Ciprofloxacin drugs

There are several methods of preparation of antibacterial quinolones, drugs widely used in the therapy of various bacterial diseases. The most general method is based on the nucleophilic cyclization of 2-halobenzoyl derivatives 402, leading to the key intermediates 403. The methodology is exemplified in Scheme 63 by the synthesis of a broad-spectrum drug ciprofloxacin... 

Over 10000 quinolone antibacterial agents have now been synthesized. Nalidixic acid is regarded as the progenitor of the new quinolones. It has been used for several years as a clinically important drug in the treatment of urinary tract infections. Since its clinical introduction, other 4-quinolone antibacterials have been synthesized, some of which show considerably greater antibacterial potency. Furthermore, this means that many types of bacteria not susceptible to nahdixic acid therapy m be sensihve to the newer derivahves. The most important development was the introduction of a fluorine substituent at C-6, which led to a considerable increase in potency and spectrum of activity compared with nalidixic add. These second-generation quinolones are known as fluoroquinolones, examples of which are ciprofloxacin and norfloxacin (Fig. 5.19). 

Antibiotics have been studied based on the rationale that they may interrupt the inflammatory response directed against endogenous bacterial flora. Metronidazole and ciprofloxacin have been the two most widely-studied agents.32 Metronidazole may benefit some patients with pouchitis (inflammation of surgically-created intestinal pouches) and patients with CD who have had ileal resection or have perianal fistulas. Ciprofloxacin has shown some efficacy in refractory active CD. Both drugs may cause diarrhea, and long-term use of metronidazole is associated with the development of peripheral neuropathy. 

Clinicians should be aware that dosage regimens with the same drug maybe different depending on the infectious process. For example, ciprofloxacin, a fluoroquinolone, has various dosage regimens based on site of infection. The dosing for uncomplicated UTIs is 250 mg twice daily for 3 days. For complicated UTIs, the dose is 500 mg twice daily for 7 to... 

Elevations of serum transaminase concentrations generally are not correlated with the residual capacity of the liver to metabolize drugs, so these markers cannot be used directly as guides for residual metabolic capacity. Hepatically cleared TB drugs include isoniazid, rifampin, pyrazinamide, ethionamide, and p-aminosalicylic acid.39 Ciprofloxacin is about 50% cleared by... 

The current drug of choice for typhoid fever is a fluoroquinolone, such as ciprofloxacin. The recommended dose of ciprofloxacin for uncomplicated typhoid is 500 mg orally twice daily for 5 to 7 days. Drug resistance is a recognized... 

The cornerstone of cholera treatment is fluid replacement. Without treatment, the case-fatality rate for severe cholera is approximately 50%. For cholera, rice-based ORT is better than glucose-based ORT because it reduces the number of stools.21 Patients with significant disease should receive a short antibiotic course, 1 to 3 days, to shorten the duration of illness and decrease the number of stools. Doxycycline 300 mg once daily is the drug of choice. Other antibiotics shown to be effective include erythromycin, azithromycin, trimethoprim-sulfamethoxazole, and ciprofloxacin.2 Antibiotic resistance has been documented in V cholerae since 1977.2 Antibiotic prophylaxis is not warranted. 

Fluoroquinolones Not approved by the United States Food and Drug Administration for use in children except for anthrax (ciprofloxacin). MRSA, methicillin-resistant 5. aureus MSSA, methicillin-sensitive 5. aureus. 

Absorption of antimicrobial agents such as fluoroquinolones and tetracyclines that can be bound by divalent and trivalent cations potentially could be compromised by administration with EN formulas containing these cations. The fluoroquinolones (e.g., levofloxacin and ciprofloxacin) have been best studied in this regard, and results of studies are not consistent. Mechanisms for an interaction between fluoroquinolones and EN formulas other than chelation by cations have been postulated.40 Some institutions hold tube feedings for 30 to 60 minutes or more before and after enteral dosages of fluoroquinolones. Because ciprofloxacin absorption has been shown to be decreased with jejunal administration, this drug probably should not be given by jejunal tube.41... 

DuPont et al. [6] randomized, active drug-controlled, double-blind adults acute travelers diarrhea NA 93 800 mg/day ciprofloxacin 94 1 g/day... 

The major types of drug therapy used in IBD include aminosalicylates, glucocorticoids, immunosuppressive agents (azathioprine, mercaptopu-rine, cyclosporine, and methotrexate), antimicrobials (metronidazole and ciprofloxacin), and agents to inhibit tumor necrosis factor-a (TNF-a) (anti-TNF-a antibodies). 

Fluoroquinolones such as ciprofloxacin (500 mg orally twice daily for 10 days in adults) are the drugs of choice for enteric fever, particularly in areas where multidrug resistance is common. A short course of 3 to 5 days is effective but a minimum of 10 days is recommended in severe cases. 

Endogenous toxins Myoglobin Hemoglobin Drugs Penicillins Ciprofloxacin Sulfonamides Infection Viral Bacterial... 

Drugs Available Yes. (Ciprofloxacin, Doxycycline, and Penicillin), although such drugs are usually not effective after symptoms are present. Supportive therapy may be necessary. Oral ciprofloxacin can be used for known or imminent exposure. 

Antibiotics Ciprofloxacin at 500 milligrams orally by mouth twice a day or doxycycline at 100 milligrams orally by mouth twice a day is the recommended drug and dose when... 

Drugs Use streptomycin at 15 mg/kg lean body mass intra-muscular every twenty-four hours for ten to fourteen days or use gentamicin at 5 mg/kg lean body mass intra-venous every twenty-four hours for ten to fourteen days or use gentamicin at 1.75 mg/kg lean body mass intra-venous every eight hours for ten to fourteen days or use ciprofloxacin at 400 mg intra-venous every twelve hours (oral therapy may be given at 750 mg orally every twelve hours after the patient is clinically improved, for completion of a ten to fourteen-day course of therapy) or use doxycycline at 200 mg intra-venous loading dose followed by 100 mg intra-venous every twelve hours (oral therapy may be given at 100 mg orally every twelve hours after the patient is clinically improved, for completion of a ten to fourteen-day course of therapy. 

Ciprofloxacin An antibiotic drug useful in treating bacterial infections the recommended antibiotic for treating anthrax infections as well as prophylaxis in a biological warfare setting. 

The data on the adverse reactions of the fluoroquinolones which have received the most extensive clinical evaluation (ciprofloxacin, ofloxacin, pefloxacin, norfloxacin and enoxacin), involving about 30,000 patients, have been the subject of a review [54a], An important point noted in this review involves the difficulty in detecting an important severe adverse reaction if it is of relatively low frequency, until there has been a very large patient exposure (some examples are provided in which at least 150,000-300,000 exposures would be required to observe the importance of side-effects, resulting in an alert, which have been discovered with specific drugs). However, the majority of side-effects observed thus far with the fluoroquinolones have been minor,... 

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