Pharmacy Practice Lecture for Pharm-D Students

1. PATIENT PROFILE & PATIENT COUNSELING
C. DRUG PROFILE OF ATLEAST 25
IMPORTANT MEDICATIONS
FLUOROQUINOLONES
CLINICAL PHARMACY
BY
Zul Kamal
DEPARTMENT OF PHARMACY
SHAHEED BENAZIR BHUTTO UNIVERSITY, SHERINGAL

2. FLUOROQUINOLONES
 Wide Spectrum Antibiotic (G+ & G-).
 Newer fluorinated quinolones offer greater potency, a
broader spectrum of antimicrobial activity, greater in vitro
efficacy against resistant organisms, and in some cases,
a better safety profile than older quinolones and other
antibiotics.
 Fluoroquinolones are classify into generations on the
basis of their antimicrobial targets; e.g.

4. PHARMACOKINETICS
ADMINISTRATION
Oral and Parenteral
ABSORPTION
Absorption is 30-70% after oral administration and 85-95%
after IV administration.
DISTRIBUTION
The drug is distributed to all body tissues including Kidney,
bone and urine.
Plasma protein binding capacity is 10-40%
METABOLIZM
Liver
EXCRETION
Urine

6. PHARMACODYNAMICS
MECHANISM OF ACTION
 Fluroquinolones inhibits the Nucleic acid synthesis of
Bacteria and thus inhibit the synthesis of DNA.
 Fluroquinolones acts on TWO Enzymes;
1-TopoIsomerase II (DNA Gyrase)- DNA Replication is
inhibited
2- TopoIsomerase IV- DNA Coiling is Inhibited

7. INDICATIONS
 Typhoid and Para-Typhoid
 UTIs
 RTIs
 Diarrhea
 Infection of joints, bones, and soft tissues
 Sexually transmitted diseases

9. CONTRAINDICATIONS
 Pregnancy
 Lactation
 Cardiac Arrhythmias
 Patient with history of Epilepsy (Especially Oflaxacin)

10. ADVERSE DRUG REACTION
 Dizziness
 Insomnia
 Skin Rashes
 Vomiting

11. DRUG INTERACTIONS
 Fluroquinolones interacts with Warfarine, Theophyllin
and Cyclosporins; it causes inhibition of
Fluroquionolones Metabolism due to which its serum
blood level increases which leads to toxicity.

12. DOSAGE FORM AND BRANDS
DOAGE FORM
• Injections, Capsules, Tablets
DOSE
250-750 MG After every 12 hrs for 7-14 days
BRAND NAMES
CIPROFLOXACIN
Novidate (Sami) 250-500 mg Tab, Infusions
LEVOFLOXACIN:
Ceflox (Getz) 250-500 mg Tab
Levo (Ferozsons) 250-500 mg Tab
NORFLOXACIN
Norcin (Rosch) 400 mg Tab