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Info about bronchitis coughing => acute bronchitis => Topic started by: glennaguilar on September 22, 2016, 08:00:22 pm
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Bronchitis - Fluoroquinolone Antibiotics Classification, Uses and Side Effects
The fluoroquinolones are a relatively new group of antibiotics. Fluoroquinolones were first introduced in 1986, but they are really modified quinolones, a class of antibiotics, whose accidental discovery occurred in the early 1960.
Classification of Fluoroquinolones
As a group, the fluoroquinolones have excellent in vitro activity against a wide range of both gram-positive and gram-negative bacteria. The newest fluoroquinolones have enhanced activity against gram-positive bacteria with only a minimal decrease in activity against gram-negative bacteria. Their expanded gram-positive activity is especially important because it includes significant activity against Streptococcus pneumoniae.
Gastrointestinal Effects
The most common adverse events experienced with fluoroquinolone administration are gastrointestinal (nausea, vomiting, diarrhea, constipation, and abdominal pain), which occur in 1 to 5% of patients. CNS effects. Headache, dizziness, and drowsiness have been reported with all fluoroquinolones. Insomnia was reported in 3-7% of patients with ofloxacin. Severe CNS effects, including seizures, have been reported in patients receiving trovafloxacin. Seizures may develop within 3 to 4 days of therapy but resolve with drug discontinuation. Although seizures are infrequent, fluoroquinolones should be avoided in patients with a history of convulsion, cerebral trauma, or anoxia. No seizures have been reported with levofloxacin, moxifloxacin, gatifloxacin, and gemifloxacin. With the older non-fluorinated quinolones neurotoxic symptoms such as dizziness occurred in about 50% of the patients. Phototoxicity. Exposure to ultraviolet A rays from direct or indirect sunlight should be avoided during treatment and several days (5 days with sparfloxacin) after the use of the drug. The degree of phototoxic potential of fluoroquinolones is as follows: lomefloxacin > sparfloxacin > ciprofloxacin > norfloxacin = ofloxacin = levofloxacin = gatifloxacin = moxifloxacin. Musculoskeletal effects. Concern about the development of musculoskeletal effects, evident in animal studies, has led to the contraindication of fluoroquinolones for routine use in children and in women who are pregnant or lactating. Tendon damage (tendinitis and tendon rupture). Although fluoroquinolone-related tendinitis generally resolves within one week of discontinuation of therapy, spontaneous ruptures have been reported as long as nine months after cessation of fluoroquinolone use. Potential risk factors for tendinopathy include age >50 years, male gender, and concomitant use of corticosteroids. Hepatoxicity. Trovafloxacin use has been associated with rare liver damage, which prompted the withdrawal of the oral preparations from the U.S. market. However, the IV preparation is still available for treatment of infections so serious that the benefits outweigh the risks. Cardiovascular effects. The newer quinolones have been found to produce additional how is bronchitis treated? (http://bronovil.com/) heart that were not found with the older compounds. Evidence suggests that sparfloxacin and grepafloxacin may have the most cardiotoxic potential. Hypoglycemia/Hyperglycemia. Recently, rare cases of hypoglycemia have been reported with gatifloxacin and ciprofloxacin in patients also receiving oral diabetic medications, primarily sulfonylureas. Although hypoglycemia has been reported with other fluoroquinolones (levofloxacin and moxifloxacin), the effects have been mild. Hypersensitivity. Hypersensitivity reactions occur only occasionally during quinolone therapy and are generally mild to moderate in severity, and usually resolve after treatment is stopped.
Side Effects
The fluoroquinolones as a class are generally well tolerated. Most adverse effects are mild in severity, self-limited, and rarely result in treatment discontinuation. However, they can have serious adverse effects.