Quinolones - Ciprofloxacin Flashcards

1
Q

Why are quinolones reserved for 2nd/3rd line treatment?

A

rapid resistance and association with C.diff

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2
Q

What are the indications of ciprofloxacin (quinolone)?

A

1) UTI
2) Severe GI infection (shigella, Campylobacter)
3) LRTI (moxifloaxacin /levofloxacin)
4) Ciprofloxacin Pseudomonas aruginosa

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3
Q

How do quinolones such as ciprofloxacin work?

A

Quinolones kill bacteria by inhibiting DNA synthesis.

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4
Q

What bacteria are quinolones such as ciprofloaxacin active against

A
  • aerobic gram-negative bacteria

moxifloxacin and levofloxacin also act against gram positive bacteria

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5
Q

What type of bacteria usually cause UTIs and GI infections?

A
  • gram negative aerobic bacteria
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6
Q

What are the side effects of quinolones?

A
  • GI upset
  • hypersensitivity
  • neuro effects (lower siezure threshold and hallucinations)
  • inflammation / rupture of muscle tendons
  • prolong QT interval (arrhythmia risk)
  • C.diff colitis
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7
Q

What are the neuro side effects of quinolones?

A
  • reduced seizure threshold

- hallucinations

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8
Q

What drugs reduce the absorption of quinolones such as ciprofloxacin?

A
  • calcium

- atacids

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9
Q

What drugs does ciprofloxacin increase risk of toxicity with?

A

Ciprofloxacin inhibits some cytochrome P450 enzymes:

increases risk of toxicity of theophylline

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10
Q

What is the side effect of prescribing quinolones with NSAIDs?

A

seizures

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11
Q

Quinolone and what drug causes increased risk of tendon rupture?

A

prednisolone

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12
Q

Quinolones should be prescribed in caution with other QT prolonging drugs due to the risk of arrhythmias. What are these drugs?

A
  • amiodarone
  • antipsychotics
  • quinine
  • macrolide antibiotics
  • SSRIs
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13
Q

What are the drug interactions of quinolones e.g. ciprofloxacin?

A
  • theophylline (toxicity)
  • NSAIDs (seizure)
  • prednisolone (tendon rupture)
    Arrhythmias:
  • amiodarone
  • macrolides (erythromcin)
  • SSRIs
  • quinine
  • antipsychotics
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14
Q

What groups of people should quinolones such as ciprofloxacin be used in caution with?

A
  • with/risk of siezures
  • growing
  • risk of QT prolongation (cardiac disease / electrolyte disturbance)
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