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Naladixic acid (the first of quinolones) has effects in what part of the body?
Urinary tract
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What is the MOA of quinolones?
Inhibit DNA gyrase (topoisomerase II) and topoisomerase IV (which are different than in eukaryotic cells)
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What is the action of DNA gyrase (topoisomerase II) and topoisomerase IV?
Nick DNA and reconnect the strands
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What are the older flouroquinolones?
Ciprofloxacin, Norfloxacin and Ofloxacin
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1st generation/older/ 2nd gen flouroquinolones treat what type of bacteria?
Gram - and aerobic bacteria
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Which is the most potent Ciprofloxacin, Norfloxacin and Ofloxacin?
Ciprofloxacin
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What are the newer flouroquinolone?
Levofloxacin, Moxifloxacin and Gemifloxacin
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What are newer fluoroquinolones used for mainly?
Respiratory infections
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How does the spectrum of newer flouroquinolones differ from older ones?
Increased G+ activity, can treat Strep pneumoniae
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Which is the most commonly used of the newer Flouroquinolines?
Levofloxacin
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What unique spectrum does Moxifloxacin have?
Treats anaerobes
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Which of the newer flouroquinolones are not ideal for UTIs and why?
Moxifloxacin and Gemifloxacin, because they are metabolized in the liver before they are excreted
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Are fluoroquinolones absorbed orally?
Yes
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Would probenecid effect the excretion of fluoroquinolones?
Yes
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Where do fluoroquinolones concentrate at?
Urine, kidney, prostate, feces and lungs
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What is the t1/2 of ciprofloxacin?
3-5 hours ( shortest of all flouroquinolines)
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Why is naladixic acid a good choice for UTIs?
It only concentrates in the kidneys, nowhere else
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Where does Nalidixic acid only concentrate?
In the kidneys
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What functional group do Levofloxacin and Ciprofloxacin have that enhances their antimicrobial potency over naladixic acid?
Flourine and piperizine structure
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The fluorine on Flouroquinolones increases the potency mainly against what bacterial group?
G-
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What is a major side effect of Flouroquinolones?
Phototoxicity, due to deposition in the skin
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Gemifloxacin has what major adverse reaction?
Phototoxicity
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What organisms are sensitive to flouroquinolones?
Atypical bacteria that include: Mycoplasma pneumonia, Legionella pneumophila, Chlamydia species and Mycobacterium tuberculosis, e. coli, Klebsiella pneumonia, Salmonella species, Neisseria gonorrhoeae, Staph aureus ( sans MRSA)
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Are flouroquinolones a first choice drug?
No
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Why can Flouroquinolones treat bacteria that penicillins and cephalosporins, etc. cannot?
They affect the DNA, so they do not need bacteria with normal cell walls to be effective
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Do G+ or G- usually cause UTIs?
G-
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Do G+ or G- usually cause travelers diarrhea?
G-
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Are flouroquinolones a good choice for Neisseria gonorrhoae?
Can treat, but lots of resistance is popping up
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Do flouroquinolones have activity against Enterococci?
No
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Which flouroquinolones can treat Pseudomoas aeruginosa?
Ciprofloxacin and Levofloxacin
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Which flouroquinolones can treat Anaerobes (Bacteroides)?
Moxifloxacin
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Which flouroquinolones can treat Streptococci?
Levofloxacin and moxifloxacin
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