DNA synthesis inhibitors: Fluoroquinolones

our<00:00:03.790> bodies<00:00:04.180> consist<00:00:04.450> of<00:00:04.779> eukaryotic<00:00:05.470> cells our bodies consist of eukaryotic cells our bodies consist of eukaryotic cells while<00:00:06.160> bacterias<00:00:06.790> consist<00:00:07.330> of<00:00:07.450> prokaryotic while bacterias consist of prokaryotic while bacterias consist of prokaryotic cells<00:00:08.440> so<00:00:09.250> in<00:00:09.549> order<00:00:09.879> to<00:00:10.000> treat<00:00:10.180> bacterial cells so in order to treat bacterial cells so in order to treat bacterial infections<00:00:10.900> we<00:00:11.709> can<00:00:11.889> develop<00:00:12.100> anti infections we can develop anti infections we can develop anti microbials<00:00:13.270> that<00:00:13.539> only<00:00:13.869> target<00:00:14.289> prokaryotic microbials that only target prokaryotic microbials that only target prokaryotic cells<00:00:15.250> while<00:00:15.699> leaving<00:00:15.730> our<00:00:16.209> cells<00:00:16.510> mostly cells while leaving our cells mostly cells while leaving our cells mostly unharmed<00:00:17.380> one<00:00:18.160> of<00:00:18.280> these<00:00:18.400> targets<00:00:18.640> is unharmed one of these targets is unharmed one of these targets is bacterial<00:00:19.540> DNA<00:00:19.750> and<00:00:20.230> we<00:00:20.500> call<00:00:20.710> these bacterial DNA and we call these bacterial DNA and we call these medications<00:00:21.340> DNA<00:00:22.060> inhibitors<00:00:22.630> or<00:00:22.870> nucleic medications DNA inhibitors or nucleic medications DNA inhibitors or nucleic acid<00:00:23.770> inhibitors<00:00:24.280> there<00:00:25.240> are<00:00:25.390> plenty<00:00:25.630> of acid inhibitors there are plenty of acid inhibitors there are plenty of processes<00:00:26.440> and<00:00:26.619> enzymes<00:00:26.980> involved<00:00:27.460> that<00:00:27.550> we processes and enzymes involved that we processes and enzymes involved that we can<00:00:27.820> target<00:00:28.030> and<00:00:28.420> the<00:00:28.660> quinolones<00:00:29.140> and can target and the quinolones and can target and the quinolones and fluoroquinolones<00:00:30.220> inhibit<00:00:30.760> an<00:00:30.850> enzyme fluoroquinolones inhibit an enzyme fluoroquinolones inhibit an enzyme called<00:00:31.539> DNA<00:00:31.980> topoisomerase<00:00:33.960> so<00:00:34.960> there<00:00:35.350> are called DNA topoisomerase so there are called DNA topoisomerase so there are many<00:00:35.560> different<00:00:35.980> types<00:00:36.190> of<00:00:36.370> topoisomerases many different types of topoisomerases many different types of topoisomerases but<00:00:37.750> we'll<00:00:37.870> be<00:00:37.989> looking<00:00:38.020> at<00:00:38.380> topoisomerase<00:00:39.280> - but we'll be looking at topoisomerase - but we'll be looking at topoisomerase - also<00:00:40.090> called<00:00:40.329> DNA<00:00:40.720> gyrase<00:00:40.960> and<00:00:41.460> topoisomerase also called DNA gyrase and topoisomerase also called DNA gyrase and topoisomerase for<00:00:42.760> both<00:00:43.720> types<00:00:44.020> of<00:00:44.200> topoisomerases<00:00:45.130> cause for both types of topoisomerases cause for both types of topoisomerases cause double<00:00:45.910> strand<00:00:46.180> breaks<00:00:46.480> in<00:00:46.660> DNA<00:00:47.050> but<00:00:47.350> at double strand breaks in DNA but at double strand breaks in DNA but at different<00:00:47.860> points<00:00:48.160> during<00:00:48.340> mitosis different points during mitosis different points during mitosis topoisomerase<00:00:50.649> -<00:00:50.920> plays<00:00:51.309> a<00:00:51.340> role<00:00:51.579> in topoisomerase - plays a role in topoisomerase - plays a role in condensing<00:00:52.239> the<00:00:52.329> chromosomes<00:00:52.840> by<00:00:53.140> making<00:00:53.469> a condensing the chromosomes by making a condensing the chromosomes by making a double<00:00:53.739> strand<00:00:54.160> break<00:00:54.430> in<00:00:54.579> the<00:00:54.670> DNA<00:00:54.820> so<00:00:55.390> that double strand break in the DNA so that double strand break in the DNA so that