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23 Cards in this Set
- Front
- Back
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What is the mechanism of the Quinolones?
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Bind to DNA gyrase and inhibit bacterial DNA supercoiling
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What effect does the inhibition of DNA gyrase have on bacterial cells?
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Bactericidal
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What happens to the ability of the Quinolones to kill bacteria as the drug dose increases?
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It reaches a max level where the drug is only bacteriostatic and no longer bactericidal.
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What are the 2 broad types of Quinolones?
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Fluorinated and nonfluorinated
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What is the main mechanism of bacterial resistance to NONfluorinated quinolones?
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Alteration of DNA gyrase
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What is the main mechanism of bacterial resistance to FLUORinated quinolones?
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Combination of decreased permeability via porin alterations, AND altered DNA gyrase.
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What are the 2 fluorinated quinolones to know?
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-Norfloxacin
-Ciprofloxacin |
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What is Norfloxacin effective in treating?
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Urinary tract infections
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Why can Norfloxacin only treat UTI's?
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Because it doesn't reach high enough concentrations at other sites.
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How does the distribution of Ciprofloxacin in the body compare to that of Norfloxacin?
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Cipro is useful for infections at MANY sites!
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What are 5 infection sites at which Ciprofloxacin is effective in treating?
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-GI tract (infectious diarrhea)
-Respiratory infections -UTI -Bone/joint -Skin infections |
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What STDs can be treated with Ciprofloxacin?
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-Uncomplicated gonorrhea
-Chlamydia -Chancroid (haemophilus ducreyi) |
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What is the disease which Cipro can treat that made it famous?
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Anthrax
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Are the quinolones equal and substitutable for each other?
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No! They have very specific approved uses.
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How are the Quinolones administered?
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Orally
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What are 2 things that can decrease the absorption of the Quinolones?
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-Antacids
-H2 blockers |
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Except for norfloxacin, how do many fluorinated quinolones distribute in the body?
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Very well - including the CSF
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Despite their good distribution in the CSF, are the quinolones indicated for meningitis?
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NO
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Which quinolones are more likely to achieve therapeutic concentrations only in the urinary tract?
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-Norfloxacin
-Nonfluorinated quinolones |
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What are some general, not very surprising side effects of the quinolones?
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-Nausea/vomiting/abdominal pain
-Dizziness, headache/depression |
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What are 7 more alarming side effects of the quinolones?
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-Seizures
-Cartilage damage -Arthropathy -Tendon rupture -Photosensitive rash -EKG irregularities -Peripheral neuropathy |
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What are 4 contraindications to giving Quinolones based on the adverse side effects they can cause?
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-Pregnancy (cartilage dmg)
-Children (cartilage dmg) -Seizure disorders -If on class IA or III antiarrythmics |
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What patients show a higher incidence of tendon rupture due to the quinolones?
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Elderly
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