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Antibiotics - Coggle Diagram

- - - - Penicillin V
        
        V-wing
      - Penicillin G
        
        G shaped hairdo
        Ivy - given IV
    - - Gram +ve cocci
        Strep + staph
        
        Purple coccoid space stations
      - N. meningitidis
        Gram -ve meningococcus
        
        Red helmeted bounty hunter with Meningitis mohawk with diplococci
      - Listeria
        Anaerobe
      - Spirochetes
        Treponema pallidum
        
        Spiral galaxy
    - - β Lactamase sensitive
        
        Beta lactamase resistance trooper
  - - - Methicillin
      - Cloxacillin
      - Flucloxacillin
        
        Ox- horns
      - Nafcillin
        
        Pen staff
        Naf for staph
    - - Penicillinase producing Staph Aureus
        
        Rebel ships resistant to beta lactamase guns due to bulky armour - bulky R group
  - - - Ampicillin
        
        Guitar Amp
      - Amoxicillin
        Amoxicillin + clavulanic acid = Co-amoxiclav
        
        Ammo box
        
        Distracting clarinette gets past Beta lactamase bouncer
        Clavulanic acid beta lactamase inhibitor
    - - Improved gram -ve coverage
        E.coli
        Proteus Mirabilis
        Salmonella
        Shigella
        H. influenza
        H. pylori
        
        H-wing - H. influenza
        
        H. pylori helicopter
        
        Diplococci drums - enterococci
      - Gram +ve dipplococci
        
        Purple coccoid space stations
    - - Good oral availability
        
        Open mouth of rebel pilot - Hans Cillin
    - - Dose
        
        250mg amoxicillin + 125mg calvulanic acid
        500mg/125mg TDS PO
      - Pharmacokinetics
        
        Oral bioavailability 70%
        
        Renal excretion
      - Adverse Effects
        
        Mucocutaneous candidiasis 👅
        
        Nausea 🤢
        
        Vomiting 🤮
        
        Raised LFTS 🐄
        
        Antibiotic ass colitis 🫄
      - Interactions
        
        Warfarin - increased INR
        
        Methotrexate - reduced excretion of methotrexate
        
        Allopurinol - skin reactions
      - Indication
        
        COPD 🌬️
        
        CAP 🫁
        
        Rusty chest plates - Pneumonia
        
        UTI 🍸
        
        Intestines like bar taps
        Activity against gastrointestinal and urinary tract gram -ve rods
  - - - Carboxypenicillins
        
        Ticarcillin
        
        CArbenicillin
      - Ureidopenicillins
        
        Mezlocillin
        
        Pipercillin
    - - Use
        
        P. aeruginosa
        
        Enterobacteriaceae (non β lactamase producing)
        
        Bacteroides
        
        E. faecalis
        
        Serious infx by Gram -ve bacteria
      - Tazobactam (Tazocin)
        
        β lactamase inhibitor
      - Dose
        
        4gm pipercillin +0.5gm tazobactam IV / 8 hours
      - Adverse Effects
        
        Hypersenitivity 🛡️
        
        Stevens Johnson syndrome 👺
        
        Sloughing mask off
        
        Antibiotic pseudomembranous colitis
        
        Bleeding abnormalities
        
        Clotting time
        
        Platelet aggregation
        
        Prothrombin time
        
        Leukopenia and neutropenia 🛡️
        
        Convulsions🪇
        Low CrCl
        
        Increased Urea and creatinine
        
        Abnormal LFTs 🐄
        Hepatitis
        Jaundice 💛
        
        Cow
        
        Tubolointerstitial nephritis
      - Resistance
        
        Legionella
        
        Mycoplasma pneumonia
      - Indications
        
        HAP / HCAP 🫁🏥
        
        VAP 🫁
        
        Complicated intrabdominal infx
        
        Sepsis of undetermined origin - Pseudomonas aeruginoa suspected
        
        Pseudomonas Lisa
        
        Neutropenic sepsis
      - Pipers
        
        Back to back tamborine - tazobactam
  - - - 1st Gen
        
        Cephlexin
        
        PKs
        
        Oral
        
        Indications
        
        RTIs
        
        Otitis media
        
        Strep pharyngitis
        
        UTIs - gram (-) rods
        
        Skin infections
        
        Adverse Effects
        
        GI disturbance
        
        Hypersensitivity reactions 🛡️
        
        Eosinophilia
        
        ↑ LFTS and RFTs
        
        Skin rash
      - 2nd Gen
        
        Cefuroxime
        
        Cefaclor
      - 3rd Gen
        
        Ceftaxime
        
        Highly resistant to β lactamases
        
        Ceftriaxone
        
        Longer t1/2 than tax
        
        Empiric Treatments
        
        Pyelonephritis / complication UTI
        
        Pelvic inflammatry disease
        
        Intra-abdominal infx and gastroenteritis
        
        CAP
        
        Septic arthritis and osteomyelitis
        
        Bacterial endocarditis
        
        Ceftazidime
        
        Excellent activityagainsts pseudomonas + other gram (-)
        
