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Antibiotics > Quinolones > Flashcards

Quinolones Flashcards

1
Q

Which Antibiotics have been linked to deactivation of birth control?

A
  • Rifampin
  • Tetracyclines
  • Ampicillin
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2
Q

What is the suspected mechanism of antibiotics leading to Birth control deactivation?

A

gut flora recycles Birth Control into patient’s system; killing gut flora expedites elimination of birth control

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3
Q

What are the 5 most common quinolones?

A

Ciprofloxacin

Levofloxacin

Moxifloxacin

Ofloxacin

Gemifloxacin

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4
Q

What is the Quinolone mechanism of action?

A
  • DNA gyrase is essential for supercoiling of cellular DNA by a nicking, pass through, and resealing process.
  • Quinolones inhibit the enzymatic activity of bacterial DNA gyrase and topoisomerase IV and promote the cleavage of DNA within the enzyme-DNA complex.
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5
Q

Are Quinolones Bacteriocidal or Bacteriostatic?

A

BACTERIOCIDAL

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6
Q

T/F

Quinolones, along with Aminoglycosides exhibit post-antibiotic-effect.

A

TRUE

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7
Q

Generally, how would you describe quinolone bioavailabilty?

A

REALLY high

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8
Q

Why wouldn’t you use Moxifloxacin, Gemifloxacin, or Ciprofloxacin to treat a UTI?

A

LOW RENAL excretion

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9
Q

What adverse reactions are associated with Quinolone usage?

A
  • Photosensitivity
  • QT Prolongation
  • Headache, Dizziness, Mental Status Change
  • Tendon Rupture (with steroids, over 60yrs)
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10
Q

Why was Gatifloxacin pulled off the market?

A
  • SEVERE HYPOGLYCEMIA
  • Kidney dysfunction
  • Liver dysfunciton
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11
Q

What does literature say to give for disease states like Spontaneous Bacterial Peritonitis?

A

Ofloxacin (though more commonly Ciprofloxacin or Levofloxacin is given)

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12
Q

Why don’t you want to give Ciprofloxacin to a pt. already on Theophylline?

A

Ciprofloxacin can double theophylline levels

Levofloxacin is good though!

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13
Q

Why should you avoid taking Antacids, Iron, or multivitamins when also on a Quinolone?

A

these drugs bind up the quinolone, diminishing its absorption

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14
Q

Why don’t you want to give Ciprofloxacin to a pt. already on Warfarin?

A

Increased anticoagulant effect

Levofloxacin is good though!

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15
Q

Why would you want to use Levofloxacin, Gemifloxacin, or Moxifloxacin to treat Staph/Strep infection rather than Ofloxacin or Ciprofloxacin?

A

Older agents, Cipro/Oflo, don’t cover G+

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16
Q

What bugs are covered by Quinolones?

A

Staph. (Levo/Gemi/Moxi)
Strep. (Levo/Gemi/Moxi)

Haemophilus influenzae
Salmonella
Shigella
Moraxella catarrhalis
Morganella morganii
Neisseria gonorrhoeae

Proteus mirabilis/vulgaris
Escherichia coli
Klebsiella pneumonia

SPACE (Cipro/Levo)
SACE (Moxi)

Anaerobes (Moxi)

Atypicals (Levo/Cipro/Moxi)

17
Q

What is most potent of the quinolones against gram negatives?

What is most potent of the quinolones against pseudomonas?

A

Ciprofloxacin

Ciprofloxacin

18
Q

What is the difference in SPACE bug coverage between Ciprofloxacin or Levofloxacin and Moxifloxacin?

A

SPACE (Cipro/Levo)

SACE (Moxi)

19
Q

What is the difference in Anaerobe coverage between Ciprofloxacin or Levofloxacin and Moxifloxacin?

A

Anaerobes only covered by Moxifloxacin

20
Q

What is the difference in Atypical coverage between Ciprofloxacin or Levofloxacin and Moxifloxacin?

A

Ciprofloxacin
Levofloxacin
Moxifloxacin

All target Atypicals (Chlamidia, Mycoplasma, Legionella)

21
Q

Why is it easy to go PO rather than IV when prescribing quinolones?

A

EXCELLENT BIOAVAILABILITY

22
Q

What is the difference in uses for Gemifloxacin and Moxifloxacin with Levofloxacin?

A

Gemi & Moxi dont get strong enough concentration in urine to treat UTI

Levofloxacin will. (Also Levo covers Pseudomonas)

23
Q

What are mechanisms of resistance for quinolones?

A
  • Volume of usage (used so ofted eg. animal feed, bound to cause resistance)
  • altered DNA gyrase
  • Altered drug permeability
  • Efflux of drug from bacterial cell
24
Q

What ABX is added to Ciprofloxacin very commonly for skin & soft tissues?

A

Clindamycin

25
Q

Which Quinolone has unique indication of intra-abdominal infections?

Which Quinolone wouldn’t you use to treat a UTI?

A

Moxifloxacin

Moxifloxacin

Antibiotics (25 decks)

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