with foods and drugs that contain heavy metals
quinolones form insoluble chelates with heavy metals
28
CNS side effects of quinolones
headache and dizziness rare hallucinations, delirium and seizures associated with peripheral neuropathies
29
Why are quinolones not recommended for patients under the age of 18
fluoroquinolones may damage growing cartilage and cause arthropathy
30
Adverse effects with specific agents:
1. photosensitivity with lomefloxacin | 2. hyperglycemia and hypoglycemia in diabetic patients with gatifloxacin