Abx with limirick Flashcards
Tetracylcines considerations
Decreased effect with cal, iron, aluminum. It crosses the placenta
the Tet doesn’t give cal, iron, or aluminum, but they do cross the placenta
Carbapenem ADRs
Type 1, type 3
C Dif
Immipenem causes szr
ONE type of Carb causes THREE types of C Dif. Gimme the pen or I’ll seize it
erTAPenem
Tap out against Sue, you only live once but it’s a long life
Doesn’t work for pseudomonas, only take once a day because of long half life
Anti-pseudomonal penicillins
Piperacillin tazobactam, used for MSSA Anaerobes neg
Piper only comes as IV and given with beta lactam
Piping hot tazo tea, Ms Aneg? I can put it in your IV bag with a nice beta-lact
Nafcillin
anti-staph penicillin, needs frequent dosing, the IV form is highly protein bound so there’s less free drug
In the AFC, the Staff makes you dose frequently, and get your protein in an IV
Which abx don’t need renal adjustment
doxyclcyine, Naf, ceftriaxone, azithromycin
Diabetics needs to Xamine their Zipper
Gram positive-
strep, staph, enterococcus, c dif.
Carbapenems
Pos anaerobes neg
carba-PAN-ems
Meropenem
1st choice for ESBL and AMPc (tied with dori and imi)
Mera can’t spell so she uses acronyms
Tetracycline uses
CAP, alternate to penicillin, MRSA, Ticks, Acne, Syphilis
TetracycLINE: Line up and put on your CAPS, instead of going to the goat PEN, Mr. SA will check your ankle for ticks, your face for acne, and your groin for syphilis
Fluoroquinolones ADRs
C diff, QTc, photosensitive
Flora was different from the Q-barn elephants because she liked taking pictures
Doripenem
tie for first choice for ESBL and AmpC.
Don’t use dori for pneumonia
Dori forgets everything but don’t bother with a pneumonic device
Moxifloxacin
moxifloxacin is the respiratory FQ
Eric Garner said I need mo air
Levofloxacin
levofloxacin for pneumonia and UTI
I levitated but a pneu i got a UTI
Azithromycin
Doesn’t inhibit P450
Take on empty stomach
excreted unchanged
Post abx effect
Aztecs didn’t live past the year 450, the EMPTIED people’s stomachs, and that NEVER CHANGED. They cleaned the blood with TISSUE, and their legends GO ON even though they’re gone.
Ciprofloxacin
Cipro - the best a pseudomonal and providers gram neg double coverage (but not pneumonia which is gram positive)
See, they’re PROFESSIONALS when it comes to PSEUDO wrestling, that’s why they eat DOUBLE cheeseburgers
Clindamycin
Use for MRSA, Good tissue penetration, alternate for pen allergy, reduces toxins, good for skin eating infections
c Linda is crying because she got MRSA, give her a TISSUE. She doesn’t use a PEN because it TOXIC to her SKIN
Fidaxomicin
Novel macrolide, take it PO, good for c dif.
Ida wrote a novel about people who ATE so much that they got DIARRHEA
Erythromycin
erythromycin inhibits the P450, it empties the stomach (promotility)
Early in the morning, in my habitat it’s 4:50am, I get up and empty my stomach
Macrolides in general are for
Atypicals, Pneumonia, COPD flare up, urogenital, pylori
Mac was atypical because he had bigs lungs that could flare up, he could run to europe faster than a pylot
Macrolide ADRs
GI, eosinophilia, heptatis in pregnancy
Mac from always sunny worked out until he looked like GI Joe, he still lives in Philia with his pregnant wife
Clarithromycin
inhibits P450
Clara stops herself from going out past 4:50pm
Bacteriostatic
Macrolides, Tetracycline, Sulfonamides, TMP
My TB Skin Test
Penicillin ADRs
From rash to anaphylaxis
Onset is up to 30 minutes
Megacolon
Szr
Anti-staph penicillins are good because they are ____ resistant
penicillinase resistant
Anti-staph penicillin examples
nafcillin, oxacillin, cloxacillin, dicloxacillin
Amoxicillin indication
Mostly for upper resp infection
Amox is Almost always at the TOP of the list for resp infection
Ampicillin IV
1st choice for listeria and enterococcus
It’s Victor’s 1st choice on my list of entamins
Bactericidal
Pigs can fly, geese can molt
Penicillin, cephalosporin, FQs,
Glycopeptides, carbapenems, monobactams
Monobactams
Only works for negative, cross allergy with ceftazidime
The monorail ended up being negative for springfield, it didnt make a DIME
Piperacillin-tazobactam
used for MSSA Anaerobes neg
Piper only comes as IV and given with beta lactam
Piping hot tazo tea, Ms Aneg? I can put it in your IV bag with a nice beta-lact
How should you use Piperacillin-tazobactam
use for extended time period
3rd generation cephalosporins
the 3 stands for crossing the 3 Bs (BBB)
But…but…but…don’t give with calcium
Ceftazidime and cefolozone
Dime me out and fly me to the ozone layer. On the plane my ABDOMEN might hurt because I need to URINATE. AMP up the BETA tract to volume ESBL
1st gen cephalosporin
Think 1 for number 1, as in high concentration in the urine.
