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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.


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.


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 A very important system is the respiratory system of the body. It distributes oxygen in order for the body to live and without it, the body dies. It is this reason that taking care of your body's respiratory system is imperative.

Because of concern about hepatotoxicity, trovafloxacin therapy should be reserved for life- or limb-threatening infections requiring inpatient treatment (hospital or long-term care facility), and the drug should be taken for no longer than 14 days.

What is Acute Bronchitis Acute Bronchitis is considered short term and should be treated immediately. Acute bronchitis can be recognized by these signs:

1. Basics of Bronchitis Bronchitis is a condition in which viral or bacterial infection leads to inflammation of the respiratory tract. However, bacteria and virus are not always responsible for this condition. Continuous exposure to highly polluted atmospheres or a lifestyle trait such as heavy smoking renders the immune system so weak that the body becomes an ideal place for bacterial or viral infection.

Pain Killers Muscle pain is another symptom of this disorder. Pain killers such as aspirin and acetaminophen provide a lot of relief. However, an over dose of these drugs can cause gastric bleeding, and so, they should be taken on a full stomach.

5. Other Medications Apart from the basic medication for bronchitis, doctors can prescribe medicines depending on the condition of individual patients.

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This illness can last anywhere from ten to twelve days after the symptoms first appear. It can also be in conjunction with the flu or cold and sometimes others you may not realize you have had.

Don't take antibiotics if the bronchitis is caused by virus or lifestyle patterns such as smoking or polluted environments because the antibiotics are of no use in such cases.

Fluoroquinolones advantages: Ease of administration Daily or twice daily dosing Excellent oral absorption Excellent tissue penetration Prolonged half-lives Significant entry into phagocytic cells Efficacy Overall safety

In case of acute bronchitis, the patient may cough for a couple of weeks or more. Persistent cough causes a strain on the muscles of the abdomen and the thoracic cavity. If not treated properly and on time, persistent coughing might result in a damaged chest wall.

The newer fluoroquinolones have a wider clinical use and a broader spectrum of antibacterial activity including gram-positive and gram-negative aerobic and anaerobic organisms. Some of the newer fluoroquinolones have an important role in the treatment of community-acquired pneumonia and intra-abdominal infections.

Conditions treated with Fluoroquinolones: indications and uses The newer fluoroquinolones have a wider clinical use and a broader spectrum of antibacterial activity including gram-positive and gram-negative aerobic and anaerobic organisms. Some of the newer fluoroquinolones have an important role in the treatment of community-acquired pneumonia and intra-abdominal infections. The serum elimination half-life of the fluoroquinolones range from 3 -20 hours, allowing for once or twice daily dosing.

Because of their expanded antimicrobial spectrum, third-generation fluoroquinolones are useful in the treatment of community-acquired pneumonia, acute sinusitis and acute exacerbations of chronic bronchitis, which are their primary FDA-labeled indications. The third-generation fluoroquinolones include levofloxacin, gatifloxacin, moxifloxacin and sparfloxacin.

Moreover, pregnant women and children are strictly not permitted to take these medicines. Aspirin is believed to cause Reye's syndrome in children. In pregnant women, it may result in severe bleeding.

Urinary tract infections (norfloxacin, lomefloxacin, enoxacin, ofloxacin, ciprofloxacin, levofloxacin, gatifloxacin, trovafloxacin) Lower respiratory tract infections (lomefloxacin, ofloxacin, ciprofloxacin, trovafloxacin) Skin and skin-structure infections (ofloxacin, ciprofloxacin, levofloxacin, trovafloxacin) Urethral and cervical gonococcal infections (norfloxacin, enoxacin, ofloxacin, ciprofloxacin, gatifloxacin, trovafloxacin) Prostatitis (norfloxacin, ofloxacin, trovafloxacin) Acute sinusitis (ciprofloxacin, levofloxacin, gatifloxacin, moxifloxacin (Avelox), trovafloxacin) Acute exacerbations of chronic bronchitis (levofloxacin, sparfloxacin (Zagam), gatifloxacin, moxifloxacin, trovafloxacin) Community-acquired pneumonia (levofloxacin, sparfloxacin, gatifloxacin, moxifloxacin, trovafloxacin)

Acute bronchitis is easier to treat than chronic. If it is caused by a virus, it is typically bothersome for a week or so and then goes away on its own. With plenty of rest and drinking lots of non-carbonated and non-alcohol drinks, the illness subsides. It's necessary to remember that acute bronchitis is contagious so it can be spread by coughing and sneezing. Try using a cloth to minimize the virus from escaping into the air when you cough.

