Antifungals

Doxycycline

Doxycycline is the first line treatment for Chlamydia Rocky Mountain Spotted Fever and Lyme Disease So imagine you’re sitting on a dock by the sea (sounds like Doxycycline) And you’re eating clams (think Chlamydia) and Rocky Mountain oysters (Rocky Mountain Spotted Fever) With a squeeze of lime (for Lyme Disease) Doxycycline is the first line treatment for Chlamydia Rocky Mountain Spotted Fever and Lyme Disease You’re sitting on a dock by the sea (Doxycycline) Eating clams (think Chlamydia) and Rocky Mountain oysters (Rocky Mountain Spotted Fever) With a squeeze of lime (for Lyme Disease) Doxycycline is the first line treatment for Chlamydia Rocky Mountain Spotted Fever and Lyme Disease This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit thesingingstethoscope.substack.com [https://thesingingstethoscope.substack.com?utm_medium=podcast&utm_campaign=CTA_1]

Hepatitis C, Hepatitis D, and Hepatitis E

Hepatitis C is Hepatitis Chronic It’s the most common cause of chronic liver disease It’s diagnosed with an HCV antibody test Followed by an HCV RNA test please It’s mostly transmitted through infected blood so IV drug users may be affected But now that newer antiviral meds are here A full cure is usually possible and expected Hepatitis D is Hepatitis Dependent Cause it requires a co-infection with Hep B So Hep B vaccination can be used for prevention And interferon alpha is how to treat it you see Hepatitis E is Hepatitis Embryo Because it usually resolves on its own Except for patients who are pregnant Then it can be a serious issue that’s full-blown This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit thesingingstethoscope.substack.com [https://thesingingstethoscope.substack.com?utm_medium=podcast&utm_campaign=CTA_1]

Hepatitis A and Hepatitis B

Hepatitis A for Hepatitis Acute Cause chronic infections are almost never found Hepatitis A for Hepatitis Anus The fecal-oral route is how it spreads around Now let’s talk about serology IgG anti-HAV tests for a past or chronic infection IgM anti-HAV tests for an infection that’s acute And there is a Hep A vaccine that’s used for prevention Hepatitis B for Hepatitis Baby Because vertical transmission is a common road And Hepatitis B for Hepatitis Bodily fluids Because sex and IV drug use are the other common modes IgG anti-HBc indicates a chronic infection Think IgG for gone because IgG anti-HBc Means the acute infection is gone And that’s how it should be IgM anti-HBc indicates an acute infection Think IgM for minute because IgM anti-HBc Means they’ve only had it for a minute And they’re still fighting it acutely Now hang in there, just a little more serology Anti-HBs is the Hepatitis B surface antibody with a B Which indicates either a booster, as in a vaccine or the patient has beat it and the infection has resolved completely HBsAg is the Hepatitis B surface antigen with a G Means the patient’s got it, it’s an active infection Hep B generally can be acute or chronic And there’s a vaccine that’s used for prevention This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit thesingingstethoscope.substack.com [https://thesingingstethoscope.substack.com?utm_medium=podcast&utm_campaign=CTA_1]

Antifungals

It’s time to have fun, fun, fun Fun with antifungals With polyene antifungals, let’s begin These are amphotericin B and nystatin Swish and swallow nystatin liquid form For esophageal candidiasis it's the norm Fungal cells’ plasma membrane is made up of ergosterol And basically, these drugs tear holes in that wall They destroy the cell membrane’s structural integrity So just remember that “tear” is in ampho-TEAR-icin B You should also know these are heavy duty medications And heavy duty side effects are the expectation Amphotericin B can cause fever, chills, and other things Am-PH-PH-PH-tericin B, pretend you’re shivering, am-PH-PH-PH-tericin B There’s also the risk of electrolyte abnormalities Decreased potassium and magnesium are potential realities So remember ampho B as in am-FLOW-tericin B To remind you it might lead to nephrotoxicity We’re having fun, fun, fun Fun with antifungals Now the next class of antifungals, we’re on a roll Are the real a-holes also known as the azoles Like clotrimazole, ketoconazole, and fluconazole They simply inhibit the synthesis of ergosterol Also inhibiting ergosterol synthesis are the allylamines A couple of examples are terbinafine and butenafine Then there’s griseofulvin, which works like this It prevents fungal cells’ proliferation by inhibiting mitosis The last class of antifungal drugs are the echinocandins Like caspofungin, anidulafungin, and micafungin They inhibit the synthesis of cell wall beta-glucan So echinocandins, as in, e-kinda-can’t-do that man Hope you had fun, fun, fun Fun with antifungals This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit thesingingstethoscope.substack.com [https://thesingingstethoscope.substack.com?utm_medium=podcast&utm_campaign=CTA_1]

Cephalosporins

There are five generations of cephalosporins And I’ve got some clever ways You can remember them For the first generation we have Cefazolin and Cephalexin Now Cef-hAZ-olin sounds kind of like “has” And Cephalexin contains the word “ale” So the first question you want to ask is, Do you has any ale? That’s the first thing you might ask When you go to a friend’s house Do you has any ale? For Cef-hAZ-olin and Ceph-ALE-xin That’s the first generation Now we’re going to skip altogether The cephalosporins in the second generation There’s no easy way to remember this group So you’ll have to use the process of elimination But fortunately the third generation is easy All you gotta do is remember the number three You can fix things in three days with Ce-FIX-ime And “tri” means three in Cef-TRI-axone Cefo-TAX-ime reminds you people do their taxes Usually in the third month of the year And for Cef-TAZ-idime, just close your eyes And picture three TAZ-manian devils That’s the third generation Along the same lines, for the fourth generation We’ll focus on the number four Cefepime covers Pseudomonas, And that has four syllables: Pseu-do-mon-as So it goes with Ce-FOUR-pime That’s the fourth generation And last but not least, Ceftaroline Ceftaroline is in the fifth generation Think of a star with five points And say Cef-STAR-oline That’s the fifth generation There are five generations of cephalosporins And now you know some clever ways to remember them This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit thesingingstethoscope.substack.com [https://thesingingstethoscope.substack.com?utm_medium=podcast&utm_campaign=CTA_1]