Quinolones

Question 1

Give some examples of the quinolones.

Answer 1

Ciprofloxacin, levofloxacin, moxifloxacin, norfloxacin, ofloxacin.

Question 2

What is the mechanism of action for the quinolones?

Answer 2

Inhibition of topoisomerases, enzymes necessary for bacterial DNA replication.

Question 3

What are the quinolones indicated to treat?

Answer 3

RTIs, anthrax, gonorrhoea, UTIs.

Question 4

What side effects are associated with quinolone use?

Answer 4

Tendon damage (rare), GI side effects, antibiotic associated colitis, headache, dizziness.

Question 5

What was the recent CSM important safety warning for quinolones relating to?

Answer 5

Possibility of increased risk of convulsions in patients with or without a history of convulsions.

Question 6

Which specific, serious side effects have been associated with moxifloxacin use?

Answer 6

QT interval prolongation and life-threatening hepatotoxicity.

Question 7

What are the cautions for the use of the quinolones?

Answer 7

Use with caution in patients with a history of epilepsy or predisposition to seizures, G6PD deficiency, myasthenia gravis, children or adolescents (risk of arthropathy).

Question 8

When should the quinolones be avoided?

Answer 8

In pregnancy. With use of NSAIDs, SSRIs, theophylline (increased risk of convulsions).

Question 9

What specific counselling should be given to patients on quinolones?

Answer 9

Avoid exposure to excessive sunlight.