it<00:00:55.600> can<00:00:55.719> be<00:00:55.840> more<00:00:55.989> tightly<00:00:56.260> wound<00:00:56.649> causing<00:00:57.340> a it can be more tightly wound causing a it can be more tightly wound causing a super<00:00:57.790> coil<00:00:58.020> when<00:00:59.020> enough<00:00:59.320> super<00:00:59.710> coils<00:01:00.010> are super coil when enough super coils are super coil when enough super coils are induced<00:01:00.460> the<00:01:00.790> DNA<00:01:01.149> condenses<00:01:02.640> topoisomerase induced the DNA condenses topoisomerase induced the DNA condenses topoisomerase 4<00:01:03.969> plays<00:01:04.269> a<00:01:04.299> role<00:01:04.569> later<00:01:04.719> on<00:01:05.019> after<00:01:05.679> the 4 plays a role later on after the 4 plays a role later on after the chromosome<00:01:06.249> has<00:01:06.369> been<00:01:06.549> replicated<00:01:07.179> where<00:01:07.569> it chromosome has been replicated where it chromosome has been replicated where it causes<00:01:08.020> a<00:01:08.049> double<00:01:08.439> strand<00:01:08.709> break<00:01:08.979> in<00:01:09.159> the<00:01:09.249> DNA causes a double strand break in the DNA causes a double strand break in the DNA so<00:01:09.700> the<00:01:10.030> new<00:01:10.270> DNA<00:01:10.569> strand<00:01:10.719> can<00:01:11.200> be so the new DNA strand can be so the new DNA strand can be disentangled<00:01:11.649> from<00:01:12.130> the<00:01:12.399> original<00:01:13.469> now disentangled from the original now disentangled from the original now quinolones<00:01:15.189> were<00:01:15.369> created<00:01:15.880> to<00:01:16.029> target quinolones were created to target quinolones were created to target bacterial<00:01:16.959> to<00:01:17.139> opossum<00:01:17.590> raises<00:01:18.039> but<00:01:18.340> it<00:01:18.429> was bacterial to opossum raises but it was bacterial to opossum raises but it was soon<00:01:18.729> discovered<00:01:18.999> that<00:01:19.299> by<00:01:19.539> adding<00:01:19.719> a soon discovered that by adding a soon discovered that by adding a fluorine<00:01:20.229> molecule<00:01:20.799> to<00:01:20.950> the<00:01:20.979> quinolones<00:01:21.549> they fluorine molecule to the quinolones they fluorine molecule to the quinolones they become<00:01:22.119> more<00:01:22.270> effective<00:01:22.749> so<00:01:23.590> these<00:01:23.799> newer become more effective so these newer become more effective so these newer medications<00:01:24.819> called<00:01:25.240> fluoroquinolones medications called fluoroquinolones medications called fluoroquinolones replaced<00:01:26.649> the<00:01:26.829> older<00:01:27.130> quinolones<00:01:27.609> in<00:01:27.789> most replaced the older quinolones in most replaced the older quinolones in most clinical<00:01:28.420> settings<00:01:28.859> common clinical settings common clinical settings common fluoroquinolones<00:01:30.670> include<00:01:31.119> ciprofloxacin fluoroquinolones include ciprofloxacin fluoroquinolones include ciprofloxacin ofloxacin<00:01:32.909> bailiff<00:01:33.909> Laxus<00:01:34.329> in'<00:01:34.509> levofloxacin ofloxacin bailiff Laxus in' levofloxacin ofloxacin bailiff Laxus in' levofloxacin Jemmy<00:01:36.459> flock<00:01:36.789> CSUN<00:01:37.179> and<00:01:37.329> moxifloxacin<00:01:38.490> one Jemmy flock CSUN and moxifloxacin one Jemmy flock CSUN and moxifloxacin one way<00:01:39.609> to<00:01:39.670> tell<00:01:39.969> a<00:01:39.999> fluoroquinolone<00:01:40.539> apart<00:01:41.200> from way to tell a fluoroquinolone apart from way to tell a fluoroquinolone apart from other<00:01:41.590> anti<00:01:41.979> microbials<00:01:42.609> is<00:01:42.789> that<00:01:43.060> they<00:01:43.179> all other anti microbials is that they all other anti microbials is that they all have<00:01:43.479> the<00:01:43.630> suffix<00:01:43.869> phlox's<00:01:44.679> n'<00:01:44.829> these have the suffix phlox's n' these have the suffix phlox's n' these medications<00:01:46.389> can<00:01:46.569> be<00:01:46.630> taken<00:01:47.049> per<00:01:47.229> oral<00:01:47.560> or<00:01:47.770> via medications can be taken per oral or via medications