Quinolones - Ciprofloxacin Flashcards
Why are quinolones reserved for 2nd/3rd line treatment?
rapid resistance and association with C.diff
What are the indications of ciprofloxacin (quinolone)?
1) UTI
2) Severe GI infection (shigella, Campylobacter)
3) LRTI (moxifloaxacin /levofloxacin)
4) Ciprofloxacin Pseudomonas aruginosa
How do quinolones such as ciprofloxacin work?
Quinolones kill bacteria by inhibiting DNA synthesis.
What bacteria are quinolones such as ciprofloaxacin active against
- aerobic gram-negative bacteria
moxifloxacin and levofloxacin also act against gram positive bacteria
What type of bacteria usually cause UTIs and GI infections?
- gram negative aerobic bacteria
What are the side effects of quinolones?
- GI upset
- hypersensitivity
- neuro effects (lower siezure threshold and hallucinations)
- inflammation / rupture of muscle tendons
- prolong QT interval (arrhythmia risk)
- C.diff colitis
What are the neuro side effects of quinolones?
- reduced seizure threshold
- hallucinations
What drugs reduce the absorption of quinolones such as ciprofloxacin?
- calcium
- atacids
What drugs does ciprofloxacin increase risk of toxicity with?
Ciprofloxacin inhibits some cytochrome P450 enzymes:
increases risk of toxicity of theophylline
What is the side effect of prescribing quinolones with NSAIDs?
seizures
Quinolone and what drug causes increased risk of tendon rupture?
prednisolone
Quinolones should be prescribed in caution with other QT prolonging drugs due to the risk of arrhythmias. What are these drugs?
- amiodarone
- antipsychotics
- quinine
- macrolide antibiotics
- SSRIs
What are the drug interactions of quinolones e.g. ciprofloxacin?
- theophylline (toxicity)
- NSAIDs (seizure)
- prednisolone (tendon rupture)
Arrhythmias: - amiodarone
- macrolides (erythromcin)
- SSRIs
- quinine
- antipsychotics
What groups of people should quinolones such as ciprofloxacin be used in caution with?
- with/risk of siezures
- growing
- risk of QT prolongation (cardiac disease / electrolyte disturbance)
