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Pharmacology LPN Practice Exam
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Why are fluoroquinolones limited in use in certain populations, and what counseling should be provided?
Risk of hyperglycemia; counsel on sugar intake.
Risk of tendinopathy/rupture and QT prolongation; avoid use in children, pregnant women; separate from antacids and supplements; monitor phototoxicity and avoid excessive sun exposure.
They cause liver failure; avoid in elderly; take with large meals.
They cause anemia; ensure iron intake.
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Correct Answer:
Risk of tendinopathy/rupture and QT prolongation; avoid use in children, pregnant women; separate from antacids and supplements; monitor phototoxicity and avoid excessive sun exposure.
Explanation:
Fluoroquinolones have safety concerns that limit their use in certain people and require specific counseling. They can cause tendinopathy and tendon rupture, especially in older adults and when combined with steroids, so patients should be told to report tendon pain or swelling and to discontinue the drug if this occurs. They can prolong the QT interval, which raises the risk of serious arrhythmias in people with baseline QT prolongation, electrolyte disturbances, or those taking other QT-prolonging drugs; this means assess heart rhythm risk and be cautious in those individuals. They are generally avoided in pregnancy and in children because of potential effects on developing cartilage and joints. They interact with multivalent cations—antacids, iron, calcium, magnesium, zinc, and sucralfate—which can bind the drug and reduce absorption, so dosing should be separated by several hours around these products. They also can cause phototoxicity, so patients should minimize sun exposure and use protective clothing or sunscreen. For counseling, review risk factors, instruct on separating administration from antacids/minerals, warn about tendon symptoms and sunlight sensitivity, and monitor for signs of QT-related issues or other adverse effects, with alternatives considered if these risks outweigh benefits.
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