can be taken per oral or via IV<00:01:48.459> but<00:01:48.819> ciprofloxacin<00:01:49.240> and<00:01:49.990> o<00:01:50.139> Foxen<00:01:50.770> are IV but ciprofloxacin and o Foxen are IV but ciprofloxacin and o Foxen are also<00:01:51.130> available<00:01:51.520> in<00:01:51.909> otic<00:01:52.299> formulations also available in otic formulations also available in otic formulations while<00:01:53.499> moxifloxacin<00:01:53.950> is<00:01:54.609> also<00:01:54.880> available<00:01:55.090> in while moxifloxacin is also available in while moxifloxacin is also available in a<00:01:55.630> thalmic<00:01:56.139> solutions<00:01:56.679> now<00:01:57.689> fluoroquinolones a thalmic solutions now fluoroquinolones a thalmic solutions now fluoroquinolones are<00:01:58.899> broad-spectrum<00:01:59.439> bacteria<00:02:00.340> Seidel are broad-spectrum bacteria Seidel are broad-spectrum bacteria Seidel antibiotics<00:02:01.509> and<00:02:01.719> ciprofloxacin<00:02:02.259> in antibiotics and ciprofloxacin in antibiotics and ciprofloxacin in particular<00:02:03.459> is<00:02:03.639> widely<00:02:04.119> used particular is widely used particular is widely used they<00:02:06.950> are<00:02:07.070> very<00:02:07.310> effective<00:02:07.820> against they are very effective against they are very effective against gram-negative<00:02:08.450> bacteria<00:02:09.379> is<00:02:09.500> like gram-negative bacteria is like gram-negative bacteria is like Enterobacteriaceae<00:02:10.759> a<00:02:10.970> Hamas<00:02:12.010> Legionella Enterobacteriaceae a Hamas Legionella Enterobacteriaceae a Hamas Legionella Masseria<00:02:13.970> Moraxella<00:02:14.660> and<00:02:15.200> even<00:02:15.650> Pseudomonas Masseria Moraxella and even Pseudomonas Masseria Moraxella and even Pseudomonas species<00:02:16.510> they<00:02:17.510> are<00:02:17.540> also<00:02:17.959> effective<00:02:18.410> against species they are also effective against species they are also effective against certain<00:02:18.890> mycobacteria<00:02:19.849> and<00:02:20.060> can<00:02:20.180> be<00:02:20.269> used<00:02:20.540> for certain mycobacteria and can be used for certain mycobacteria and can be used for the<00:02:20.870> treatment<00:02:21.319> of<00:02:21.440> tuberculosis<00:02:22.540> however the treatment of tuberculosis however the treatment of tuberculosis however more<00:02:24.080> and<00:02:24.140> more<00:02:24.260> bacteria<00:02:24.890> are<00:02:25.069> becoming more and more bacteria are becoming more and more bacteria are becoming resistant<00:02:26.000> to<00:02:26.060> ciprofloxacin<00:02:26.480> either resistant to ciprofloxacin either resistant to ciprofloxacin either through<00:02:27.709> mutations<00:02:28.280> in<00:02:28.430> the<00:02:28.519> genes<00:02:28.790> that through mutations in the genes that through mutations in the genes that Cotto<00:02:29.510> blossom<00:02:29.959> raises<00:02:30.380> or<00:02:30.709> through<00:02:30.920> efflux Cotto blossom raises or through efflux Cotto blossom raises or through efflux pumps<00:02:31.730> that<00:02:31.880> pump<00:02:31.940> the<00:02:32.239> medication<00:02:32.780> out pumps that pump the medication out pumps that pump the medication out another<00:02:34.069> downside<00:02:34.340> is<00:02:34.730> that<00:02:34.760> the<00:02:35.000> older another downside is that the older another downside is that the older fluoroquinolones<00:02:36.140> are<00:02:36.379> less<00:02:36.590> effective fluoroquinolones are less effective fluoroquinolones are less effective against<00:02:37.370> gram-positive<00:02:37.840> bacteria<00:02:38.840> but<00:02:39.349> the against gram-positive bacteria but the against gram-positive bacteria but the newer<00:02:39.709> ones<00:02:40.010> like<00:02:40.400> levofloxacin<00:02:40.880> Jemmy<00:02:41.780> flock newer ones like levofloxacin Jemmy flock newer ones like levofloxacin Jemmy flock season<00:02:42.410> and<00:02:42.590> moxifloxacin<00:02:43.099> have<00:02:43.880> improved season and moxifloxacin have improved season and moxifloxacin have improved effectiveness<00:02:45.019> against<00:02:45.440> gram-positive<00:02:45.709> coxy