1. Ciprofloxacin (most common) Norfloxacin
FLUOROQUINOLONES
Ciprofloxacin (most common) Norfloxacin
Ofloxacin Pefloxacin
All these dugs are given oral except ciprofloxacin is given oral & injection
CIPROFLOXACIN
Mechanism of action
Inhibit DNA synthesis by inhibiting DNA gyrase(topoisomerase II).
It’s the only injected quinolone

2. It doesn’t work against anerobes
CIPROFLOXACIN ( CONT. )
Antibacterial spectrum
Mainly effective against G – bacteria :
Enterobacteriacae H. influenzae M. catarrhalis
Campylobacter Pseudomonas N. gonorrheae
Intracellular pathogens
M. Tuberculosis Mycoplasma Chlamydia
Legionella Brucella
It doesn’t work against anerobes

3. Ciprofloxacin ( Cont. ) Pharmacokinetics
Well absorbed orally ( available i.v. )
Di & tri- valent cations interfere with its absorption (milk, Mg, Al, Ca, antacid)
Concentrates in many tissues, esp. kidney, prostate, lung & bones/ joints
Do not cross BBB
Excreted mainly through the kidney (tubular & glomerular) (probencid interferes with tubular secretion)
Accumulate in renal insufficiency
Up to 20% metabolized by liver
t1/2 = 3.3 hrs

4. CIPROFLOXACIN ( CONT. ) Clinical uses
1. Urinary tract infections (P.aeruginosae,E.coli,Klebsiella)
2. Osteomyelitis due to P. aeruginosa
3. Gonorrhea
4. Travellers’ diarrhea- ciprofloxacin commonly used (if there’s a bloody diarrhea)
5. Prostatitis
6. Legionnaires’ disease
7. Brucellosis
8. Diabetic foot infections
9. Anthrax
10. Eradication of menengiococci from carriers
For P.aeruginosa infection outside urinary tract or the bones use AGS, penicillin

5. CIPROFLOXACIN ( CONT. ) Side effects Contraindications
Nausea , vomiting & diarrhea
CNS effects : confusion, insomnia, headache, dizziness & anxiety.(indirectly by modifying GAPA transmitter in the CNS)
May damage growing cartilage
Tendinitis ( rare but more serious ) (irreversible) (may lead to tendon rupture)
Phototoxicity  avoid excessive sunlight
Contraindications
Children / adolescents (under 18), pregnancy and lactation (secreted in milk)
It’s not contraindicated in adolescents it’s not preferred so u have to measure benfits vs. risks
Drug interaction
Iron or antacids containing Mg, Ca, or Al  reduce oral absorption
Elevates serum levels of theophylline, warfarin & glibenclamide