Other Learning Resources

Top Antibiotic Coverage Mnemonics

It is common for learners to struggle with memorizing antibiotic coverage when they are first introduced to the subject. With so many unfamiliar bacteria and antibiotics to know, it can be more than enough to get your head spinning.

In school, you probably learned the spectrum of activity for antibiotics by grouping bacteria into 3 common classifications:

Gram-positive bacteria (e.g., Streptococcus, Staphylococcus, Enterococcus)
Gram-negative bacteria (e.g., E. coli, Klebsiella, Salmonella, Shigella, Pseudomonas)
Atypicals (e.g., Chlamydophilia, Legionella, Mycoplasma)

Additionally, you learned that they are then further subclassified into aerobes, anaerobes, lactose-fermenting, and non-lactose-fermenting. But wait, don’t get cross-eyed just yet! Memorizing the spectrum of activity of antibiotics does not have to be that difficult. In this article, I’ll share some memorization tips on remembering the common bugs and what drugs cover them.

BUGS AND DRUGS

A great tip for remembering antibiotic coverage starts with memorizing the antibiotics that cover the major categories of bacteria including anaerobes and atypicals as well as resistant pathogens such as methicillin-resistant staphylococcus aureus (MRSA) and pseudomonas. From there, you can build upon your knowledge of other less commonly seen bacteria or infections through the application of the material during class, rotations, and clinical practice. 

Needless to say, these are a MUST for you to know for exams. Review the mnemonics below and quiz yourself to see how much you remember. 

NOTE: Clindamycin, doxycycline, and Bactrim (generic: sulfamethoxazole/trimethoprim) cover community-acquired MRSA infections while vancomycin, ceftaroline, and daptomycin cover hospital-acquired MRSA infections. Other antibiotics not listed include: linezolid, telavancin, dalbavancin, oritavancin, tigecycline (this mnemonic story can get pretty long!)

NOTE: Atypical bacteria do not color with Gram staining (because they lack a cell wall) and remain colorless. They are neither gram-positive nor gram-negative; they are ATYPICAL! 🙂

NOTE: These are the main antibiotics that empirically cover anaerobes. There are other antibiotics that do have some anaerobic coverage but since anaerobes are hard to culture and identify, empiric therapy is often used in practice.

NOTE: Other antibiotics not listed include: cefiderocol, colistin, ceftolozane/tazobactam

TIPS FOR SUCCESS

  • Keep in mind, memorizing these antibiotic spectra of activity can come in handy for exams but it doesn’t always apply to clinical practice (ex: you wouldn’t recommend daptomycin for MRSA pneumonia since daptomycin gets deactivated by the lung surfactants. You also wouldn’t recommend doxycycline as the first-line option for hospital-associated pneumonia.)
  • Other things to keep in mind when recommending an antibiotic to the team: potential toxicities, renal and hepatic function, CPK monitoring (esp. with daptomycin), which type of infection the drugs can or cannot be used for (moxifloxacin should not be used for UTIs as it doesn’t concentrate well in the urine making it ineffective), contraindications, drug interactions, and routine antibiotic doses (pneumonia dosing vs. bacteremia dosing)
  • At the end of the day, the best way to become comfortable with bugs and drugs is to practice, practice, practice. It takes time and effort but eventually, you’ll start to see a pattern with which antibiotic should be used based on patient-specific factors, cultures and sensitivity, and the type of infectious disease. 

QUIZ YOURSELF

A) Which of the following antibiotics can be used for a patient with MRSA+ pneumonia?

  1. Daptomycin
  2. Vancomycin
  3. Gentamicin
  4. Azithromycin

B) All of the following antibiotics cover pseudomonas EXCEPT for?

  1. Meropenem
  2. Cefepime
  3. Ertapenem
  4. Piperacillin/tazobactam

C) A patient is in need of anaerobic coverage for a diabetic foot infection, which of the following antibiotics would provide adequate anaerobe coverage?

  1. Levofloxacin
  2. Cefepime
  3. Clindamycin
  4. Tobramycin

D) Which antibiotic would provide coverage for atypical pathogens and streptococcus pneumoniae in a healthy patient diagnosed with community-acquired pneumonia (assuming local resistance is low)?

  1. Metronidazole
  2. Clindamycin
  3. Azithromycin
  4. Amoxicillin

ANSWERS: A. 2, B. 3., C. 3., D. 3. 