* Persistent cough with mucus * Shortness of breath or (Dyspnea) * Mild fever * Fatigue/tiredness * Minor chest pains * Ability to feel vibrations in chest when breathing

To help aid in recovery and heal faster, it is imperative that you stay away from pollutants that cause the irritation in the first place. If you live with or are a smoker, you need to be rid of the situation as soon as you can. Stop smoking and don't let anyone smoke inside your home.

During a person's life, they will get a breathing disorder. One such illness is chronic bronchitis. This is an obstructive pulmonary disorder where the bronchi become inflamed. It's commonplace for smokers and people who live with smokers to have this issue.

Second-generation agents include ciprofloxacin, enoxacin, lomefloxacin, norfloxacin and ofloxacin. Ciprofloxacin is the most potent fluoroquinolone against P. aeruginosa. Ciprofloxacin and ofloxacin are the most widely used second-generation quinolones because of their availability in oral and intravenous formulations and their broad set of FDA-labeled indications.

To treat bronchitis, you can use some home remedies like honey with a tea spoon of ginger juice, or a liquid mixture of tulsi, ginger and black pepper in same proportion and must be taken 20-25 ml 3 times a day. You can also increase the intake of water, because that will help to make the mucus in the lungs thin and in this way cough clears out easily, and while going to bed or before breakfast you can take with sugar and honey the mixture that results after boiling 1 tea spoon of Jushanda in a cup of water. You should also avoid smoking, because it irritates lungs and slows down healing; in order to relax sore chest muscles and obtain faster relief you can massage your chest and back muscles, and it was seen that Mulathi if chewed for some time helps. It is important to know that we must overcome the sources of irritation and infection in the throat, nose, sinuses, mouth, and bronchial tubes. Staying indoor during the cold weather may be of real help, and also avoiding any sort of polluted air and dusty working conditions.

Bronchitis can easily be mistaken for a common cold. Dealing with bronchitis becomes easier once you learn to identify the various symptoms and signs of bronchitis.

* Feeling of coldness Should you suffer from any of these symptoms, consult a physician right away for treatment so they can do a physical examination to provide you with a diagnosis. A stethoscope will be used to listen to your chest and chest x-rays may get ordered to see how bad the infection is.

All of the fluoroquinolones are effective in treating urinary tract infections caused by susceptible organisms. They are the first-line treatment of acute uncomplicated cystitis in patients who cannot tolerate sulfonamides or TMP, who live in geographic areas with known resistance > 10% to 20% to TMP-SMX, or who have risk factors for such resistance.

Antibiotics Antibiotics are prescribed in cases of bacteria-caused bronchitis. However, an over dose of antibiotics will only make the bacteria more resistant to the medication.

Bronchodilators dilate the tissues of the respiratory tract to enable free flow of air. Consequently, they reduce wheezing. In extreme cases of chronic bronchitis, the patient might need additional oxygen to help him or her breathe.

Second Generation. The second-generation fluoroquinolones have increased gram-negative activity, as well as some gram-positive and atypical pathogen coverage. Compared with first-generation quinolones, these drugs have broader clinical applications in the treatment of complicated urinary tract infections and pyelonephritis, sexually transmitted diseases, selected pneumonias and skin infections.

There are two types of bronchitis--acute and chronic--and the symptoms of muscular aches, mild fever, chills, sore throat, insomnia, and breathlessness are common to both types of bronchitis; however, dyspnea is peculiar to chronic bronchitis.

This type of illness is caused usually by viruses that attack the lining of said bronchial tube. Sometimes, these viruses are the same cold viruses that cause the common cold. Bacteria can also cause acute bronchitis.

Third Generation. The third-generation fluoroquinolones are separated into a third class because of their expanded activity against gram-positive organisms, particularly penicillin-sensitive and penicillin-resistant S. pneumoniae, and atypical pathogens such as Mycoplasma pneumoniae and Chlamydia pneumoniae. Although the third-generation agents retain broad gram-negative coverage, they are less active than ciprofloxacin against Pseudomonas species.

What are the ways to prevent the illness? One of the best ways is to clean your hands all the time, drink plenty of fluid and get some sleep. Remember that these viruses and bacterias are transmitted to your hands and then to your lungs.

 
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Antibiotics may also be used in case of patients suffering from long-term pulmonary disorders because their immune systems are so weak that they are susceptible to all sorts of bacterial infections.

We must remember that bronchitis can be contagious, it can be spread by direct or indirect contact, the treatment is mainly aimed to reduce irritation in the bronchial tubes, and we should follow the recommendations mentioned above in order to effectively and properly ward of and control this illness.

