Chapter 91- flouroquinolones : exam 5
Which age groups should not take flouroquinolones?
Below 18 Above 60
what is c-dif usually preceded by with antibiotics
Ciprofoxacin Levofloxacin
What kind of antibiotic is flouroquinolones?
Broad spectrum- multiple applications
What is the big side effect with flouroquinolones?
Can cause tendons to rupture, usually achilles
what does c-dif infect
bowel
What is rhe mechanism of action for Flouroquinolones?
Disrupt DNA replication and cell division
What kind of antibotic is ciprofloxacim
Flouroquinolone- broad spectrum for both gram positive and negative
what is the big problem with Ciprofloxacin
can harm the achilles tendon
what does Ciprofloxacin do?
inhibits bacterial dna gyrase and topoisomerase II
what is c-dif usually treated with?
vancomycin metronidazole
what bacteria have already become resistant to Ciprofloxacin
-Staphylococcus aureus -Serratia marcescens -Campylobacter jejuni, -Pseudomonas aeruginosa -Neisseria gonorrhoeae
what reduces drug absorption of Ciprofloxacin
-aluminum & magnesium antacids -iron & zinc salts -sucralfate -milk/dairy
what are the uses of Ciprofloxacin
-drug of choice for anthrax -respiratory infection -uti -gi, bones, skin, and soft tissue
What is the mechanisms of action for ciprofloxacin?
-inhibits bacterial DNA gyrase and topoisomerase II
What other groups of people should not take flouroquinolones?
-people taking glucocorticoids -people who hace had kidney, heart, or lung transplants
what causes drug levels of Ciprofloxacin to increase?
-theophyllines -warfarine -tinidazole
what are the mild adverse effects of Ciprofloxacin
-Gi effects -dizziness, headache, confusion and sometimes seizures -tendon rupture (achilles) -phototoxicity -yeast infections -increase c-dif
what are the adverse effects of Metronidazole (Flagyl)
-Neurotoxicity -Allergy -Superinfection -Taste perversion - mouth tastes like metal
what is Metronidazole (Flagyl) used for?
-Protozoal infection -C-dif -Helicobacter pylori
The patient is being discharged with continued ciprofloxacin therapy. When providing discharge teaching, the nurse should advise the patient to call the healthcare provider immediately if what develops? A. Pain in the heel of the foot B. Nausea C. Diarrhea D. Headache
Answer: A Rationale: Rarely, ciprofloxacin and other fluoroquinolones have caused tendon rupture, usually of the Achilles tendon. The incidence is 1 in 10,000 or less. Because tendon injury is reversible if diagnosed early, fluoroquinolones should be discontinued at the first sign of tendon pain, swelling, or inflammation. In addition, patients should refrain from exercise until tendinitis has been ruled out.
A patient has been prescribed oral ciprofloxacin [Cipro] for a skin infection. When administering the medication, it is most important for the nurse to do what? A. Monitor for a decrease in the prothrombin time (PT) if the patient is also taking warfarin [Coumadin] B. Withhold antacids and milk products for 6 hours before or 2 hours afterward C. Inform the healthcare provider if the patient has a history of asthma D. Assess the skin for Stevens-Johnson syndrome
Answer: B Rationale: Absorption of ciprofloxacin can be reduced by ingestion of antacids and milk products. Ingestion of these products should occur at least 6 hours before ciprofloxacin or 2 hours afterward. Ciprofloxacin can increase the PT if the patient is also taking warfarin. Use of ciprofloxacin is contraindicated in patients with a history of myasthenia gravis. Patients taking ciprofloxacin are at risk for development of phototoxicity.
A patient is diagnosed with C. difficile infection. The nurse anticipates administering which medication? A. Daptomycin B. Metronidazole C. Rifampin D. Rifaximin
Answer: B Rationale: Metronidazole is a drug of choice for C. difficile infection. Daptomycin has a unique mechanism and can rapidly kill virtually all clinically relevant gram-positive bacteria, including MRSA. Rifampin [Rifadin] is a broad-spectrum antibacterial agent used primarily for tuberculosis. However, the drug is also used against several nontuberculous infections. Rifampin is useful for treating asymptomatic carriers of Neisseria meningitidis. Rifaximin [Xifaxan] is an oral, nonabsorbable analog of rifampin used to kill bacteria in the gut.
A patient has been prescribed ciprofloxacin for treatment of a urinary tract infection with Escherichia coli. Before administering the drug, it is most important for the nurse to assess the patient for a history of what? A. Hypertension B. Diabetes mellitus C. Myasthenia gravis D. Seasonal allergies
Answer: C Rationale: Ciprofloxacin and other fluoroquinolones can exacerbate muscle weakness in patients with myasthenia gravis. Accordingly, patients with a history of myasthenia gravis should not receive these drugs.
Fluoroquinolones should be discontinued immediately if what happens? A. Nausea, vomiting, or diarrhea is experienced. B. Dizziness, headache, or confusion occurs. C. Tendon pain or inflammation develops. D. Theophylline is prescribed for asthma.
Answer: C Rationale: Fluoroquinolones can cause tendon rupture and should be discontinued if tendon pain or inflammation develops.
It is most important for the nurse to avoid administering oral ciprofloxacin to this patient with which food? A. Bananas B. Baked chicken C. Grapefruit juice D. Milk
Answer: D Rationale: Absorption of ciprofloxacin can be reduced by compounds that contain cations. Among these are (1) aluminum- or magnesium-containing antacids, (2) iron salts, (3) zinc salts, (4) sucralfate, (5) calcium supplements, and (6) milk and other dairy products, all of which contain calcium ions. These cationic agents should be administered at least 6 hours before ciprofloxacin or 2 hours after.
How are flouroquinolones administered?
IV or orally
what are c-dif spores resistant to?
alcohol drying temp change they can survive on a surface for up to a week
what is c-dif?
gram postive, spore forming bacillus