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12.13 Anti-Infective – Fluoroquinolones

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Overview

  1. Overview
    1. Bacterial agents
    2.  Types
      1. Norfloxacin (Noroxin)
      2. Ciprofloxacin (Cipro)
      3. Levofloxacin (Levaquin)
      4. Moxifloxacin (Avelox)
      5. Gatifloxacin (Tequin)
      6. Gemifloxacin (Factive)
  2. Mechanism of Action
    1. Destroy bacteria by altering their DNA
    2. Kill gram – / gram + organisms
  3. Indications
    1. Urinary tract infections
    2. Respiratory infections / Pneumonia
    3. Sexually transmitted infections (STIs)
    4. Bone and joint infections
    5. Prostate infections
  4. Contraindications
    1. Drug allergy
    2. Cardiac function
      1. Dysrhythmias
  5. Interactions
    1. Antacids
    2. Iron
    3. Zinc preparations
    4. Sucralfate
    5. Magnesium / Calcium
    6. Oral anticoagulants

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Video Transcript

Hey there, and today’s we are going to discuss fluoroquinolones, which are a certain type of antibiotic class.

Alright, let’s review. Fluoroquinolones are bactericidal, meaning that these antibiotics KILL bacteria. They don’t simply suppress bacterial reproduction.

Fluoroquinolones all end in -FLOXACIN, which is an easy way to remember this drug class.

The mechanism of action that causes these antibiotics to work is related to their ability to alter bacterial DNA. Fluoroquinolones are used to treat gram +/- organisms.

Indications for fluoroquinolones include urinary tract infections, respiratory infections, sexually transmitted infections, bone/joint infections and prostate infections. The top three indications can be remember by URS.

Contraindications for fluoroquinolones include drug allergy and cardiac dysrhythmias. If your patient has a past medical history of ventricular tachycardia, for example, this drug wouldn’t be a good choice. Any cardiac dysrhythmia history would be a concern regarding this antibiotic use.

Some other medications that can Interact with fluoroquinolones include sucralfate, antacids, iron, magnesium, calcium, oral anticoagulants and zinc preparations. An easy way to remember these is SAIMOZ.

Psychiatric side effects for fluoroquinolones include depression and anxiety.

Sensation and muscle side effects for fluoroquinolones include sensation changes and swelling, pain and tendon rupture. There isn’t a definitive reason, researchers speculate it can be linked to mitochondrial damage, likely oxidative stress.

Cardiovascular side effects for fluoroquinolones include aortic tear and rupture. Signs and symptoms include sudden, severe chest pain, hypotension, flank or back pain. These patients often die before they are able to seek surgical intervention.

Endocrine side effects for fluoroquinolones include hypoglycemia. If your patient has a baseline of hypoglycemia, this will exacerbate their condition.

Priority nursing concepts for fluoroquinolones include pharmacology and infection control.

Alright let’s review fluoroquinolones. These antibiotics end in -FLOXACIN. Top three indications can be remembered by URS (urine, respiratory and sexual transmitted infections). Contraindications include drug allergies and cardiac dysrhythmias. This drug class has many interactions, which can be remembered by SAIMOZ (sucralfate, antacids, iron, magnesium/calcium, oral anticoagulants and zinc preparations). Lastly side effects include – depression and anxiety / sensation changes and swelling, pain and tendon rupture / aortic tear and rupture / hypoglycemia.

You know now the important details regarding fluoroquinolones. Now, go out and be your best self today and as always, Happy Nursing!

 
  • Question 1 of 6

A nurse receives in report that a client will be discharged with a prescription for oral fluoroquinolone and knows that the client would have which of the following types of infections? Select all that apply.

  • Question 2 of 6

A nurse is reviewing a client’s history before giving fluoroquinolone and would be concerned about administrating it to the client if which of the following was seen in the client history?

  • Question 3 of 6

A client is receiving fluoroquinolones and takes warfarin. The nurse is aware that these two drugs could cause which of the following reactions?

  • Question 4 of 6

A nurse is caring for a client receiving fluoroquinolones for a respiratory infection. The client begins to have severe burning pain. This concerns the nurse because the nurse knows that which of the following types of ruptures could be occurring as a side effect of this medication?

  • Question 5 of 6

A nursing student knows that fluoroquinolones have which of the following types of suffix ending?

  • Question 6 of 6

The nurse is caring for a 70-year-old client who has just started PO ciprofloxacin for a urinary tract infection. Which of the following statements by the client demonstrates understanding of this drug? Select all that apply.

Module 0 – Pharmacology Course Introduction
Module 3 – Disease Specific Medications

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