        CefTAZZZZ for PseudomonASS
      - 4th Gen
        
        Cefepime
    - - Inhibition of bacterial wall synthesis
    - - 1st and 2nd good Oral availibility
      - Excretion
        
        Renal
      - Penetration
        
        3rd and 4th can penetrate CSF
    - - 1st gen
        
        Skin and soft tissue
        
        UTI - cephlexin
      - 2nd gen
        
        Limited use die to 3rd gen agents
      - 3RD GEN
        
        Serious infx
        
        Menigitis in non immunocompromised
        
        CAP
    - - Pathogens
        
        S. pneumonia
        
        N. meningitidis
        
        H. influenzae
        
        Listeria monocytogenes
      - Emperic Treatment
        
        Cetriaxone IV
        
        Vancomycin IV
        
        Dexmethasone IV
      - Penicillin hypersensitive treatment
        
        Chloramphenicol IV
        
        Vancomycin IV
        
        Dexmethasone IV
      - Listeria Monocytogenes Infx
        
        Add Amoxicillin
        or in Pen allergy
        Co-trimoxazole
  - - - Aztreonam
        
        One eyes AZ-3M bot
      - Meropenem
      - Imipenem
        (+cilastatin to prevent renal degradation)
        
        Amy
        Keep it lastin with cilastin
        
        Renal degradation
    - - Imipenem
        
        Broad spectrum
      - Aztreonam
        
        Gram negative bacteria
        
        Gram neg rods aerobic
        
        Enterobacteriacea
        
        Pseudomonas
      - Meropenem
        
        Legionella is resistant
        
        All MRSA are resistant
    - - Carbapenemase producing enterobacterales (CPE)
    - - Indications
        
        Severe pneumonia
        
        Complicated UTIs
        
        Skin / soft tissue infx
        
        Acute bacterial meningitis
        
        Neutropenic sepsis
        
        Serious systemic infx
        Pneumo
        Meningitis
        UTI
        Sepsis
      - Dose
        
        500mg IV
        
        1g infusion 8hrly
        
        Adjust fro renal impairment
      - PKs
        
        Good CSF distriburtion
        
        Renal excretion
      - Factors for selection
        
        Severity of Infx
        
        Resistance patterns
        
        Risk of carbapenem resistant bacteria
      - Adverse Effects
        
        Diarrhoea
        
        Skin rash
        
        Altered LFTs
        
        Cholestasis
        
        Thrombocytosis
        
        Seizures
        
        Hypersensitivity reactions
      - Interactinos
        
        Reduces valproate levels
        
        MAy increased INR
- - - - Judo master
    - - Cobra ninja
    - - Used in ezyme aminoglycoside resistance
      - Katana master
    - - Sai master
    - - Ninjitsu master
        Colon tunnel - remains active in GI tract
  - - - Red bacilli bricks - Gram -ve Rods
        Bellows - aerobic
        Couple with beta-lactam bombs to break through cell wall
  - - - Beta lactam bombs
    - - Ivy - IV
  - - - Raised creatinine
        Hypokalaemia
        Hypocalaemia
        Hypophophatemia
    - - Auditory
        Hearing loss
        Tinnitus
      - Vesibular
        Nausea
        Vomiting
        Vertigo
        Ataxia
- - - - Anorexia 🍽️
      - Nausea 🤢
      - Vomiting 🤮
      - Oesophagitis with ulceration
      - Pancreatitis 🍳
      - Hepatitis 🐄
      - Jaundice 💛
    - - Exacerbation of increased Urea
    - - Haemolytic anaemia 🎈
      - Thrombocytopenia
- - - - Staphylococci
      - Streptococci
      - Enterococci
        
        Purple diplococci drums
      - Gram + anaerobic coci
      - Gram positive rods - Listeria monocytogenes
      - purple clusters and chains
    - - S. pneumo
        