effectiveness against gram-positive coxy effectiveness against gram-positive coxy especially<00:02:47.480> streptococcus<00:02:48.260> pneumoniae<00:02:48.709> so especially streptococcus pneumoniae so especially streptococcus pneumoniae so they're<00:02:49.400> called<00:02:49.640> respiratory they're called respiratory they're called respiratory fluoroquinolones fluoroquinolones fluoroquinolones since<00:02:51.440> they're<00:02:51.650> often<00:02:51.950> used<00:02:51.980> to<00:02:52.280> treat since they're often used to treat since they're often used to treat hospital-acquired<00:02:53.120> pneumonia<00:02:53.709> the hospital-acquired pneumonia the hospital-acquired pneumonia the trade-off<00:02:55.160> is<00:02:55.190> that<00:02:55.370> they're<00:02:55.640> less<00:02:55.849> effective trade-off is that they're less effective trade-off is that they're less effective against<00:02:56.569> Pseudomonas<00:02:57.200> than<00:02:57.440> ciprofloxacin against Pseudomonas than ciprofloxacin against Pseudomonas than ciprofloxacin most<00:02:59.299> fluoroquinolones<00:03:00.110> are<00:03:00.319> not<00:03:00.560> effective most fluoroquinolones are not effective most fluoroquinolones are not effective against<00:03:01.400> MRSA<00:03:01.819> as<00:03:02.200> a<00:03:03.200> general<00:03:03.739> rule against MRSA as a general rule against MRSA as a general rule fluoroquinolones<00:03:05.060> should<00:03:05.360> not<00:03:05.569> be<00:03:05.720> taken<00:03:06.079> per fluoroquinolones should not be taken per fluoroquinolones should not be taken per orally<00:03:06.650> together<00:03:07.040> with<00:03:07.310> mineral<00:03:07.670> supplements orally together with mineral supplements orally together with mineral supplements like<00:03:08.420> iron<00:03:08.720> zinc<00:03:09.019> or<00:03:09.620> calcium<00:03:09.890> pills<00:03:10.310> they'll like iron zinc or calcium pills they'll like iron zinc or calcium pills they'll bind<00:03:11.420> to<00:03:11.600> each<00:03:11.630> other<00:03:11.930> a<00:03:12.170> process<00:03:12.709> called bind to each other a process called bind to each other a process called chelation<00:03:13.310> preventing<00:03:14.269> their<00:03:14.420> absorption chelation preventing their absorption chelation preventing their absorption from<00:03:15.170> the<00:03:15.290> gut<00:03:15.470> they're<00:03:16.280> metabolized<00:03:16.639> in<00:03:17.090> the from the gut they're metabolized in the from the gut they're metabolized in the liver<00:03:17.239> by<00:03:17.690> a<00:03:17.720> family<00:03:18.139> of<00:03:18.230> enzymes<00:03:18.380> called liver by a family of enzymes called liver by a family of enzymes called cytochrome<00:03:19.370> p450<00:03:20.329> but<00:03:20.690> there<00:03:20.840> are<00:03:20.900> also cytochrome p450 but there are also cytochrome p450 but there are also inhibitors<00:03:21.709> of<00:03:21.859> this<00:03:21.980> enzyme<00:03:22.340> for inhibitors of this enzyme for inhibitors of this enzyme for side-effects<00:03:23.900> fluoroquinolones<00:03:24.889> can<00:03:25.160> cause side-effects fluoroquinolones can cause side-effects fluoroquinolones can cause tendinitis<00:03:26.090> especially<00:03:26.900> in<00:03:26.989> the<00:03:27.109> Achilles tendinitis especially in the Achilles tendinitis especially in the Achilles tendon<00:03:27.560> where<00:03:28.280> they<00:03:28.400> can<00:03:28.549> cause<00:03:28.730> it<00:03:28.910> to tendon where they can cause it to tendon where they can cause it to rupture<00:03:29.440> due<00:03:30.440> to<00:03:30.590> this<00:03:30.739> they<00:03:31.160> should<00:03:31.340> not<00:03:31.459> be rupture due to this they should not be rupture due to this they should not be used<00:03:31.790> by<00:03:31.970> active<00:03:32.359> athletes<00:03:32.840> and<00:03:33.109> the<00:03:33.230> elderly used by active athletes and the elderly used by active athletes and the elderly furthermore<00:03:34.880> they<00:03:35.209> can<00:03:35.389> damage<00:03:35.569> the furthermore they can damage the furthermore they can