Yesterday’s Notes Featuring Actual Winter Sunshine!!

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)

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

Sulfonamides

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

black and white checklist for sketchy micro

Mechanism of Fever

Virus Classification

fungal infectors by systems 

Sorry guys haven’t been updating much lately 

Palmoplantar Rash - Secondary Syphilis

classically a generalised polymorphic rash

usually non-itchy, often affecting palms + soles

important to exclude HIV seroconversion

similar appearance to “target lesions” of erythema multiforme

diagnosis —> syphilis serology

Flashcards  with quizlet!

For more: instagram: https://www.instagram.com/studydiaryofamedstudent/

Antimicrobial Agents  - Cell wall inhibitors

Based on mode of action • divided into families based on chemical structure

 Modes of action Interference with: 

cell wall synthesis 

protein synthesis 

nucleic acid synthesis 

plasma membrane integrity 

metabolic pathway 

Inhibitors of Bacterial Cell Wall (peptidoglycan) Synthesis 

The Beta-lactam Family 

The Glycopeptides 

Peptidoglycan is composed of N-acetylglucosamine (NAG) and N-acetylmuramic acid (NAM) repeat units, and amino acids.  Each NAM is linked to peptide chain and the peptide chains are cross-linked.

β-lactams 

Includes penicillin derivatives (penams), cephalosporins (cephems), monobactams, and carbapenems.

class of broad-spectrum antibiotics containing a β-lactam ring

Bacterial transpeptidase enzymes are responsible for catalysing cross-linking of the peptide chains

β-lactam ring bind to these transpeptidases – this inhibits cross-linking between peptide chains and prevents synthesis of stable PG

Cell wall synthesis ceases and the bacterial cells eventually die due to osmotic instability or autolysis. 

Glycopeptides 

Polypeptide agents - basic structural elements amino acids 

Vancomycin: 

complexes with peptide portion of peptidoglycan’s precursor units 

vancomycin is a large hydrophilic molecule able to form hydrogen bonds with the terminal D-alanyl-D-alanine moieties of the NAM/NAG-peptides

preventing PG transglycosylation reaction – PG precursor subunits (NAG-NAM+peptide) cannot be inserted into peptidoglycan matrix;

Vancomycin also alters bacterial-cell-membrane permeability and RNA synthesis

Uses:  serious Gram positive infections e.g. MRSA wound infection

Adverse effects:

damage to auditory nerve 

hearing loss (ototoxicity) 

“Red man/neck” syndrome - rash on face, neck, upper torso 

Hi, everyone!! I’ve had a studyblr for about a week now and have already met so many kind, supportive people. I couldn’t be more thankful. That said, I really wanted to give back to such an amazing community! So here’s my first printable for you! 

It includes:

a 5AM-10PM schedule (for my early hustlers)

‘Top 3 Priorities’ + ‘Can Wait’ categories

a ‘To-Do’ list

Daily Goals, Notes, Doodles

a water tracker (stay hydrated, friends!)

10 Good Things (reflect back on your day and jot down the little things that made you happy even if your day wasn’t the greatest)

They’re available for download in PDF and PNG formats + in pink, blue, yellow, and white! I’ve also made a grid and grid-less version! 

Grid

Blue: pdf / png Pink: pdf / png White: pdf / png Yellow: pdf / png

No Grid

Blue: pdf / png Pink: pdf / png White: pdf / png Yellow: pdf / png

And here’s a link to the entire folder on my DropBox!

Please tag me with #arystudies or mention me if you use these!! I’d love to see them in action. :’) I’m also really curious to see what you all think of them, so please let me know!! 

Be sure to check out my monthly calendars too!

Happy studying!