Hope these were helpful! If you have any additional memorization tips of your own, feel free to share them in the comments below. 

If you are interested in learning more, check out our Antibiotics Pharmacology Coloring Book or Top 200 Drugs Made Easy Coloring Book for additional memorization tips!

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Top 25 Drug Suffixes You Need to Know

Pharmacology can be a difficult subject due to the numerous drug names and facts that are required to be committed to memory. Fortunately, generic names tend to follow patterns, with prefixes and suffixes to help determine which class of medications they belong to. An example is the class angiotensin converting enzyme inhibitors (ACEIs) which all end in the suffix ‘-pril’ such as lisinoPRIL or benazaPRIL.

Learning the roots of common medication classes can definitely come in handy as it can save time from having to memorize every single drug on the market. Instead, you can group them into classes and identify them based on the prefix or suffix. This can be helpful as drug classes often share common contraindications, black box warnings, and side effects, all of which are commonly tested.

Learning and recognizing these prefixes and suffixes could SAVE you on an exam and is a subject that may or may not be emphasized enough in pharmacy, nursing, or medical school.

Check out the list below of the top 25 drug roots you need to know. If you are on the lookout for the best way to study for this, check out our drug suffix cheat sheet here that can serve as a great reference guide or if folded down the middle can be used in flashcard format to quiz yourself!

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Top 5 Tips on Learning Vasopressors and Inotropes

One of the most intimidating environments for pharmacy students on rotation can be the intensive care unit. Not only is it where the sickest patients in the hospital go, but they are often on many medications and monitors we never see anywhere else in the world of pharmacy. One of the most frequent reasons patients go to the ICU is because of low blood pressure causing organ failure and critical care pharmacists have a big role in helping manage this! While it’s normal to feel intimidated, we’ve put together a “survival pack” of tips and tricks to learning and understanding shock, hemodynamics, and the medications that can be used!

Top 5 tips for understanding hemodynamics:

  • Tip # 1: Understand what caused the shock and what will reverse it. The golden rule of critical care is treating the underlying cause while providing supportive care. Knowing what you’re treating, whether it is sepsis or heart failure, will help you plan out which therapies the patient should start on, like antibiotics or diuretics. In the meantime, you can then focus on supporting the patient’s blood pressure and organ function until the underlying cause is treated.
  • Tip #2: Determine what kind of shock the patient. Sometimes shock is caused by blood vessels being too dilated, sometimes it’s caused by active bleeding, and sometimes it’s because the heart isn’t working correctly to pump blood. No matter the cause, it’s important to categorize the shock to know what the correct supportive therapies, whether they be fluids, vasopressor, or inotropes, should be used.
  • Tip #3: We often think of shock as low blood pressure, but really it’s low blood pressure + organ failure. The ICU can be information overload, but all the numbers are just telling you about how different organs are performing or not performing. For example, if someone’s serum creatinine doubles and their urine output becomes zero, you know they’re going into renal failure. If someone suddenly develops altered mental status, that could be because not enough oxygen is getting to his or her brain. Learn how to interpret the “information overload,” and you can use that to determine how “sick” from shock a patient is.
  • Tip #4: After determining what kind of medications should be used temporarily to manage the shock (e.g., fluids, vasopressors, inotropes), the next step is to monitor the efficacy of these medications. For example: if someone has septic shock with renal failure, we know that it is most often caused by leaky blood vessels or distributive shock. Based on that information, we would want to start a vasopressor which is the first-line treatment to manage this type of shock. Once we start a vasopressor like norepinephrine, we can monitor the patient’s urine output and creatinine to determine if the medication is working!
  • Tip #5: Learn the mechanism of action of all the vasopressors and inotropes. I know you hear this all the time in school but understanding what drugs work at which receptors and what those receptors do will help you UNDERSTAND how to pick between the different agents, not just MEMORIZE which one to use. Remember- critical care is not black and white; you must know how drugs work in order to select the right drug for the right patient.

Written by: Ellen Huang, PharmD, BCCCP. Critical Care Clinical Pharmacist

Looking for study resources to help you master vasopressors and inotropes?

Check out the Vasopressor and Inotrope Mnemonic Workbook! Designed to help save you time and make studying more effective. 

This 28-page digital book includes:

  • Numerous memorization tips
  • Worksheets for active recall
  • Simplified pathophysiology
  • Key points about vasopressors and inotropes

Created by a critical care content expert and perfect for current or aspiring pharmacy students, nurses, doctors, and healthcare students who are visual learners. 

