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Summary For Antibiotic For USMLE Exam - USMLE MATERIALS - Updated USMLE Study Data

The document provides an overview of important antibiotic classifications and characteristics for the USMLE exam, including which antibiotics are susceptible to beta-lactamase, cross the blood-brain barrier, cover specific organisms like MRSA and Pseudomonas, and have drug interactions or side effects like phototoxicity or QT prolongation. Key classes discussed are penicillins, cephalosporins, aminoglycosides, tetracyclines, and macrolides. Mnemonics are provided to remember antibiotic properties.

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661 views

Summary For Antibiotic For USMLE Exam - USMLE MATERIALS - Updated USMLE Study Data

The document provides an overview of important antibiotic classifications and characteristics for the USMLE exam, including which antibiotics are susceptible to beta-lactamase, cross the blood-brain barrier, cover specific organisms like MRSA and Pseudomonas, and have drug interactions or side effects like phototoxicity or QT prolongation. Key classes discussed are penicillins, cephalosporins, aminoglycosides, tetracyclines, and macrolides. Mnemonics are provided to remember antibiotic properties.

Uploaded by

omy yadav
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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Summary For Antibiotic For

USMLE Exam
DR.Paul

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Also you should remember this..


+Sulfonamides compete for albumin with:

Bilirrubin: given in 2°,3°T, high risk or indirect hyperBb and


kernicterus in premies
Warfarin: increases toxicity: bleeding

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* Beta-lactamase (penicinillase) Suceptible:

Natural Penicillins (G, V, F, K)


Aminopenicillins (Amoxicillin, Ampicillin)
Antipseudomonal Penicillins (Ticarcillin, Piperacillin)

* Beta-lactamase (penicinillase) Resistant:

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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

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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
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* 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

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