damage the cartilage<00:03:36.380> and<00:03:36.530> growing<00:03:36.799> children's<00:03:37.400> so<00:03:37.609> they cartilage and growing children's so they cartilage and growing children's so they should<00:03:37.880> not<00:03:37.970> be<00:03:38.120> given<00:03:38.389> to<00:03:38.510> people<00:03:38.630> under<00:03:38.959> 18 should not be given to people under 18 should not be given to people under 18 and<00:03:39.680> those<00:03:39.980> who<00:03:40.130> are<00:03:40.220> pregnant<00:03:40.510> these and those who are pregnant these and those who are pregnant these medications<00:03:42.019> also<00:03:42.440> have<00:03:42.739> CNS<00:03:43.220> toxicity<00:03:43.880> and medications also have CNS toxicity and medications also have CNS toxicity and could<00:03:44.299> cause<00:03:44.450> insomnia<00:03:44.930> agitation<00:03:45.819> seizures could cause insomnia agitation seizures could cause insomnia agitation seizures and<00:03:47.060> peripheral<00:03:47.720> neuropathy<00:03:48.700> finally<00:03:49.700> they and peripheral neuropathy finally they and peripheral neuropathy finally they can<00:03:50.060> prolong<00:03:50.510> the<00:03:50.720> QT<00:03:50.900> interval<00:03:51.139> leading<00:03:51.950> to can prolong the QT interval leading to can prolong the QT interval leading to arrhythmias<00:03:52.720> now<00:03:53.720> we<00:03:53.780> want<00:03:54.200> to<00:03:54.260> make<00:03:54.380> a<00:03:54.410> simple arrhythmias now we want to make a simple arrhythmias now we want to make a simple and<00:03:55.040> fun<00:03:55.220> mnemonic<00:03:55.760> that<00:03:56.000> will<00:03:56.090> help<00:03:56.269> you and fun mnemonic that will help you and fun mnemonic that will help you efficiently<00:03:56.930> memorize<00:03:57.319> and<00:03:57.620> retain<00:03:57.950> all efficiently memorize and retain all efficiently memorize and retain all these<00:03:58.280> farm<00:03:58.579> facts<00:03:58.959> since<00:03:59.959> all these farm facts since all these farm facts since all fluoroquinolones<00:04:00.889> have<00:04:01.160> floc<00:04:01.639> Sisson<00:04:02.120> in fluoroquinolones have floc Sisson in fluoroquinolones have floc Sisson in their<00:04:02.419> name<00:04:02.630> will<00:04:02.930> use<00:04:03.109> a<00:04:03.139> flock<00:04:03.620> of<00:04:03.650> seagulls their name will use a flock of seagulls their name will use a flock of seagulls outside<00:04:04.730> a<00:04:04.760> restaurant<00:04:05.239> okay<00:04:05.989> for<00:04:06.680> the<00:04:06.769> older outside a restaurant okay for the older outside a restaurant okay for the older drugs<00:04:07.310> like<00:04:07.579> ciprofloxacin<00:04:08.120> let's<00:04:09.019> use<00:04:09.169> an drugs like ciprofloxacin let's use an drugs like ciprofloxacin let's use an old<00:04:09.500> seagull<00:04:10.010> whose<00:04:10.220> sipping<00:04:10.730> on<00:04:10.910> a<00:04:10.940> discarded old seagull whose sipping on a discarded old seagull whose sipping on a discarded drink<00:04:11.780> with<00:04:11.989> a<00:04:12.019> straw drink with a straw drink with a straw for<00:04:13.430> the<00:04:13.519> newer<00:04:13.730> drugs<00:04:14.090> we<00:04:14.390> can<00:04:14.510> have<00:04:14.689> a<00:04:14.720> few for the newer drugs we can have a few for the newer drugs we can have a few young<00:04:15.260> and<00:04:15.470> hip<00:04:15.650> seagulls<00:04:16.120> one<00:04:17.120> is<00:04:17.269> wearing young and hip seagulls one is wearing young and hip seagulls one is wearing leave<00:04:17.810> o's<00:04:18.049> brand<00:04:18.409> knockoff<00:04:18.890> jeans<00:04:19.130> for<00:04:19.519> leave leave o's brand knockoff jeans for leave leave o's brand knockoff jeans for leave Laxus<00:04:20.240> in<00:04:20.420> another<00:04:21.020> is<00:04:21.200> wearing<00:04:21.470> moccasins Laxus in another is wearing moccasins Laxus in another is wearing moccasins for<00:04:22.370> moxifloxacin<00:04:22.820> and<00:04:23.570> the<00:04:23.840> last<00:04:24.050> one<00:04:24.320> is for moxifloxacin and the last one is for moxifloxacin and the last one is