Fluoroquinolones (Quinolones) Pharmacology Nursing Mnemonic, Mechanism of Action NCLEX

Summary

This video provides an in-depth overview of fluoroquinolones, a class of antibiotics effective against both gram-negative and gram-positive bacteria. The speaker explains their mechanisms of action, particularly how they inhibit DNA replication enzymes to kill bacteria. Key points include the common types of infections treated with these antibiotics, how they are administered, and identifying them by the suffix '-floxacin.' The video also highlights crucial considerations for nurses, such as monitoring for side effects like crystaluria, prolonged QT intervals, tendon ruptures, and interactions with other medications. Important patient education topics are also discussed.

Takeaways

• 💊 Fluoroquinolones, also known as quinolones, are antibiotics effective against gram-negative and gram-positive bacteria.
• 🔬 These antibiotics can target bacteria like Haemophilus influenzae, Neisseria gonorrhea, Chlamydia, E. coli, Klebsiella pneumoniae, and more.
• 🦠 They treat various infections, including urinary tract, skin, respiratory, sexually transmitted infections, and infections affecting the abdomen, joints, and bones.
• 📋 Fluoroquinolones are often administered orally but can also be given parenterally. The generic names usually include 'floxacin' (e.g., ciprofloxacin, levofloxacin).
• 🧬 These antibiotics work by inhibiting bacterial DNA replication, specifically targeting enzymes like DNA gyrase and topoisomerase IV.
• 💉 Fluoroquinolones have a bactericidal effect, meaning they kill bacteria rather than merely inhibiting growth.
• 👩‍⚕️ Nurses should monitor patients for allergies, infection effectiveness, vital signs, and potential side effects like septic shock.
• 🚰 Patients should be educated on staying hydrated to prevent crystalluria, especially when taking ciprofloxacin.
• ⚠️ Fluoroquinolones may cause tendon rupture, especially in older adults, and should not be administered with medications or supplements containing cations like calcium, magnesium, or zinc.
• ☀️ Patients taking fluoroquinolones should be cautious about sun exposure due to the risk of photosensitivity, which can lead to burns and blistering.

Q & A

What are fluoroquinolones, and what types of bacteria do they target?

Fluoroquinolones, also known as quinolones, are a group of antibiotics effective against both gram-negative and gram-positive bacteria. They target bacteria like Haemophilus influenzae, Neisseria gonorrhoeae, Chlamydia, E. coli, Klebsiella pneumoniae, Salmonella, Pseudomonas aeruginosa, Streptococcus pneumoniae, Enterococcus, and Staphylococcus aureus.

What types of infections can fluoroquinolones treat?

Fluoroquinolones can treat urinary tract infections, skin infections, respiratory infections, sexually transmitted infections, abdominal infections, joint, and bone infections.

How are fluoroquinolones administered, and how can you identify them?

Fluoroquinolones are typically administered orally due to their good absorption in the gut but can also be given parenterally if needed. They can be identified by the suffix '-floxacin' in their generic names, such as ciprofloxacin, levofloxacin, and moxifloxacin.

How do fluoroquinolones work to kill bacteria?

Fluoroquinolones have a bactericidal effect by inhibiting bacterial DNA replication. They target enzymes like DNA gyrase and topoisomerase IV, which are crucial for DNA replication in bacteria. Disrupting these enzymes kills the bacteria by preventing them from replicating.

What is the difference in how fluoroquinolones affect gram-negative and gram-positive bacteria?

For gram-negative bacteria, fluoroquinolones primarily inhibit DNA gyrase, preventing supercoiling and further replication. For gram-positive bacteria, they target topoisomerase IV, preventing the separation of daughter DNA strands, thus halting replication.

What are some key points to monitor when administering fluoroquinolones to a patient?

Key points include ensuring the patient is not allergic, monitoring the effectiveness of the treatment (e.g., temperature, white blood cell count), and watching for signs of septic shock, such as hypotension, tachycardia, mental status changes, and breathing problems.

What are the important patient education points related to fluoroquinolone use?

Patients should maintain adequate fluid intake to prevent crystal formation in the urinary system, avoid medications containing cations (e.g., calcium, zinc, iron), be cautious of prolonged QT intervals, report tendon pain or swelling, avoid sun exposure, and monitor for signs of C. difficile infection.

Why is it important to avoid fluoroquinolones in children and pregnant women?

Fluoroquinolones can cause bone and cartilage problems in children and are therefore contraindicated in children and during pregnancy to prevent these adverse effects.

What side effect is associated with prolonged QT intervals when using fluoroquinolones?

Fluoroquinolones can prolong the QT interval, which increases the risk of a potentially fatal arrhythmia called torsades de pointes, especially when combined with other QT-prolonging medications.

What should patients with myasthenia gravis be cautious about when taking fluoroquinolones?

Fluoroquinolones can exacerbate muscle weakness in patients with myasthenia gravis, so they should be closely monitored for worsening symptoms.