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Learn with Memory Pharm on Youtube

*Drum roll* Announcing the launch of Memory Pharm’s Youtube channel!

We are so excited to share the great news. For all of our visual and audio learners, these videos are aimed to help you understand medications in a fun and effective way.  With tons of great illustrations and animations PLUS memorization tips, we hope these videos will help make learning medications easier and more enjoyable. It is a great tool all healthcare professionals currently in school and a nice review for practicing clinicians. If this is you, check out our channel below. 

Our first two videos are on the topic of asthma, a common respiratory disorder that affects millions of people worldwide. Stay tuned for more videos coming soon. Until then, happy studying!

-Memory Pharm Team

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Pharmacology Study Tips

If studying pharmacology seems like a daunting task, you are not alone. It is probably one of the most challenging subjects for every student to learn owing to the amount of drug information that needs to be committed to memory. Some might even say it is similar to memorizing a dictionary!

You cannot possibly learn everything about all the drugs available on the market. So, where do you start? Check out these top 5study tips below!

Study Tip #1: Group the information

 

You only have a limited time to study; therefore, you want to get the most bang for your buck. The grouping technique, also known as the chunking method, is an effective way to organize information to enhance the amount of information you can retain to memory. Our brains naturally file things into categories. During exams and in clinical practice, we get asked questions that require us to retrieve information that is grouped (e.g., which antibiotic can I give in a patient with renal insufficiency? anti-nausea medication should I prescribe?) so studying information in this format is ideal.

 

Here is how you can group the information:

  • Group the drugs by their class (e.g., cephalosporins, calcium channel blockers, etc.)
  • Mechanism of action of that drug class
  • Side effects common to that drug class
  • Side effects that are unique to a drug in that class
  • Commonalities of drug names in that group of class
  • Indications for that drug class
  • Unique drug interactions for that drug class/drugs
  • Pregnancy considerations for that drug class/drug

 

Study Tip #2: Ask yourself these 2 questions

 

Rather than memorizing information for the exam and then dumping it after, studying with these two questions in mind will help you retain the information longer and improve your confidence. They will help you understand the underlying pathophysiology and why we use certain drugs in certain disease states.

 

  1. What normally happens in the body?
  2. What is going wrong when this disease state happens?
 

Study Tip #3: Understand the mechanism of action

 

If you know this one fact about the drug class, it can help you remember the indication and some of the side effects. For example, lisinopril works by inhibiting an enzyme that converts angiotensin I to angiotensin II, a hormone that causes vasoconstriction of blood vessels leading to hypertension. Less of this active hormone leads to a decrease in blood pressure. From this, you’ll know that lisinopril is used to treat hypertension and some common side effects include hypotension, dizziness, and headache. 

 

This study tip may not be possible for all drugs as some medications (e.g., antiepileptics) have unknown mechanisms of action. 

Study Tip #4: Use mnemonics

 

Mnemonics are popular memory tools used to aid in committing important pharmacology facts. Below are 5 different pharmacology mnemonics that you can use to help you during your studies.

 

Acronyms

Acronym-based mnemonics use the first letters of the target words to assist in remembering large amounts of information. For example, to remember the side effects of statins, think of the acronym HMGCoA: Hepatotoxicity, Myalgia, GI effects (nausea, flatulence), CPK increase, and Avoid in pregnancy.

 

Drug names

Drug companies often name drugs with stem words that hint at their class or mode of action. For example, riivaroxaban, apixaban, edoxaban are direct factor Xa inhibitors as denoted by the stem -xa in their names. Macrobid is dosed BID versus Macrodantin is dosed four times a day. Pay attention to the drug name when studying to see if you can spot some of these stems. 

 

Keyword mnemonics 

Use sound-alikes to help you associate the word to a new key term. Of the second-generation antipsychotics, risperidone and paliperidone have the highest risk for EPS and tardive dyskinesia. Mnemonic: “Movement disorders are no fun, so don’t RISK (Risperidone) it Pal (Paliperidone)!”

Grouping method  ALL antibiotics need to be renally adjusted. The list is endless. It is usually easier to remember the outliers or those that do not need to be renally adjusted: moxifloxacin, linezolid, clindamycin, nafcillin, tigecycline. 

