Question
Classify fluoroquinolones. Explain the mechanism of action, uses and adverse effects
of fluoroquinolones. (2+1+2+1)
Q16 marksEssays
Answer
Classification of fluoroquinolones
- First generation: Nalidixic acid
- Second generation: Ciprofloxacin, Norfloxacin, Ofloxacin
- Third generation: Levofloxacin, Sparfloxacin
- Fourth generation: Moxifloxacin, Gatifloxacin
Mechanism of action
- Inhibit bacterial DNA gyrase (topoisomerase II) and topoisomerase IV, blocking DNA supercoiling/replication — bactericidal
Uses
- Urinary tract infections, typhoid fever, bacillary dysentery
- Respiratory tract infections (third/fourth generation, enhanced Gram-positive cover)
- Anthrax, sexually transmitted infections
Adverse effects
- GI upset
- Tendinitis/tendon rupture
- Arthropathy in growing cartilage (avoided in children/pregnancy)
- CNS effects, QT prolongation
- Photosensitivity
- 1Quinolones
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