        Lung stains on coughing nurse
      - Methicillin resistant and vancomyin -resistant staph and enterococci (MRSA and VRE)
  - - - Near 100%
    - - nonenzymatic oxidation
        80% excreted in urine
    - - 4-6hours
    - - PO BD
      - IV infusion
  - - - Soft tissue on faces
  - - - Broken plates - thrombocytopenia
    - - Gloves and shoe covers
    - - Cut wire on secirity camera
        Long term use associated
  - - - Risk of serotonin syndrome
- - - - Levofloxacin
      - Ciprofloxacin
      - Ofloxacin
      - Moxifloxacin
  - - - Mycoplasma
      - Legionella
      - Brecella
      - Mycobacterium
      - Chlamydia
  - - - Infective exacerbation of COPD 🌬️
      - CAP 🫁
      - Epiglottitis 👄
      - Periorbital cellulitis 👁️
      - UTI 🍸
      - Acute pancreatitis 🍳
      - Acute osteomyelitis 🦴
      - In pts with penicillin hypersensitivity
    - - Respiratory tract infection 🧣
      - Skin and soft tissue infx
      - UTIs 🍸
      - GIT infx 🫃
      - Sinitus 💀
      - Genital tract infx 🧘🤸
      - CAP 🫁
  - - - Nausea 🤢
      - Vomiting 🤮
      - Abdominal discomfort
      - Clostridium difficle colitis (ciprofloxacin)
      - Elevations in LFTs 🐄
    - - Headache 🤕
      - Dizziness 😵‍💫
      - Delirium 😕
      - Seizures 🪇
    - - Achilles tendon rupture / tendinitis 🦶
    - - Leukopenia
      - Eosinophilia
    - - QT prolongation ⚡
      - Aortic and mitral valve regurgitation
- - - - Hepatotoxicity
    - - Peripheral neuropathy
- - - - Bacteriostatic - may be bactericidal at higher conc
      - Indications
        
        Gram +ve cocci
        Staph and Strep
        
        Bacilli
        C. perfingens
        Listeria
        
        Gram -ve
        H. influenzae
        N. meningitidis
        
        H. influenzae pneumonia
        
        Mycoplasma pneumonia
        Legionella pneumophilia
        
        Atypical walking pneumonia
        Atypical winter
        
        Legion of ships in atypical winter
      - Contraindications
        
        Aerobic enteric gram -ve bacilli
      - Pharmacokinetics
        
        Inactivated by gastric acid
        Admin in enteric coated tablets
        
        Excreted in bile
      - Red crow
    - - Pharmacokinetics
        
        Rapidly absorbed
        
        1st pass metabolism
        
        Non linear kinetics at higher doses
      - Keep clear
    - - Pharmacokinetics
        
        Hepatic metabolism
        
        Bilary excretion
      - Birds A-Z
  - - - Jammed paper in Ribosome-like typewriter
        Preventing translocation
        Bacteriostatic
  - - - Strep pneumoniae
      - H. influenzae
      - Mycoplasma
      - Legionella
      - Rusty chest palte - pneumonia
      - Legion of ships - legionella
        Atypical snowshoer - Mycoplasma walking pneumonia
    - - Clam lady covering genitals
    - - H. pylori triple therapy
    - - Mockingbird avium
  - - - Jaundice 💛
      - Fever 🌡️
      - Leukocytosis 🛡️
      - Elevated LFTs
      - Jaundiced Poe
    - - Nausea 🤢
      - Vomiting 🤮
      - Abdominal pain
      - Poo puddle - GIT symptoms
    - - QT prolpngation ⚡
      - Cardiac arrythmias 💗
      - Torsades paper and beating heart
  - - - Crhome bumper carriage
- - - - Anaemia
      - Leukopenia
      - Thrombocytopaenia
    - - Aplastic anaemia
      - May lead to fatal pancytopenia
    - - Nausea 🤢
      - Vomiting 🤮
      - Diarrhoea 💩
    - - Grey baby syndrome
      - Altered respiration 😤
      - Abdominal distention 🫄
      - Flaccid limbs 🥀
      - Hypothermia ❄️
    - - Blurred vision 👁️
      - Digital paraesthesiae 🖐️
- - - - 500mg 6hrly
    - - Renal excretion 🫘
    - - Skin and soft tissue infx - MRSA
      - CNS infections
      - Community Meningitis from S. pneumoniae
      - Nosocomial meningitis
      - Staphlococcal endocarditis
      - MRSA pneumonia
      - Pseudomembranous colitis - C. difficile
    - - Hypersensitivity 🛡️
        
        Macular rash
        
        anaphylaxis
        
        feer
      - Phlebitis at admin 🩸
      - Red man syndrome
        
        Erythematous or urticarial reactions, flushing, tachycadia, hypotension
      - Nephrotoxicity 🫘
      - Neutropenia 🛡️
      - Caution prescription with ototoxic and nephrotoxic drugs
      - Auditory impairment
        
        tinnitus