Term
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Definition
* Broad spectrum CIDAL for most Gram-, some Gram+
* G- inhibits DNA Gyrase
* G+ Inhibits topoisomerase IV
* 4 generations but 2nd and 3rd used today. |
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Term
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Definition
* LEss active against S. pneumoniae than 3rd
* Ciprofloxacin
* Norfloxacin
* Ofloxacin |
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Term
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Definition
* 2nd generation Fluoroquinolone
* Opthalmi= Ciloxan, Otic= Cipro HC OTIC
* Best for G- activity
* |
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Term
Ciprofloxacine Rx Interactions |
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Definition
* Decreases clearance of theophylline, increase levels and toxicity
* Inhibits isoforms of CYP3A4 and CYP1A2, increases levels of methadone and leading to respiratory depression, sedation, hypotension, hallucinations
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Term
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Definition
* 2nd Gener fluoroquinolone
* Least active, low systemic levels>UTI Only
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Term
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Definition
* 2nd Generation fluoroquinolone
* oral is generic. Ocuflox=opthalmic product, otic also available |
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Term
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Definition
* More active vs S. pneumoniae
* Gatifloxacin- opthalmic only
* Gemifloxacin- respiratory
* Levofloxacin- respiratory Opthalmic-Iquix. Avtive isomer of ofloxacin
* Moxifloxacin- respiratory opthalmic-Vigamox. Metabolized mainly by liver
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Term
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Definition
| * Levofloxocin: Avoid if cardiac conduction anomalies. Increases risk ofporlonging Q-T interval on EKG in elderly. Can cause ventricular erythmia or Torsades de pointes. Risk of acute hepatitis and fatal events, although RARE |
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Term
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Definition
| * Caution if hepatic disease. Can prolong Q-T in HEALTHY patients. |
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Term
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Definition
| * Besifloxacin for bacterial conjunctivitis due to susceptible organisms. Had toxic side effects, but this is a new drug. |
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Term
general Side effects of ALL FQs |
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Definition
* Photoxicity, burning redness swelling blisters rach itch
* Arthropathy- damages growing cartilage. do not use in prepubertal children or pregnant.
* tendon rupture BBW risk great if>65 or on steroids
* Diabetics: Can increase or decrease blood sugar with insulin or an oral hypoglycemic
* CNS stimulation> Convulsion, anxiety
* Nausea, vomitting, diarrhea. Cause C. diff induced diarrhea adn pseudomembranous colitis. |
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Term
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Definition
| * Avoid antacids and iron supplements as they can chelate with mono and divalent cations and decrease antibiotic absorption. |
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