Author Question: Fluoroquinolones are very effective against both gram-negative and gram-positive organisms. Several ... (Read 134 times)

ap345 · **on:** Jul 23, 2018

Fluoroquinolones are very effective against both gram-negative and gram-positive organisms. Several of the drugs in this class have been discontinued from use. What adverse effects have caused the removal of these drugs from the market?

1. The development of dysrhythmias after administration of fluoroquinolones
2. The development of pathologic fractures after administration of fluoroquinolones
3. The development of insomnia after administration of fluoroquinolones
4. The development of severe phototoxicity after administration of fluoroquinolones

Question 2

The nurse is caring for a client who has developed an infection that is resistant to fluoroquinolone therapy. The nurse knows that this resistance is due to which reasons?

Standard Text: Select all that apply.
1. A mutation to the DNA gyrase.
2. The development of resistant pumps within the bacteria.
3. The bacterial cell wall structure has become impermeable.
4. Mutations to DNA helicase alter its ability to bind with fluoroquinolones.
5. The client administered the medication improperly.

djofnc · **Reply #1 on:** Jul 23, 2018

Answer to Question 1

Correct Answer: 1
Rationale 1: Fluoroquinolones have been indicated as the cause of potentially fatal dysrhythmias after the administration of gatifloxacin and moxifloxacin. These two fluoroquinolones have been removed from the market.
Rationale 2: Fluoroquinolones have caused joint toxicity, and rupture of tendons has been reported. However, this has not caused the removal of fluoroquinolones from the market.
Rationale 3: Fluoroquinolones cause dizziness, headache, and sleep disturbances in a small number of clients. However, this adverse effect has not caused the removal of fluoroquinolones from the market.
Rationale 4: Fluoroquinolones are indicated in the development of moderate-to-severe phototoxicity in clients exposed to direct or indirect sunlight. However, it has not caused the removal of fluoroquinolones from the market.
Global Rationale: Some of the most serious adverse effects of drugs in this class are dysrhythmias (moxifloxacin). Several of the drugs in this class were removed from the market due to the potential for fatal dysrhythmias. Nearly all fluoroquinolones prolong the QT interval. Fluoroquinolones have caused joint toxicity, and rupture of tendons has been reported. However, this has not caused the removal of fluoroquinolones from the market. Fluoroquinolones cause dizziness, headache, and sleep disturbances in a small number of clients. However, this adverse effect has not caused the removal of fluoroquinolones from the market. Fluoroquinolones are indicated in the development of moderate-to-severe phototoxicity in clients exposed to direct or indirect sunlight. However, it has not caused the removal of fluoroquinolones from the market.

Answer to Question 2

Correct Answer: 1,2,3
Rationale 1: Mutations to DNA gyrase can alter its ability to bind fluoroquinolones, thus rendering the drug less effective.
Rationale 2: Some bacteria have developed resistance pumps that remove fluoroquinolones from inside their cells, thus rending the drug less effective.
Rationale 3: Some bacteria have developed a cell wall structure that is less permeable to the drugs, thus rendering the drug less effective.
Rationale 4: Mutations to DNA helicase have not rendered fluoroquinolones less effective.
Rationale 5: Improper administration of medication does not render the drug less effective.
Global Rationale: Mutations to DNA gyrase can alter its ability to bind fluoroquinolones, thus rendering the drug less effective. Some bacteria have developed resistance pumps that remove fluoroquinolones from inside their cells, thus rending the drug less effective. Some bacteria have developed a cell wall structure that is less permeable to the drugs, thus rendering the drug less effective. Mutations to DNA helicase have not rendered fluoroquinolones less effective. Improper administration of medication does not render the drug less effective.