Fluoroquinolones on the NCLEX
Cipro, levofloxacin, moxifloxacin: tendon rupture, C. diff, QT prolongation, dairy interaction.
Fluoroquinolones end in -floxacin. Black box for tendinopathy. NCLEX tests dairy interaction, QT prolongation, and the tendon rupture warning.
Common drugs
Ciprofloxacin (Cipro), levofloxacin (Levaquin), moxifloxacin (Avelox), ofloxacin.
Black box warnings
Tendinopathy/tendon rupture (especially Achilles, especially with steroids, especially elderly). CNS effects including seizures. Peripheral neuropathy. QT prolongation.
Dairy interaction
Calcium, iron, antacids chelate fluoroquinolones → reduced absorption. Separate by 2 hours.
C. diff
High-risk antibiotic class for C. diff. Counsel on diarrhea reporting.
Uses
UTI (cipro), pyelonephritis, CAP (levofloxacin, moxifloxacin), bone/joint infections, traveler's diarrhea (cipro).
Frequently asked
Tendon pain, what to do?
Discontinue immediately. Avoid the tendon area exercise.
Cipro for UTI, always?
Increasing resistance. Often nitrofurantoin or fosfomycin first-line for uncomplicated UTI now.
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