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mynotes4usmle:

ANTIBIOTICS CHEAT SHEET :)

Also, REMEMBER!!!!

* 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
  • Carbapenems 
  • Monobactams
  • 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)
  • RSA (except Ceftaroline, 5°G)
  •  nterococci

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* 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)

* Covers MRSA: Ceftaroline (rhymes w/ Caroline, Caroline the 5°G Ceph), Vancomycin, Daptomycin, Linezolid, Tigecycline.

Covers VRSA: Linezolid, Danupristin/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?

  • uinolones
  • Sulfonamides
  • T etracyclines

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* 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

currentsinbiology:

Premature baby’s shrill cry may be sign of something deeper (AAAS) By

Premature babies are more likely to produce piercing cries than their full-term peers are, researchers report online today in Biology Letters. Scientists have studied infant crying as a noninvasive way to assess how well a baby’s nervous system develops. Previous research of full-term babies indicates that an abnormally high pitch is associated with disturbances in an infant’s metabolism and neurological development. The team recorded spontaneous crying in preterm babies and full-term babies of the same age and compared the pitch of their sobs. They found that preterm babies whimper in a shriller voice, but not because they are smaller in size or grew at a slower rate in their mothers’ wombs. Instead, the researchers suspect the high pitch could reflect lower levels of activities in a premature baby’s vagal nerve, which extends from the brain stem to the abdomen. Vagal nerve activities are believed to decrease tension in the vocal cords, thus producing a lower pitch. Previous studies show that giving preterm babies massage therapies can stimulate their vagal activities, improve their ingestion, and help them gain weight.

Photo: Shannon Drawe/iStockphoto/Thinkstock

rhamphotheca:

TSA Turtle Tuesday: African soft-shelled turtle

The African soft-shelled turtle (Trionyx triunguis) is the largest of the genus and can reach a weight of over 100 pounds. As juveniles, the upper shell has white spots that may be ringed in yellow. These spots usually fade with age.

The African soft-shell is an omnivorous turtle with a wide distribution in both fresh and brackish waters in Africa and the Near East. It is known to be ambush hunter lying quietly in the muddy stream bottoms then rapidly reaching out with their long, flexible necks grabbing prey with its strong jaws and using its claws to hold onto prey!

Photo credit – Brandon Greaves and Alexander Stream

(via: Turtle Survival Alliance)

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