Comprehension Understanding is always best for long-term retention! For example, the respiratory fluoroquinolones are gemifloxacin, moxifloxacin, and levofloxacin (remember Go, My Lungs!). There is a common misconception that ciprofloxacin has poor lung penetration because it isn’t a respiratory FQ when the actual reason is that it lacks activity against streptococcus pneumoniae, a common bacteria that causes pneumonia.

Study Tip #5: Check out Memory Pharm!

 

Memory Pharm is a educational website that aims at simplifying complicated pharmacology topics using humor and practicality. We are updating our content regularly. Check out our social media for weekly drug facts, mnemonics, and encouragement as well as subscribe to our email listing to get the latest updates and tips exclusive to members of our list.

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(PART 2) Starting a Business During COVID-19: What They Don’t Teach You in Workshops

In this week’s post, we’ll continue talking about what we’ve learned while starting our own business. Whether it is something legal,  technical, or even about ourselves, we’re still learning something new everyday.

 

Classes and mentoring were invaluable. However, there are things you must experience to fully absorb the meaning. We’re going to get a little gritty on this topic since this post is mostly about a popular buzzword in the entrepreneurial community: “grit”. We’ll mainly discuss what keeps us motivated through any doubts or hurdles that arise and some of the traps we’ve fallen into ourselves.  

 

Here are just a handful of raw accounts of what we’ve learned through our journey so far:

 

  1. Fear is not a weakness. In fact, it takes courage to admit you’re afraid.

We had to learn to be comfortable with fear fast. It’s okay to be scared. Fear is a natural instinct. It’s how you react to fear that defines you. Whether it’s fear of failure, of looking incompetent, or of the unknown- all of these feelings are valid. Frankly, these fears are not uncommon. 

 

I don’t know if we will ever be fully comfortable with fear. We push to recognize when we’re afraid so we can plan how to tackle what’s driving that fear. What really prevented us from falling victim to all of our smaller fears was the fear of regret. We harnessed the biggest fear of all to overcome the other inevitable ones that came with taking on this venture. It’s a daily struggle, but starting a business isn’t for the faint of heart.

 

  1. You can apply for an LLC yourself (or whatever entity you plan on filing).

This one is highly debatable between my partner and me, but I have still no regrets in hiring an attorney to file our incorporation paperwork. It came at a steep cost. There were cheaper alternative services scattered throughout the internet, but we ultimately decided on hiring a law firm. When we decided to pursue forming Memory Pharm, we both believed that we should focus on what we’re good at and find the right people to fill out where we needed help. Legal work was one of those looming major tasks we weren’t as familiar with, so outsourcing that task seemed like a logical decision. However, we jumped in too soon. We later found out from our mentors that they were already well-acquainted with the process. They could have helped us with our filing for no charge. It was an expensive lesson on being too eager and afraid to trust ourselves.

 

  1. Building a strong partnership/team.

No matter how smart or talented you are, you can’t do and be good at everything. We all have our limitations. Everyone brings a different value to the table and fills in gaps the other may be missing. Finding the right team and partner can make a world of difference.

 

If I had a nickel for every time I’ve said: “It feels like I’m in a marriage”, I’d have enough to fund our entire venture. Going into a healthy business partnership is a huge commitment. We’ve had to have very hard and open communications about finances, how we would run the business, and our roles. Starting a business is hard. Having that proper support from someone who believes in the same vision relieved the load and helped facilitate productivity. I can’t begin to count the days where I was overwhelmed or had doubts and vice versa. We were both there to lift each other up and remind each other why we’re doing this; then, had the other pick up slack in areas the other needed help in. Not to make it sound like a love letter to my partner, but I would not have gotten this far on my own. Coming from someone who thrives on working alone, it was a pivotal change in my mindset about being a good teammate, open communication, honesty, and not being afraid to admit you need help.

 

  1. While it is important to look at competitors, stop comparing yourself to others.

It was really easy to go look through all of the websites with similar concepts as ours and get down on ourselves. It got in our heads that there was so much competition and they are so far along. One, competition is good. It means there is a demand. Two, we all have to start somewhere and the important thing is that we’re starting. At some point, we had to stop obsessing over the competition before it started stunting our own creativity. We still go back and forth constantly reminding each other that we aren’t trying to be our competition. We weren’t studying them to use them as a template but rather researching ways we’re standing out.

 

  1. Self-worth. 

Sometimes we forget the value we bring into building a product or even the product itself. While we firmly believe what we’re trying to accomplish could make a difference in enriching peoples’ lives, we found ourselves questioning whether what we were creating was good enough. It’s already bad enough when you are your own “devil’s advocate”, but when you add well-meaning advice from your loved ones, it really makes you question if all the time, money, and resources are being well spent.

