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Questions and Answers
What type of organisms is ciprofloxacin particularly effective against?
What type of organisms is ciprofloxacin particularly effective against?
- Aerobic gram-negative organisms (correct)
- Anaerobic bacteria
- Fungi
- Aerobic gram-positive organisms
Which of the following adverse effects is NOT commonly associated with fluoroquinolones?
Which of the following adverse effects is NOT commonly associated with fluoroquinolones?
- Nausea
- Hallucinations
- Tendon rupture
- Cardiac arrhythmia (correct)
Which statement about the pharmacokinetics of ciprofloxacin is correct?
Which statement about the pharmacokinetics of ciprofloxacin is correct?
- Food enhances its absorption.
- It is excreted mainly in urine. (correct)
- It is poorly absorbed from the gut.
- It accumulates only in muscle tissue.
What can potentiate the CNS side effects of fluoroquinolones?
What can potentiate the CNS side effects of fluoroquinolones?
What is a potential serious effect of moxifloxacin?
What is a potential serious effect of moxifloxacin?
Which population should avoid fluoroquinolones due to risk of cartilage damage?
Which population should avoid fluoroquinolones due to risk of cartilage damage?
What effect do antacids have on fluoroquinolones?
What effect do antacids have on fluoroquinolones?
Which bacteria is included in the antibacterial spectrum of ciprofloxacin?
Which bacteria is included in the antibacterial spectrum of ciprofloxacin?
What is the primary mechanism of action of fluoroquinolons?
What is the primary mechanism of action of fluoroquinolons?
Which of the following organisms is NOT typically susceptible to ciprofloxacin?
Which of the following organisms is NOT typically susceptible to ciprofloxacin?
What common gastrointestinal adverse effect is associated with ciprofloxacin?
What common gastrointestinal adverse effect is associated with ciprofloxacin?
How does food affect the absorption of ciprofloxacin?
How does food affect the absorption of ciprofloxacin?
Which fluoroquinolone is noted for potentially lengthening the QT interval?
Which fluoroquinolone is noted for potentially lengthening the QT interval?
What is a potential risk associated with the use of fluoroquinolons in young children?
What is a potential risk associated with the use of fluoroquinolons in young children?
What type of drug interaction can ciprofloxacin have with theophylline?
What type of drug interaction can ciprofloxacin have with theophylline?
Which of the following is true about the effect of antacids on fluoroquinolons?
Which of the following is true about the effect of antacids on fluoroquinolons?
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Study Notes
Fluoroquinolons Overview
- Bactericidal antibiotics that inhibit bacterial DNA synthesis.
- Ciprofloxacin serves as the prototype fluoroquinolone.
- Effective against a wide range of aerobic gram-negative organisms.
Antibacterial Spectrum
- Specifically targets:
- E. coli, Enterobacter, Proteus, Klebsiella, Salmonella, Shigella
- H. ducreyi, H. influenzae, N. gonorrhea, N. meningitidis
- Vibrio cholera, Campylobacter jejuni
- Displays activity against:
- S. aureus, Pseudomonas aeruginosa, Mycobacterium tuberculosis
- Most anaerobic bacteria exhibit resistance to ciprofloxacin.
- Newer fluoroquinolones (e.g., levofloxacin, gemifloxacin, moxifloxacin) show increased efficacy against streptococci and some anaerobes.
Pharmacokinetics
- Administered via oral, intravenous, or topical routes.
- Well-absorbed in the gastrointestinal tract; however, food delays absorption.
- Widely distributed in the body, achieving high concentrations in:
- Kidneys, lungs, prostatic tissue, bile, macrophages.
- Primarily excreted in urine.
Adverse Effects
- Common gastrointestinal issues include:
- Nausea, vomiting, abdominal discomfort.
- Central nervous system effects may cause:
- Headaches, dizziness, insomnia, confusion, hallucinations, convulsions.
- Possible hypersensitivity reactions include:
- Skin rashes, urticaria, itching, eosinophilia, photosensitivity.
- Risks of tenosynovitis and tendon rupture, particularly in athletes.
- Moxifloxacin poses a risk for prolonging the QT interval.
- Can cause cartilage damage in animals; thus, use in young children is discouraged.
Drug Interactions
- Ciprofloxacin elevates plasma concentrations of:
- Theophylline, warfarin by inhibiting metabolism.
- NSAIDs may exacerbate CNS side effects like confusion and irritability, with rare convulsions.
- Absorption of fluoroquinolones can be decreased by:
- Antacids, ferrous salts, and sucralfate, similar to tetracyclines.
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