UTIs And Fluoroquinolones Flashcards
Are methenamine and nitrofurantoin helpful for anything other than UTIs?
No, because they only reach cidal concentrations in the urine
What is the mechanism of fluoroquinolones?
Inhibit DNA gyrase, preventing the DNA from uncoiling for transcription
What are the contraindications for methenamine?
Hepatic insufficiency (ammonia)
Renal insufficiency
What are the drugs that are exclusively used in UTIs?
Nitrofurantoin
Methenamine
Are fluoroquinolone well absorbed orally?
Yes
What drug is an alternate to oral vancomycin for C.diff and is an option for H. Pylori?
Metronidazole
What is the spectrum of nitrofurantoin?
Wide spectrum of static and cidal activity but NOT proteus or pseudomonas
How does metronidazole become active?
By getting reduced by ferredoxin, which is only found in anaerobes
Who are fluoroquinolones contraindicated for?
Pregnant women
Nursing women
Children under 18*** due to cartilage damage
What is an absolute contraindication to nitrofurantoin?
G6PDase deficiency. Causes hemolytic anemia.
What two organisms are not affected by nitrofurantoin?
Proteus- keeps pH too high
Pseudomonas
What are moxifloxacin and gemifloxacin indicated for/
Anaerobes
If your pt has any type of hepatic insufficiency, can you give them methenamine? Why?
No because it breaks down into formaldehyde and ammonia. Ammonia will hurt them
What is a common side effect of nitrofurantoin that is seen with chronic usage, especially in the elderly?
Pulmonary fibrosis
Is metronidazole in its active form when you take it?
No, it must be reduced by ferredoxin (only in anaerobes)
If the bacteria has a gyrase mutation, would you give a fluoroquinolone?
No, they wouldn’t work
How does nitrofurantoin target bacteria?
Damages their DNA
What drug would you give for prostatitis
Ofloxacin
What is the spectrum of metronidazole?
G- and G+ ANAEROBES
What is ofloxacin for?
Prostatitis
Only drug that can penetrate prostate
Can your patient keep taking their multivitamins, antacids and calcium supplements if you give them a fluoroquinolone?
No
What is methenamine‘s mechanism of killing bacteria?
It breaks down into formaldehyde and ammonia. Formaldehyde kills them
What are the major side effects of metronidazole?
Disulfiram-like reaction
Disgeusia- metallic taste
What is a side effect of nitrofurantoin that you need to tell your pt about?
It turns urine brown