 

That’s when it hit us we too often make so many assumptions before we’ve even tested the market. We sell ourselves short and undermine our value before the market could even tell us our product’s value, or even if we effectively explained it’s value. This ties back into our fears. The fear that no one will believe in our vision and we’re wasting our time. How do we know if we haven’t tested it out?  And if that test “fails”, it’s not the end of the world. It’s just another point where we have to change directions and find a solution that works. When we remove our fear of failure that’s when we do the most learning. And that’s what in the business of- learning how to learn. It is a concept we embody every day.

 

We can say whole-heartedly that this is a dream come true. Through all of the “learning experiences”, tears, hiccups, epiphanies, frustrations, we have no regrets (maybe except paying the attorney- but still I’m happy we did it). We have both gained so much knowledge, confidence, and are more dedicated than ever to learning about what makes for an impactful learning experience. We don’t intend to quit until we’ve inspired a new wave of excited learners.

 

Did we cover any valuable talking points for you? Any new business owners going through the same learning processes?  What else do you think we and our community of learners should know about how to run a business in this climate? We’d like to hear what you have to add to the conversation.

 

(PART 2) Starting a Business During COVID-19: What They Don’t Teach You in Workshops Read More »

Starting a Business During COVID-19

Why is an online pharmacy education service writing about helpful ways to start a business?
 

Because we are in the business of learning and starting a company has been nothing short of a learning experience. These past few months have taught us much about business and ourselves. Coming from a limited business background, we have gained tremendous insight and knowledge in our journey, including developing a business plan and marketing. We want to highlight what resources were vital to our growth to help other aspiring entrepreneurs and small businesses.

During these uncertain times, innovation and creativity have become necessary. The economic strain may seem like a barrier to starting a business, but that did not stop us, and neither should it stop you. 

Here are a few low-cost educational resources we utilized while starting Memory Pharm that could help get you started:

Take advantage of your local Small Business Development Center (SBDC)

One of the best resources we have found was our local SBDC. Our company was founded in Atlanta, GA, and our SBDC referred us to a local mentor. Not only is mentoring free, but also the training courses which have become free until the end of the year (usually $50-75 per course). All services are rendered online since operations have temporarily gone remotely.

The SBDC has been an incredible resource; they paired us with a similar industry mentor that ended up being an excellent fit with our company’s vision and mission. Our mentor provided us with comprehensive materials on how to start a business and market research studies. They have access to databases that usually come at a cost but were made available to us at no charge. The mentor can help you with anything from completing the paperwork required to form your company to connecting you to a member of their network. With our mentor’s guidance, we learned how to strategize our growth and brainstorm ideas for a sustainable business model, saving us time and energy.

The SDBC also provides virtual training courses in subjects offered at no cost until the end of the year 2020, thanks to special funding from the CARES Act. Topics from these courses include how to start a business, online marketing, search engine optimization (SEO), tips on developing a content calendar, how to write a business plan, tips on Quickbooks, and much more. You are not solicited for payment information throughout the process of registering and attending these courses. In our experience, all course instructors have been knowledgeable, experienced, and enthusiastic. The SBDC has been and will continue to be an incredibly underrated resource. With the SBDC office’s eventual opening, they plan to offer free office and meeting space for members to use.

Find free and valuable mentoring through SCORE

SCORE is a non-profit organization that provides mentoring and educational resources for small businesses at no cost. They offer a full library of free content with templates, tips, and other community resources to help you start and grow your business. They also offer free networking events and paid workshops. The workshops are generally $25, but some company-sponsored workshops offer coupon codes.

Meeting our SCORE mentor was vital during the early stages of founding our company. We were initially overwhelmed with all of the bureaucracy and technical details with starting a business. Our mentor guided us through the early stages of starting our business, and weekly sessions with our SCORE mentor helped push us out of the planning process and into implementation.

Need to brush up on the basics of starting a business? Small Business Administration (SBA) Learning is a great start!

The Small Business Administration (SBA) collaborates with local partners to counsel, mentor, and train small businesses. The SBA website in itself is a thorough guide on how to start a business. It offers a virtual campus for anyone wanting to learn about business. The courses are module based and require Adobe Flash.

Were these tips helpful? Are there other great resources that you have come across? Please feel free to share and comment.

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