Chapter 91- Miscellaneous Antibacterial Drugs: Fluoroquinolones

Who should avoid fluoroquinolones

- Patients younger than 18 years - Risk to all patients, especially those older than 60 years - Those taking glucocorticoids - Those who have undergone kidney, heart, or lung transplantation

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

A

Fluoroquinolones- Ciprofloxacin drug food interactions

Absorption reduced by: Aluminum antacids Magnesium antacids Iron salts Zinc salts Sucralfate Calcium supplements Milk and dairy products

Side effects of fluoroquinolones

Achilles tendon rupture, cartilage damage, increased LFTs, nephrotoxicity

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.

B

Fluoroquinolones

Broad-spectrum agents with multiple applications Disrupt DNA replication and cell division All can be administered orally or IV

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

C

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.

C

Fluoroquinolones prototype

Ciprofloxacin

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

D

Adverse effects of ciprofloxacin

GI: Nausea/vomiting, diarrhea, abdominal pain -Tendon rupture - Phototoxicity - Candida infections: Pharynx and vagina Older patients: Myasthenia gravis

Uses of Ciprofloxacin

Multiple systems, Drug of choice for anthrax

What elevates drug levels

Theophylline (used for asthma) Warfarin (an anticoagulant) Tinidazole (an antifungal drug)

Candida infections (caused by Ciprofloxacin)

yeast infections