š 5-HT3 Inhibitors (ex: ondansetron) ā
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š¤¢š¤® Nausea and vomiting are two of the most common presenting complaints ā
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5-HT3 inhibitors (such as ondansetron) are one of the top 200 drugs prescribed and are used for the prevention of:ā
šĀ chemotherapy-induced nausea and vomitingā
šĀ radiation-induced nausea and vomitingā
šĀ postoperative nausea and vomitingā
šĀ off-label for nausea and vomiting associated with pregnancy
Vancomycin belongs to a class of antibiotics called glycopeptides. Drugs in this class are composed of a cyclic peptide bound by two sugar molecules (glycogen), hence the name glycopeptides! ā
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MOA: binds to D-alanyl-D-alanine on the outer surface of cell membranes preventing cross-linking. This interferes with cell wall synthesis and results in bacterial cell death. ā
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Another way to think of it: cell walls are like LEGO pieces linking together. The more that are linked, the stronger the structure is. Vancomycin prevents this cross-linking leading to an unstable structure. ā
ā Vancomycin = think mainly gram-positive coverage including MRSA! (gram-negatives do NOT have a thick cell wall and lack the D-ala-D-ala sequence, making vancomycin useless against them)ā
NOTE: Recently, the term āred man syndrome (RMS)ā has been replaced and is now recognized as āvancomycin flushing syndromeā or “vancomycin infusion reaction”.
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Mind the Gap- HAGMA Read More Ā»
ā This is a great way to remember the names of antiretrovirals ā Antiretroviral medications are used to treat HIV by blocking different stages of the virus’s life cycle (e.g., blocking entry into the host’s CD4 lymphocyte, inhibiting viral DNA from replicating, etc.)ā ā š However, learning the names of antiretroviral medications is horribly difficult. There are lots of drugs, with a dizzying array of names, abbreviations, and combination tablets.ā Hopefully, this will help you not to completely BLANK on which drug belongs to which type of antiretroviral! š¤
Vasopressors and Inotropesā
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Vasopressors and inotropes OH NO! šš»āāļø These medications are commonly used in the critical care setting in patients with shock (or those with extremely low blood pressure) leading to end-organ damage (acute kidney injury, increased LFTs, etc.). ā
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šš» Vasopressors are drugs that cause vasoconstriction, therefore increasing mean arterial pressure (MAP). Vaso refers to blood vessels and pressor means to put pressure on or constrict making up the word ā VASO-pressor. š©øā
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Examples of vasopressors include:ā
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ā Norepinephrineā
ā Epinephrineā
ā Vasopressinā
ā Phenylephrineā
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šš» Inotropes are drugs that affect cardiac contractility (or the force of muscular contractions). They can also be used as chronotropes (drugs that increase heart rate). THINK: Ino = strength; Chrono = time. Some vasopressors may also have effects on contractility and are called inopressors. ā
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Examples of positive inotropic agents include: ā
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ā Milrinoneā
ā Dobutamineā
ā Dopamineā
ā Isoproterenoneā
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š§ With the many different types of vasopressors and inotropes, it is important to understand how they work to use them effectively. Choosing the wrong agent or using it inappropriately, can harm the patient. ā
Vasopressors and Inotropesā Read More Ā»
IV chemotherapy agents with high emetic risksā Read More Ā»
Drugs that cause Constipation Read More Ā»
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.Ā 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.Ā
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.Ā
NOTE:Ā 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! š
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
QUIZ YOURSELF
A) Which of the following antibiotics can be used for a patient with MRSA+ pneumonia?
B) All of the following antibiotics cover pseudomonas EXCEPT for?
C) A patient is in need of anaerobic coverage for a diabetic foot infection, which of the following antibiotics would provide adequate anaerobe coverage?
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)?
ANSWERS: A. 2, B. 3., C. 3., D. 3.Ā
Hope these were helpful! If you have any additional memorization tips of your own, feel free to share them in the comments below.Ā
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!
Top Antibiotic Coverage Mnemonics Read More Ā»
š¶š» Preterm labor occurs when labor begins too early. If this happens before the 37th week of gestation, the fetal organs, especially the lungs, might not be fully developed.ā
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š In these cases, labor can be suppressed with uterine relaxants that relax the uterine muscle and slow down contractions for up to 48 hours. It gives the fetus a few more days in the uterus as a corticosteroid is given to speed up the development of a preterm infant’s lungs. Steroids help the lungs mature and may promote the production of surfactant, a substance that prevents the collapse of alveoli (small sacs in the lungs where the air is exchanged). ā
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š Uterine relaxants are also called tocolytics (toco = childbirth, lytic = terminate) and include several different types of drugs. ā
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Uterine Relaxant Drugs Read More Ā»
Antibiotic Renal Dosing Read More Ā»
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Antibiotics that Cover MRSA Read More Ā»