What? I Like to Feel the Breeze!
Oh, blog, we really need to stop meeting like this...
Something about this song has always given me chills.
Guards: Oh no. Wait. Stop. No. Don’t steal those. Get back here, you criminal. (Pfft! Can’t believe they’re falling for it!)
I read that in a sarcastic voice
why is this so funny?
ANTIBIOTICS CHEAT SHEET :)
* Sulfonamides compete for albumin with:
- Bilirrubin: given in 2°,3°T, high risk or indirect hyperBb and kernicterus in premies
- Warfarin: increases toxicity: bleeding
* Beta-lactamase (penicinillase) Suceptible:
- Natural Penicillins (G, V, F, K)
- Aminopenicillins (Amoxicillin, Ampicillin)
- Antipseudomonal Penicillins (Ticarcillin, Piperacillin)
* Beta-lactamase (penicinillase) Resistant:
- Oxacillin, Nafcillin, Dicloxacillin
- 3°G, 4°G Cephalosporins
- Beta-lactamase inhibitors
* Penicillins enhanced with:
- Clavulanic acid & Sulbactam (both are suicide inhibitors, they inhibit beta-lactamase)
- Aminoglycosides (against enterococcus and psedomonas)
* Aminoglycosides enhanced with Aztreonam
* Penicillins: renal clearance EXCEPT Oxacillin & Nafcillin (bile)
* Cephalosporines: renal clearance EXCEPT Cefoperazone & Cefrtriaxone (bile)
* Both inhibited by Probenecid during tubular secretion.
* 2°G Cephalosporines: none cross BBB except Cefuroxime
* 3°G Cephalosporines: all cross BBB except Cefoperazone bc is highly highly lipid soluble, so is protein bound in plasma, therefore it doesn’t cross BBB.
* Cephalosporines are ”LAME" bc they do not cover this organisms
- L isteria monocytogenes
- A typicals (Mycoplasma, Chlamydia)
- M RSA (except Ceftaroline, 5°G)
- E nterococci
* Disulfiram-like effect: Cefotetan & Cefoperazone (mnemonic)
* Cefoperanzone: all the exceptions!!!
- All 3°G cephalosporins cross the BBB except Cefoperazone.
- All cephalosporins are renal cleared, except Cefoperazone.
- Disulfiram-like effect
* Against Pseudomonas:
- 3°G Cef taz idime (taz taz taz taz)
- 4°G Cefepime, Cefpirome (not available in the USA)
- Antipseudomonal penicillins
- Aminoglycosides (synergy with beta-lactams)
- Aztreonam (pseudomonal sepsis)
* Covers MRSA: Ceftaroline (rhymes w/ Caroline, Caroline the 5°G Ceph), Vancomycin, Daptomycin, Linezolid, Tigecycline.
* Covers VRSA: Linezolid, Dalfopristin/Quinupristin
* Aminoglycosides: decrease release of ACh in synapse and act as a Neuromuscular blocker, this is why it enhances effects of muscle relaxants.
* DEMECLOCYCLINE: tetracycline that’s not used as an AB, it is used as tx of SIADH to cause Nephrogenic Diabetes Insipidus (inhibits the V2 receptor in collecting ducts)
* Phototoxicity: Q ue S T ion?
- Q uinolones
- T etracyclines
* p450 inhibitors: Cloramphenicol, Macrolides (except Azithromycin), Sulfonamides
* Macrolides SE: Motilin stimulation, QT prolongation, reversible deafness, eosinophilia, cholestatic hepatitis
* Bactericidal: beta-lactams (penicillins, cephalosporins, monobactams, carbapenems), aminoglycosides, fluorquinolones, metronidazole.
* Baceriostatic: tetracyclins, streptogramins, chloramphenicol, lincosamides, oxazolidonones, macrolides, sulfonamides, DHFR inhibitors.
* Pseudomembranous colitis: Ampicillin, Amoxicillin, Clindamycin, Lincomycin.
* QT prolongation: macrolides, sometimes fluoroquinolones
"A mother’s 200-year-old gift to anatomy"
The woman in labor has no name. She must have had one at some point, but as bad luck would have it, she was hit and killed by a carriage as she walked in front of the San Carlos Royal College of Surgery, back in 18th-century Madrid.
Nobody claimed the body, whose round belly contained a child about to be born. It was quite a windfall for the surgeons in training at the school, which was always short of corpses on which to learn anatomy.
The body handlers proceeded according to customs of the era: mud was applied and a mold created; this mold was filled with wax, and today it remains the most striking sculpture of those at the Complutense University School of Medicine. She is a Pietá lying back against a chair with her belly sliced open like a pomegranate and the fetus exposed, its little head pointing down. She is a life-like, life-size wax statue.