Antibiotics: fluoroquinolone cautions: practice question

A Pharmacology question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Pharmacology · Antibiotics: fluoroquinolone cautions

Sample item

A 60-year-old woman with myasthenia gravis stable on pyridostigmine develops a urinary tract infection. Which antibiotic should be avoided?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

B. Ciprofloxacin

Fluoroquinolones block neuromuscular transmission and can precipitate acute weakness and respiratory failure in myasthenia gravis, and carry a boxed warning. Aminoglycosides and macrolides can do the same. Cephalosporins, nitrofurantoin and fosfomycin do not significantly affect neuromuscular transmission.

Option by option

  • A. Fosfomycin

    Fosfomycin has no significant neuromuscular effect.

  • B. Ciprofloxacin (correct)

    Correct. Fluoroquinolones can precipitate myasthenic crisis.

  • C. Nitrofurantoin

    Nitrofurantoin is safe from the neuromuscular standpoint, with other adverse effects instead.

  • D. Cefalexin

    Cefalexin does not impair neuromuscular transmission and is safe to use.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Pharmacology question

What is the answer to this Pharmacology question?

The best answer is B, Ciprofloxacin. Fluoroquinolones block neuromuscular transmission and can precipitate acute weakness and respiratory failure in myasthenia gravis, and carry a boxed warning.

Why is "Fosfomycin" not the answer?

Fosfomycin has no significant neuromuscular effect.

Why is "Nitrofurantoin" not the answer?

Nitrofurantoin is safe from the neuromuscular standpoint, with other adverse effects instead.

Why is "Cefalexin" not the answer?

Cefalexin does not impair neuromuscular transmission and is safe to use.

What concept does this question test?

It tests Antibiotics: fluoroquinolone cautions in Pharmacology. Aminoglycosides and macrolides can do the same. Cephalosporins, nitrofurantoin and fosfomycin do not significantly affect neuromuscular transmission.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Antibiotics: fluoroquinolone cautions?

Learn drugs as classes, then the exception in each class that an examiner would pick. Then use the flashcards and the other Pharmacology questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.