Atypical bacteria are bacteria that do not color with gram-staining but rather remain colorless, they are neither Gram-positive nor Gram-negative (they’re atypical! ๐). These include Chlamydiaceae, Legionella, and Mycoplasma; though Rickettsiaceae are also often considered atypical bacteria. โ
Pseudomonas is a type of bacteria (bug) that is found commonly in soil and in water. Of the many different types of Pseudomonas, the one that most often causes infections in humans is called Pseudomonas aeruginosa, which can cause infections in the blood, lungs (pneumonia), or other parts of the body after surgery.โ
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๐บ Pseudomonas aeruginosa treatment has become increasingly difficult as bacteria become more resistant to the available antibiotics on the market. If they develop resistance to several types of antibiotics, these germs can become multidrug-resistant.โ
Tuberculosis (TB) is caused by Mycobacterium tuberculosis (aerobic, non-spore forming bacillus). Active TB is transmitted by aerosolized droplets (sneezing, coughing, talking, etc.) and is highly contagious. โ
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Active disease treatment is divided into two treatment phases, initial and continuation. To avoid treatment failure due to resistance, the preferred initial treatment consists of a 4 drug regimen of rifampin, isoniazid, pyrazinamide, and ethambutol (RIPE). โ
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These 4 drugs are taken for about 8 weeks during the initiation phase. In the continuation phase, the regimen is narrowed based on susceptibilities.
Antibiotics can be bacteriostatic (static=unmoving) meaning that the agent prevents the growth of bacteria or bactericidal (rhymes with suicidal) meaning that it kills bacteria.
Keep in mind that bacteriostatic and bactericidal categorizations in clinical practice are not absolute and can vary depending on the dose and what is being treated.
โค๏ธ Cardioselective beta-blockers work on the beta-1 receptors. Beta-1 receptors primarily are found in cardiac tissues whereas beta-2 receptors are located in the lungs (remember: 1 heart, two lungs). โ
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โค๏ธ Cardioselective beta-blockers exert their effect by binding to the beta-1 receptor sites selectively and inhibiting the action of epinephrine and norepinephrine on these sites. They are often preferred in patients with respiratory disease as they are less likely to cause constriction of airways or peripheral vasculature.โ
Brand/generics can be overwhelming to learn but a good tip is to first group the drugs into classes, starting with the ACE-inhibitors. ACE-inhibitors are antihypertensive medications that all end in ‘-pril’. โ
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๐๐ป Cholinergic muscarinic agonists are drugs that bind to and activate muscarinic cholinergic receptors and increase the activity of the parasympathetic nervous system. They are most commonly used when it is desirable to increase smooth muscle tone, especially in the GI tract, urinary bladder, and eye. They may also be used to reduce heart rate. โ
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๐๐ป Direct cholinergic agonists work by resisting acetylcholinesterase, thus preventing its breakdown. Drugs in this class include bethanechol, carbachol, and methacholine, and pilocarpine.โ
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๐๐ป Indirect cholinergic agonists work by inhibiting the acetylcholinesterase enzyme preventing the degradation of acetylcholine. Drugs in this class include neostigmine, physostigmine, galantamine, donepezil, and rivastigmine. โ
Ever been on corticosteroids before? Due to the activation of the sympathetic system (“fight or flight”), your body responds with an increase in blood pressure, blood sugar, mood changes, and blood volume. With short term use, side effects are minor but can vary depending on their dose and how long they are taken.
๐๐ป Drugs that are inducers increase CYP450 enzyme activity by increasing enzyme synthesis. โ
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๐๐ป A drug also may be metabolized by the same CYP450 enzyme that it induces. Carbamazepine (Tegretol), a potent enzyme inducer, must be initiated at a low dose and then increased at weekly intervals as its half-life gradually decreases over time.โ
The CYP450 enzymes are essential for the production of numerous agents including cholesterol and steroids. Additionally, these enzymes are necessary for the detoxification of foreign chemicals and the metabolism of drugs.โ
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Drugs that are CYP450 inhibitors block the metabolic activity of one or more of the CYP450 enzymes. The extent to which an inhibitor affects the metabolism of a drug depends upon factors such as the dose and the ability of the inhibitor to bind to the enzyme.โ
Diuretics work to enhance sodium and water excretion through 4 main sites on the nephron.
1– Proximal convoluted tubule: Mannitol and acetazolamide (extends into the descending loop of Henle)
2– Ascending loop of Henle: loop diuretics
3– Distal convoluted tubule: thiazides
4– Collecting ducts: Potassium-sparing diuretic (e.g., spironolactone and triamterene)
There are a plethora of drug facts to memorize for school, but it is definitely helpful when their names hint at what they are used for, their mechanism of action, frequency, or duration.
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๐ Lasix: short for ‘last six hours’ because of the 6-hour duration of action. Try not to administer this diuretic to patients after 4 pm to decrease nighttime awakenings.โ
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๐ Macrobid: this formulation of Macrodantin is given BID (twice a day). Macrodantin is recommended to be given 4 times a day. Ensure you are using the right formulation for the right frequency. โ
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๐ Protonix: Protonix belongs to a class of proton pump inhibitors. Its brand name, Protonix, tells you that it is used to ‘nix protons’ or acid and is used to treat GERD and acid-reflux disorders. โ
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๐ Lopressor: brand name for metoprolol, a beta-blocker that is used for high blood pressure. The brand name, lo-pressor, tells you that it is used to help ‘lower pressures’. โ
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๐ Flonase: brand name for fluticasone nasal spray. Its name, Flonase, sounds an awful lot like ‘flow nasal’ which tells you that it is used to treat allergies that commonly cause nasal congestion. โ
๐ Ambien: AM is the sig for morning and Bien means good in Spanish. It is a sleeping aid medication that translates into ‘good morning’. โ
Part 2 of It’s all in the name! Hope these mnemonics make it easier for you to memorize these medications.
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๐ Flomax: brand name for tamsulosin, a medication used to treat urinary retention or benign prostatic hyperplasia (BPH). Its name tells you that it is used to ‘maximize flow’. โ
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๐ Lunesta: a sleep aid medication whose root word Luna means moon in Latin. โ
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๐ Xarelto: brand name for rivaroxaban, an oral anticoagulant. Its name hints at its mechanism of action, inhibiting factor Xa in the clotting cascade. โ
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๐ Fosamax: brand name for alendronic acid, it is a medication used to treat osteoporosis or bone weakening. Its name means os = bone, and max = great in Latin. โ
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๐ Prevacid: brand name for lansoprazole, it belongs to a class of proton pump inhibitors. Its name tells you that it ‘prevents acid’ and is used to treat GERD and acid-reflux disorders. โ
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๐ Glucophage: brand name for metformin. It is a medication used to treat type 2 diabetes. Its name derives from the Greek words gluco= glucose and phage = eat or consume. โ This helps you remember metformin’s mechanism of action is to increase uptake of glucose by cells in the body to be used as energy (or in other words increase insulin sensitivity). โ
๐ Vicodin is the brand name for hydrocodone/acetaminophen. Its component hydrocodone is approximately 6 times (VI) times as potent as codeine (codin). โ
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๐ Levitra is the brand name for vardenafil, a medication used to treat erectile dysfunction. The article ‘Le’ is used to describe masculine nouns in French (‘La’ is used with feminine nouns) and vitra is similar to the word vitality. So together, the name masculine vitality will help you remember the indication for Levitra. โ
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๐ Actigall is the brand name for ursodiol, a medication used to dissolve certain types of gallstones. It sounds a lot like “ACTS ON THE GAL-bladder” to help you remember what it is used for. โ