Also, if 1 penicillin doesn’t work, use 1st gen ceph
Aminoglycoside toxicity
Ami-NO-glycoside
Oh no no! (otoxicity, nephrotoxicity, not for pregnancy)
First line for strep
penicillin G
Methicillin is not used much anymore because (besides the obvious reason)
renal tox
Silver sulfonamide
its for the eye (remember because babies get silver)
but it’s also for skin
TMP
TMP-SMX interactions
they have 3 letters, so 3 interactions, with 3 major things
Increase warfarin, dig, K
Aminoglycosides excretion
drug clearance is proportionate with creat clearance
What’s special about aminoglycoside formulas?
it comes in an inhaler
Aztreonam is in what class
monobactam
imipenem is a tie for first with
two others for ESBL and AMPc
Aminogylcoside examples
amikacin, gentamicin, tobramycin
Aminogylcoside considerations
Post abx effect, No crossing the BBB, work well with cell wall inhibitors, inhibits translocation, one big dose is better then many except for with endorcarditis
SIDE with your political party:
He’s the POSTER boy for No crossing The Wall, Trans-pacific partnership was one big let down.
TMP works by attacking bacteria’s
folic acid
Dicloxacillin
dic-LOX-acillin
I just had lox for lunch so I can’t take my dicloxacillin yet
TMP uses
MRSA, UC, Rheumatoid arthritis, PJP, Prostate/vagina
It’s what Randy took for MRSA.
The UNIT secretary will show you to your RHEUM. Change into hospital PJs before they check your PROSTATE.
Sulfanomide ADRs
x-allergy with hypoglycemics and thiazides. Not for late pregnancy
Sully flew past the HIPPOS in the bronx zoo, he braced his THIGH before the crash, good thing his PREGNANT wife was too LATE to board the flight
Bactram precautions
hyponatremia, hyperkalemia
sodium backed out, so the potassium comes out to take its place
FQs are not for which 2 kinds of peoples
pregnant and kids
Ceftriaxone ADRs: s___ and l___
sludge and lithiasis
Aminoglycoside uses
Amina made Tara explode
MDR TB, Endocarditis
Two uses for Penicillin G
strep and syphilis
Gentamicin ADRs
remember its an aminoglycoside so the ADRs are ototoxicity and nephrotoxicity
Aminoglycosides monitoring
Once daily is good, get a level within hours and match to renal function
Oxacillin considerations
doesn’t cause renal problems but you have to take frequent doses so it’s a pain
4th generation Cephalosporin
its 4 a lot of things but not anaerobes
broad spectrum but not anaerobes
3 FQs that are good for respiratory
moxi, levo, gemi
5th generation cephalosporin
(ceftaroline) Its the newest generation so it works for the toughest thing: MRSA
TMP ADRs
can be reversed by folic acid
Don’t give with G6PD
The 3 older FQs are
It’s all a CON
Ciprofloxacin, Ofloxacin, Norfloxacin
Ampicillin
Take on an empty stomach
Works well with Sulbactam
Needs high doses
Cifederocol
especially good for carbapenem resistance
think ROCO-Resistance
Cephalosporin ADRs
cephalopods HAVE ARMS LINED with SUCKERS, THREE hearts, HaveBrains, and are DIFferent than anything else
Hemolytic anemia, Lithiasis, sludge, type 3, HypoprothromBinemia, c dif
2 gen Cephalosporins
Oral is for pharyngitis, sinusitis, and resp
IV is for abd and periop procedure
2 = Tupac orally rapped until he was hoarse, he got pharyngitis, sinusitis, a resp infection.
Biggie ate too much, got abd infection and had an IV for his periop procedure
Tetracyclines: because of the teeth thing, don’t give it to
pregnant and kids
Measure the ____ if you’re going to use aminoglycosides for a long time.
troughs
TMP has cross allergy with
sulfonamides, oral hypoglycemics and thiazides