wearing<00:04:24.650> a<00:04:24.800> gem<00:04:25.130> studded<00:04:25.490> jacket<00:04:25.790> for<00:04:26.330> Jamie wearing a gem studded jacket for Jamie wearing a gem studded jacket for Jamie flock<00:04:26.870> season<00:04:27.370> for<00:04:28.370> indications<00:04:28.760> let's<00:04:29.330> put flock season for indications let's put flock season for indications let's put some<00:04:29.690> pink<00:04:29.960> colored<00:04:30.260> gram-negative<00:04:30.560> bacteria some pink colored gram-negative bacteria some pink colored gram-negative bacteria on<00:04:31.700> the<00:04:31.820> ground<00:04:32.060> between<00:04:32.480> the<00:04:32.600> two<00:04:32.630> groups<00:04:32.960> of on the ground between the two groups of on the ground between the two groups of seagulls<00:04:33.670> also<00:04:34.670> there<00:04:35.060> are<00:04:35.180> some<00:04:35.270> discarded seagulls also there are some discarded seagulls also there are some discarded toilet<00:04:36.200> paper<00:04:36.380> tubes<00:04:36.740> for<00:04:37.040> tuberculosis<00:04:37.930> this toilet paper tubes for tuberculosis this toilet paper tubes for tuberculosis this is<00:04:39.080> because<00:04:39.410> all<00:04:39.650> fluoroquinolones<00:04:40.520> are is because all fluoroquinolones are is because all fluoroquinolones are effective<00:04:41.240> against<00:04:41.600> these<00:04:41.720> organisms effective against these organisms effective against these organisms however<00:04:43.160> the<00:04:43.520> young<00:04:43.730> seagulls<00:04:44.210> have<00:04:44.390> more however the young seagulls have more however the young seagulls have more purple<00:04:45.050> colored<00:04:45.320> gram<00:04:45.590> positive<00:04:46.130> bacteria<00:04:46.160> in purple colored gram positive bacteria in purple colored gram positive bacteria in front<00:04:47.150> of<00:04:47.240> them<00:04:47.360> since<00:04:47.720> they<00:04:47.870> have<00:04:48.020> enhanced front of them since they have enhanced front of them since they have enhanced effect<00:04:48.830> against<00:04:49.220> these<00:04:49.340> bacteria<00:04:49.910> this<00:04:50.840> is effect against these bacteria this is effect against these bacteria this is why<00:04:51.200> they<00:04:51.470> are<00:04:51.500> the<00:04:51.590> respiratory why they are the respiratory why they are the respiratory fluoroquinolones<00:04:53.150> and<00:04:53.420> are<00:04:53.660> often<00:04:53.900> used<00:04:54.110> to fluoroquinolones and are often used to fluoroquinolones and are often used to treat<00:04:54.380> hospital-acquired<00:04:55.100> pneumonia<00:04:55.780> to treat hospital-acquired pneumonia to treat hospital-acquired pneumonia to help<00:04:56.960> you<00:04:57.050> remember<00:04:57.290> this<00:04:57.620> let's<00:04:58.070> give<00:04:58.250> the help you remember this let's give the help you remember this let's give the three<00:04:58.610> young<00:04:58.790> seagulls<00:04:59.240> some<00:04:59.450> cigarettes three young seagulls some cigarettes three young seagulls some cigarettes which<00:05:00.320> causes<00:05:00.740> them<00:05:00.890> to<00:05:00.920> cough<00:05:01.280> now<00:05:02.240> since which causes them to cough now since which causes them to cough now since ciprofloxacin<00:05:03.080> is<00:05:03.770> more<00:05:03.980> effective<00:05:04.430> against ciprofloxacin is more effective against ciprofloxacin is more effective against Pseudomonas<00:05:05.360> let's<00:05:05.840> say<00:05:05.990> that<00:05:06.170> the<00:05:06.290> old Pseudomonas let's say that the old Pseudomonas let's say that the old seagull<00:05:06.980> is<00:05:07.100> very<00:05:07.310> classy<00:05:07.820> and<00:05:08.030> he's<00:05:08.240> admiring seagull is very classy and he's admiring seagull is very classy and he's admiring a<00:05:08.870> painting<00:05:09.230> of<00:05:09.350> the<00:05:09.440> Mona<00:05:09.620> Lisa<00:05:09.890> all<00:05:10.400> right a painting of the Mona Lisa all right a painting of the Mona Lisa all right now<00:05:11.840> let's<00:05:12.050> look<00:05:12.140> at<00:05:12.260> the<00:05:12.380> important<00:05:12.890> side