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PoD Test 2 > Quinolones and Tetracyclines > Flashcards

Quinolones and Tetracyclines Flashcards

1
Q

What is the MoA for quinolones?

A

Targets DNA gyrase and topoisomerase IV

Bactericidal

Exhibits postantibiotic effect

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2
Q

What are the new warnings associated with fluoroquinolone?

A

Hypoglycemic coma and aortic aneurysm in elderly

Diabetic coma and neuropsychiatric warnings

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3
Q

Which quinolones are mostly renally excreted?

A

Ofloxacin and Levofloxacin

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4
Q

What are the ADRs for quinolones?

A

Hypersensitivity

Hematologic - neutropenia/eosinophilia

QT prolongation

Diarrhea

Nephrotoxicity

CNS

MSK - arthropathy/tendon rupture

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5
Q

What are the drug interactions with quinolones?

A

Theophylline - ciprofloxacin can double levels

Warfarin - increased anticoagulant effect

Levofloxacin has little to no effect on either

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6
Q

What substance shouldn’t be given within 2-4 hours of quinolone dose?

A

Antacids

Iron

Sucralfate

Multivitamins

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7
Q

Which quinolones have better staph/strep coverage?

A

Levofloxacin

Moxifloxacin

Gemifloxacin

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8
Q

Which quinolones have SPACE coverage?

A

Cipro and levofloxacin

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9
Q

What is the only quinolone with anaerobic coverage?

A

Moxifloxacin

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10
Q

Describe the coverage of ciprofloxacin

A

Considered poor for G +

Most potent of the quinolones against G-, specifically Pseudomonas

Excellent bioavailability

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11
Q

Describe the coverage of levofloxacin/gemifloxacin/moxifloxacin.

A

G+ coverage (PCN resistant Strep pneumo, Staph)

G- negative coverage - Levo for SPACE, gemi and moxi for SACE

All have atypical coverage

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12
Q

What is unique about moxifloxacin coverage?

A

Anaerobes for complicated intra-abdominal infections

Does not cover UTIs

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13
Q

What is the dose and coverage for Delafloxacin (Baxdela)?

A

Dose: IV 300mg BID or PO 450mg BID

Coverage: Staph/Strep/MRSA, E. coli, Klebsiella, Pseudomonas

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14
Q

How is delafloxacin different from other FQNs?

A

Has not demonstrated QT prolongation or phototoxicity

No markers of ADRs to liver, kidneys or glucose control

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15
Q

What are the mechanisms of resistance against quinolones?

A

Altered target enzyme

Altered drug permeability and efflux of drug

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16
Q

What is the MoA for tetracyclines?

A

Reversibly binds to 30S ribosomal subunit, decreasing protein synthesis

Bacteriostatic

17
Q

What is the bioavailability of tetracyclines?

A

Doxy and Minocycline 90-100%

Tetra, demeclo, oxytetra - 58-75%

18
Q

Which tetracyclines are eliminated via renal excretion?

A

Tetracycline

Oxytetracycline

Demeclocycline

19
Q

Which tetracyclines are eliminated via hepatobiliary excretion?

A

Coxycycline

Minocycline

20
Q

What are the ADRs for tetracyclines?

A

Photosensitivity

Discoloration of developing teeth

Reversible diabetes insipidus associated with Demeclocycline (can be used to treat SIADH)

21
Q

What ADRs are associated with minocycline?

A

Vestibular side effects

Sizziness, ataxia, vertigo

22
Q

What ADR is associated with the citric acid formulation of tetracycline?

A

Fanconi-like syndrome

N/V, lethargy, polydipsia, polyuria, proteinuria, acidosis, hypokalemia

23
Q

What are the drug interactions with tetracyclines?

A

Decreased absorption when co-administered via chelation (cations, antacids, dairy)

Potential antagonism effect due to static effect, cidal agents require active growth

Enhances anticoagulation of warfarin

24
Q

What is the spectrum of activity for tetracyclines?

A

Broad Spectrum Coverage

G+ and G-

Atypicals

Rickettsia

25
Q

What are the clinical uses for tetracyclines?

A

Rikettsia infection

M. pneumonia

Chlamydia

Acne

H. pylori in combination with other agents

26
Q

What is Brucellosis and its treatment?

A

Similar to flu symptoms, caused by Brucella from unpasteurized cheeses, milk

Tetracycline + Gentamicin

Severe infections of CNS or endocarditis may occur

27
Q

What acute diarrheal disease are tetracyclines used for?

A

Vibrio cholera or vulnificus

28
Q

What is Borrelia burgdorferi?

A

Causes Lyme disease

Bull’s-eye rash with flue like symtpoms

Treated with tetracyclines

29
Q

What is the atypical use for demeclocycline?

A

SIADH

PoD Test 2 (23 decks)

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