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Pharmacology Exam 2 (Lauren) > UTIs And Fluoroquinolones > Flashcards

UTIs And Fluoroquinolones Flashcards

1
Q

Are methenamine and nitrofurantoin helpful for anything other than UTIs?

A

No, because they only reach cidal concentrations in the urine

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2
Q

What is the mechanism of fluoroquinolones?

A

Inhibit DNA gyrase, preventing the DNA from uncoiling for transcription

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3
Q

What are the contraindications for methenamine?

A

Hepatic insufficiency (ammonia)

Renal insufficiency

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4
Q

What are the drugs that are exclusively used in UTIs?

A

Nitrofurantoin

Methenamine

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5
Q

Are fluoroquinolone well absorbed orally?

A

Yes

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6
Q

What drug is an alternate to oral vancomycin for C.diff and is an option for H. Pylori?

A

Metronidazole

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7
Q

What is the spectrum of nitrofurantoin?

A

Wide spectrum of static and cidal activity but NOT proteus or pseudomonas

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8
Q

How does metronidazole become active?

A

By getting reduced by ferredoxin, which is only found in anaerobes

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9
Q

Who are fluoroquinolones contraindicated for?

A

Pregnant women

Nursing women

Children under 18*** due to cartilage damage

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10
Q

What is an absolute contraindication to nitrofurantoin?

A

G6PDase deficiency. Causes hemolytic anemia.

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11
Q

What two organisms are not affected by nitrofurantoin?

A

Proteus- keeps pH too high

Pseudomonas

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12
Q

What are moxifloxacin and gemifloxacin indicated for/

A

Anaerobes

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13
Q

If your pt has any type of hepatic insufficiency, can you give them methenamine? Why?

A

No because it breaks down into formaldehyde and ammonia. Ammonia will hurt them

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14
Q

What is a common side effect of nitrofurantoin that is seen with chronic usage, especially in the elderly?

A

Pulmonary fibrosis

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15
Q

Is metronidazole in its active form when you take it?

A

No, it must be reduced by ferredoxin (only in anaerobes)

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16
Q

If the bacteria has a gyrase mutation, would you give a fluoroquinolone?

A

No, they wouldn’t work

17
Q

How does nitrofurantoin target bacteria?

A

Damages their DNA

18
Q

What drug would you give for prostatitis

A

Ofloxacin

19
Q

What is the spectrum of metronidazole?

A

G- and G+ ANAEROBES

20
Q

What is ofloxacin for?

A

Prostatitis

Only drug that can penetrate prostate

21
Q

Can your patient keep taking their multivitamins, antacids and calcium supplements if you give them a fluoroquinolone?

A

No

22
Q

What is methenamine‘s mechanism of killing bacteria?

A

It breaks down into formaldehyde and ammonia. Formaldehyde kills them

23
Q

What are the major side effects of metronidazole?

A

Disulfiram-like reaction

Disgeusia- metallic taste

24
Q

What is a side effect of nitrofurantoin that you need to tell your pt about?

A

It turns urine brown

25
Q

What two classes of drugs increase QT interval?

A

Fluoroquinolones

Macrolides

26
Q

What are the 3 properties of nitrofurantoin and methenamine that make them appropriate for UTIs?

A

Really excreted

Achieve high urinary concentrations

Require acidic pH to be active

27
Q

What is gatifloxacin for?

A

Eyes. Ocular application only

28
Q

Are fluoroquinolones static or cidal?

A

Cidal

Interrupting DNA would be deadly

29
Q

What is ciprofloxacin indicated for?

A

UTIs (2nd DOC)

Pseudomonas

30
Q

Do we see bactiieral resistance to methenamine?

A

No, because it decomposes into formaldehyde and ammonia, and no resistance to formaldehyde can develop

31
Q

What is levofloxacin indicated for?

A

Community acquired pneumonia

32
Q

What are the fluoroquinolone drugs?

A

Ciprofloxacin

Ofloxacin

Levofloxacin

Moxifloxacin

Gatifloxacin

Gemifloxacin

33
Q

Can we give nitrofurantoin to a woman in late pregnancy?

A

NO, because we don’t know if the fetus is G6PDase deficient, and if it was, it would get hemolytic anemia

34
Q

What are the 4 major side effects of fluoroquinolones?

A

Increase QT interval

Cartilage erosions

Tendon rupture

Photosensitivity

Pharmacology Exam 2 (Lauren) (7 decks)

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