Quinolones Flashcards

1
Q

MOA of quinolones

A
  • Avoid if MRSA
  • Inhibits nucleic acid tf DNA synthesis (bactericidal)
  • Broad spec
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2
Q

What is the indication of quinolones?

A

RTI

UTI
- MHRA: new restrictions, long term, irreversible side effects. Do not prescribe for non-severe or self limiting infections (uncomplicated lower UTI)

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3
Q

Give examples of quinolones

A
  • Ciprofloxacin (BD)
  • Levoflocaxin
  • Moxiflocacin (most QT prolongation + life threatening hepatotoxicity)
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4
Q

What are the side effects of quinolones?

A

Tendon damage
- Caution: 60+, RI, organ transplants, Myasthenia gravis
- Counsel: STOP + seek medical attention if joint/tendon pain + swelling, muscle pain
- Avoid corticosteroids: causes muscle wasting + myopathy s/e

Peripheral neuropathy (pins + needles)

Aortic aneurysm
- MHRA: seek medical attention sudden severe abdominal, chest or back pain

Lower seizure threshold/induce convulsions

QT prolongation
- CI (moxifloxacin): hypokalaemia or concomitant drugs

Heart valve regurgitation
- MHRA: report dyspnoea, oedema, palpitation

Suicidal thoughts + behaviours

Hypersensitivity

Arthropathy (not in children)

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5
Q

Pregnancy + quinolones

A

Avoid

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6
Q

What are the counselling points of quinolones?

A

Reduced absorption
- Label: do not take indigestion remedies or medicines containing iron or zinc 2 hours before or after taking this medicine
- Label (cipro): do not take milk, indigestion remedies or medicines containing iron or zinc 2 hours before or after taking this medicine

Avoid sunlight during treatment + 48H after stopping
- Label (ofloxacin): protect your skin from sunlight - even on bright but cloudy day. Do not use sunbeds

Driving

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7
Q

What are the interactions of quinolones?

A

Cipro is an enzyme inhibitor

Cipro + theophylline/NSAIDs → INC seizures

Warfarin → bleed

Drugs that prolong QT interval → ventricular arrhythmias

Drugs that cause hypokaelaemia → INC risk of torsade de pointes

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