now let's look at the important side now let's look at the important side effects<00:05:13.430> of<00:05:13.580> fluoroquinolones<00:05:14.270> a<00:05:14.510> jogger effects of fluoroquinolones a jogger effects of fluoroquinolones a jogger coming<00:05:15.620> out<00:05:15.710> of<00:05:15.860> the<00:05:15.920> restaurant<00:05:16.040> is<00:05:16.550> kneeling coming out of the restaurant is kneeling coming out of the restaurant is kneeling down<00:05:17.090> holding<00:05:17.600> his<00:05:17.720> ankle<00:05:18.080> where<00:05:18.350> his down holding his ankle where his down holding his ankle where his Achilles<00:05:18.920> tendon<00:05:19.310> has<00:05:19.430> ruptured<00:05:19.880> due<00:05:20.060> to Achilles tendon has ruptured due to Achilles tendon has ruptured due to tendinitis<00:05:20.810> his<00:05:21.680> likes<00:05:21.980> are<00:05:22.130> also<00:05:22.280> covered<00:05:22.700> in tendinitis his likes are also covered in tendinitis his likes are also covered in bandages<00:05:23.000> to<00:05:23.480> represent<00:05:23.930> peripheral bandages to represent peripheral bandages to represent peripheral neuropathy<00:05:25.060> when<00:05:26.060> he<00:05:26.180> was<00:05:26.300> falling<00:05:26.540> he neuropathy when he was falling he neuropathy when he was falling he accidentally<00:05:27.530> slammed<00:05:27.860> into<00:05:28.040> a<00:05:28.130> kid<00:05:28.430> and accidentally slammed into a kid and accidentally slammed into a kid and broke<00:05:28.790> his<00:05:28.970> nose<00:05:29.150> causing<00:05:29.750> him<00:05:29.840> to<00:05:29.990> cry<00:05:30.200> since broke his nose causing him to cry since broke his nose causing him to cry since the<00:05:31.310> nose<00:05:31.520> is<00:05:31.700> mostly<00:05:32.030> cartilage<00:05:32.600> this<00:05:32.990> will the nose is mostly cartilage this will the nose is mostly cartilage this will help<00:05:33.290> you<00:05:33.380> remember<00:05:33.620> that<00:05:33.920> fluoroquinolones help you remember that fluoroquinolones help you remember that fluoroquinolones are<00:05:34.970> harmful<00:05:35.300> to<00:05:35.450> the<00:05:35.690> cartilage<00:05:35.960> in<00:05:36.290> growing are harmful to the cartilage in growing are harmful to the cartilage in growing children<00:05:37.040> a<00:05:37.190> mean<00:05:38.000> squirrel<00:05:38.390> who's<00:05:38.750> actually children a mean squirrel who's actually children a mean squirrel who's actually very<00:05:39.350> cute<00:05:39.740> and<00:05:39.920> has<00:05:40.220> a<00:05:40.250> long<00:05:40.610> tail<00:05:41.060> is very cute and has a long tail is very cute and has a long tail is laughing<00:05:41.990> at<00:05:42.080> the<00:05:42.200> poor<00:05:42.380> kid<00:05:42.620> and<00:05:42.800> it laughing at the poor kid and it laughing at the poor kid and it represents<00:05:43.460> long<00:05:43.730> QT<00:05:44.120> syndrome<00:05:44.740> the<00:05:45.740> child's represents long QT syndrome the child's represents long QT syndrome the child's pregnant<00:05:46.580> mother<00:05:46.760> is<00:05:47.030> trying<00:05:47.270> to<00:05:47.390> comfort<00:05:47.840> him pregnant mother is trying to comfort him pregnant mother is trying to comfort him to<00:05:48.140> no<00:05:48.260> avail<00:05:48.410> to<00:05:48.920> represent<00:05:49.370> the to no avail to represent the to no avail to represent the contraindication<00:05:50.330> during<00:05:50.660> pregnancy contraindication during pregnancy contraindication during pregnancy an<00:05:51.380> unfortunate<00:05:52.220> chrome<00:05:52.760> colored<00:05:53.120> cell<00:05:53.360> also an unfortunate chrome colored cell also an unfortunate chrome colored cell also got<00:05:53.900> squished<00:05:54.230> during<00:05:54.680> this<00:05:54.770> incident<00:05:55.070> and got squished during this incident and got squished during this incident and this<00:05:55.670> will<00:05:55.790> help<00:05:56.000> you<00:05:56.090> remember<00:05:56.240> that this will help you remember that this will help you remember that