Quinolone Antimicrobial Agents

Question 1

What do first generation quinolones have limited activity against

Answer 1

gram (+) bacteria

Question 2

What are first generation quinolones only useful for

Answer 2

treatment of lower urinary tract infections

Question 3

Describe the activity of second generation quinolones

Answer 3

broader spectrum of bactericidal activity and are more potent

Question 4

Most potent fluoroquinolone

Answer 4

Ciprofloxacin

Question 5

What do second generation quinolones have activity against

Answer 5

extended activity against gram (+) organisms and mycoplasma

Question 6

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

Answer 6

gram (+) organisms, particularly Streptococcus pneumoniae

Question 7

Moxifloxacin is considered?

Answer 7

a drug of last resort because of its severe side effects

Question 8

What do gyrases and topoisomerases do?

Answer 8

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

Question 9

How do different topoisomerases cleave DNA

Answer 9

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

Question 10

The topoisomerase-catalyzed reaction is?

Answer 10

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

Question 11

How do bacterial/mammalian gyrases and topoisomerases cleave DNA

Answer 11

cleaves both opposing strands with a four-base stagger

Question 12

What step is blocked by quinolones

Answer 12

DNA religation

Question 13

Most common use of quinolones

Answer 13

urinary tract infections

Question 14

Which quinolones are effective for urinary tract infections

Answer 14

Norfloxacin, ciprofloxacin, ofloxacin, and nalidixic acid

Question 15

Which quinolones are effective for prostatitis?

Answer 15

Norfloxacin, ciprofloxcin, and ofloxacin

Question 16

Which STDs are quinolones effective against

Answer 16

Neisseria gonorrhoeae, Chlamydia trachomatic, and Haemophilus ducreyi

Question 17

Which quinolones do you use for Chlamydia trachomatis

Answer 17

ofloxacin or sparfloxacin

Question 18

Which quinolone do you use for Haemophilus ducreyi

Answer 18

ciprofloxacin

Question 19

First line treatment of Neisseria gonorrhoeae

Answer 19

ceftriaxone (a cephalosporin)

Question 20

Effective quinolone treatments for shigellosis

Answer 20

Norfloxacin, ciprofloxacin, and ofloxacin

Question 21

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

Answer 21

Streptococcus pneumoniae

Question 22

Respiratory tract exacerbations in cystic fibrosis patients are responded to?

Answer 22

fluoroquinolone therapy

Question 23

Sole therapy in 50% of diabetic foot infections

Answer 23

ciprofloxacin

Question 24

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

Answer 24

fluoroquinolones (except norfloxacin)

Question 25

Which quinolones have useful activity against intracellular bacteria

Answer 25

norfloxacin and ciprofoxacin

Question 26

Clearance of fluoroquinolones?

Answer 26

renal and hepatic clearance (except oxafloxacin)

Question 27

Why should quinolones not be administered with foods and drugs that contain heavy metals

Answer 27

quinolones form insoluble chelates with heavy metals

Question 28

CNS side effects of quinolones

Answer 28

headache and dizziness
rare hallucinations, delirium and seizures
associated with peripheral neuropathies

Question 29

Why are quinolones not recommended for patients under the age of 18

Answer 29

fluoroquinolones may damage growing cartilage and cause arthropathy

Question 30

Adverse effects with specific agents:

Answer 30

1. photosensitivity with lomefloxacin

2. hyperglycemia and hypoglycemia in diabetic patients with gatifloxacin