Fourth Generation. The fourth-generation fluoroquinolones add significant antimicrobial activity against anaerobes while maintaining the gram-positive and gram-negative activity of the third-generation drugs. They also retain activity against Pseudomonas species comparable to that of ciprofloxacin. The fourth-generation fluoroquinolones include trovafloxacin (Trovan).

Since a cough might mean many things, a doctor will have to thoroughly examine the patient for any other medical condition that might be responsible for it. In case of severe, uncontrollable cough, the doctor might prescribe cough suppressants.

3. Dealing with Other Symptoms Use a humidifier to deal with the uncomfortable feeling in the respiratory tract. Taking plenty of liquids helps cool the body temperature.

Fluoroquinolones are approved for use only in people older than 18. They can affect the growth of bones, teeth, and cartilage in a child or fetus. The FDA has assigned fluoroquinolones to pregnancy risk category C, indicating that these drugs have the potential to cause teratogenic or embryocidal effects. Giving fluoroquinolones during pregnancy is not recommended unless the benefits justify the potential risks to the fetus. These agents are also excreted in breast milk and should be avoided during breast-feeding if at all possible.

First Generation. The first-generation agents include cinoxacin and nalidixic acid, which are the oldest and least often used quinolones. These drugs had poor systemic distribution and limited activity and were used primarily for gram-negative urinary tract infections. Cinoxacin and nalidixic acid require more frequent dosing than the newer quinolones, and they are more susceptible to the development of bacterial resistance.

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Herbal medicines that can be inhaled or taken in the form of a tea can also be used to alleviate the symptoms of bronchitis. However, it is crucial that you take herbal medication only after consulting your doctor.

In addition, liquid intake also helps liquefy the phlegm, and the body will find it easier to eliminate it via coughing. Expectorants such as quaifenesin also have the same effect.

Even after it has been treated, for some people the cough simply does not go away. If it persists for more than a month, it is time to see the doctor again. This could mean another illness is making you cough.

In addition, patients are advised to take a flu vaccine along with a pneumococcal vaccine once in five or seven years. Mucolytic agents, alpha 1 antitrypsin therapy, and antitussive medications are also used in the treatment of bronchitis.

Bronchitis usually begins with an infected sinus or a common cold. At first, the victims of bronchitis experience an irritating sensation in the posterior part of their throat, which is followed by a persistent cough accompanied by phlegm.

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.

However, the same cannot be said for bacterial infections. This typically takes antibiotics. Also, increase the humidity in your environment by placing humidifiers or even wet towels or blankets in the home.

It is known that bronchitis can appear because of an infection from bacteria or virus, and these are causes that make this illness contagious. Patients with bronchitis have inflammation of the bronchial tubes, or bronchi located in the chest of human body, and this can result in discharge of phlegm or sputum. Some causes of bronchitis are dust and air pollution, but especially smoking. It was seen that cigarettes smokers are the most affected by this illness. Usually bronchitis appears in winter, but when it becomes chronic, it can continue during the year.

Fluoroquinolones disadvantages: Tendonitis or tendon rupture Multiple drug interactions Not used in children Newer quinolones produce additional toxicities to the heart that were not found with the older agents

2. Dealing with Cough A common symptom of bronchitis is cough, which may be a dry cough or accompanied by phlegm. Cough accompanied by sputum generally indicates infection of the lower parts of the respiratory system.

If you feel the symptoms of bronchitis coming on, consult your doctor as soon as you can so he can be sure to make a diagnosis of the condition and to treat it in its early stages.

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 toxicities to the 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.

The fluoroquinolones are a family of synthetic, broad-spectrum antibacterial agents with bactericidal activity. The parent of the group is nalidixic acid, discovered in 1962 by Lescher and colleagues. The first fluoroquinolones were widely used because they were the only orally administered agents available for the treatment of serious infections caused by gram-negative organisms, including Pseudomonas species.

4. Medication for Bronchitis In most cases, virus are responsible for this condition. Virus-caused bronchitis does not require any major treatment. It is easy to control and treat it at home. A few medicines, however, are taken to gain relief from the various symptoms.

There are a lot of signs of bronchitis. We can mention severe cough, that appears during the morning of the winter months, while coughing there is a large amount of cough that comes, and another sign of being infected with this disease is yellow sputum discharged during coughing. It must be said that patients with bronchitis complain tightness of the chest, they get fever when infected, and there can appear breathlessness, which will lead to exertion.



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