fluoroquinolones<00:05:57.470> are<00:05:57.710> cytochrome<00:05:58.160> p450 fluoroquinolones are cytochrome p450 fluoroquinolones are cytochrome p450 inhibitors<00:05:59.660> all<00:06:00.590> right<00:06:00.980> as<00:06:01.220> a<00:06:01.430> quick<00:06:01.700> recap inhibitors all right as a quick recap inhibitors all right as a quick recap quinolones<00:06:03.440> and<00:06:03.710> fluoroquinolones<00:06:04.610> work<00:06:04.910> by quinolones and fluoroquinolones work by quinolones and fluoroquinolones work by inhibiting<00:06:05.420> DNA<00:06:06.050> replication<00:06:06.560> by<00:06:07.010> disabling inhibiting DNA replication by disabling inhibiting DNA replication by disabling DNA<00:06:07.970> topoisomerase<00:06:08.870> for<00:06:09.200> and<00:06:09.440> DNA<00:06:09.890> gyrase DNA topoisomerase for and DNA gyrase DNA topoisomerase for and DNA gyrase quinolones<00:06:11.780> were<00:06:11.990> the<00:06:12.110> first<00:06:12.350> medications quinolones were the first medications quinolones were the first medications with<00:06:13.190> this<00:06:13.310> mechanism<00:06:13.520> but<00:06:14.150> they<00:06:14.240> have<00:06:14.330> been with this mechanism but they have been with this mechanism but they have been replaced<00:06:14.750> by<00:06:15.110> the<00:06:15.170> newer<00:06:15.440> fluoroquinolones replaced by the newer fluoroquinolones replaced by the newer fluoroquinolones in<00:06:16.750> general<00:06:17.750> they<00:06:18.080> are<00:06:18.110> more<00:06:18.350> effective in general they are more effective in general they are more effective against<00:06:19.160> gram-negative<00:06:19.450> bacteria<00:06:20.450> but<00:06:20.780> the against gram-negative bacteria but the against gram-negative bacteria but the newer<00:06:21.140> fluoroquinolones<00:06:22.130> have<00:06:22.340> enhanced newer fluoroquinolones have enhanced newer fluoroquinolones have enhanced activity<00:06:23.030> against<00:06:23.780> the<00:06:23.900> gram-positive activity against the gram-positive activity against the gram-positive bacteria<00:06:25.190> all<00:06:25.960> fluoroquinolones<00:06:26.960> are<00:06:27.140> known bacteria all fluoroquinolones are known bacteria all fluoroquinolones are known to<00:06:27.500> cause<00:06:27.650> tendinitis<00:06:28.400> lower<00:06:29.000> seizure to cause tendinitis lower seizure to cause tendinitis lower seizure threshold<00:06:29.660> cause<00:06:30.560> peripheral<00:06:31.010> neuropathy threshold cause peripheral neuropathy threshold cause peripheral neuropathy prolong<00:06:32.390> the<00:06:32.540> QT<00:06:32.720> interval<00:06:32.960> in<00:06:33.470> the prolong the QT interval in the prolong the QT interval in the and<00:06:33.949> might<00:06:34.460> cause<00:06:34.669> arrhythmias<00:06:35.300> toxic and might cause arrhythmias toxic and might cause arrhythmias toxic epidermal<00:06:36.229> necrolysis<00:06:36.650> and<00:06:37.550> stevens-johnson epidermal necrolysis and stevens-johnson epidermal necrolysis and stevens-johnson syndrome<00:06:39.490> but<00:06:40.490> wait<00:06:40.669> there's<00:06:41.030> more<00:06:41.300> here's<00:06:42.110> a syndrome but wait there's more here's a syndrome but wait there's more here's a mind<00:06:42.470> map<00:06:42.680> with<00:06:42.919> all<00:06:42.949> of<00:06:43.190> the<00:06:43.280> mnemonics<00:06:43.819> from mind map with all of the mnemonics from mind map with all of the mnemonics from the<00:06:44.120> video<00:06:44.360> go<00:06:45.169> ahead<00:06:45.380> and<00:06:45.530> pause<00:06:45.710> the<00:06:45.919> video the video go ahead and pause the video the video go ahead and pause the video so<00:06:46.370> you<00:06:46.430> can<00:06:46.610> test<00:06:46.880> yourself<00:06:47.030> to<00:06:47.360> see<00:06:47.389> what<00:06:47.660> you so you can test yourself to see what you so you can test yourself to see what you remember<00:06:48.039> stay<00:06:49.039> tuned<00:06:49.250> for<00:06:49.490> the<00:06:49.610> answers<00:06:49.910> at remember stay tuned for the answers at remember stay tuned for the answers at the<00:06:50.210> end [Music]