TAP TO ADVANCESPACE / ENTER TO ADVANCE
Antibiotics Rap
PENICILLINS*
Let's start with penicillin, in the IV,
if you want it PO, you need Pen V.
All these beta-lactams, attach to PBPs,
Strep and a SNAP, Syphilis another,
Now let's start this rap, I'm here with my brother
AMINOPENICILLINS
Now we got aminos, pulling up in El Caminos,
Amp by IV, Amox by PO,
Keep their flow low, don't need no hysteria,
H flu, E coli, Proteus, Listeria.
BETA-LACTAMASE INHIBITORS*
Add a new pal, amox and clav.
Stopping the malaise, beta-lactamase.
ANTI-STAPH*
Now last but not least, we got Naf for Staph,
M-S-S-A, we attack this track
CEPH GEN 1*
you might think they boring,
but on boards they're important.
Cephalosporins, yeah you need to record them.
Generation one, a faz and a flex.
Before surgery, give them a PEcK!
CEPH GEN 2*
Generation two, Fox and its fur,
Add a HEN to PEcK and coverage occurs.
CEPH GEN 3*
Generation three,
An absolute win
When you see SHIN you know where to begin
CEPH GEN 4*
Generation four, changes the onus,
Choose cefepime and you'll cover Pseudomonas.
CEPH GEN 5*
Generation five takes a little dive,
Covers MRSA but Pseudomonas survives
CARBAPENEMS*
Last beta-lactams are our carbapenems,
To negatives, anaerobes, carbapenems venom
ESBLs fall, but seizures be pendin'.
Remember this verse then all is forgiven!
VANCOMYCIN*
I got another rhyme, let's talk about MRSA,
let's start with IVs, let's start this verse ya,
Vancomycin first line, 'fore MRSA mercs ya.
But watch the time, kidney's online
give it too quick and you'll turn red,
but that's still better than dead
DAPTOMYCIN*
No time for rest, Daptomycin's next,
Sold in a vial, impactin' the myo,
While in the lung, surfactant says no.
Dose too high and muscles pay the prices, crisis,
Rhabdomyolysis, kidneys roll the dices. AYYYY
LINEZOLID*
If you need more, God forbid open the door,
Linezolid, now catch your breath,
Rock the moment,
Block fifty S but watch serotonin!
PO MRSA*
Now let's take it slow and go to PO,
Bactrim, Clinda, Doxy let's go!
PROTEIN SYNTHESIS*
That's a perfect segue to our next topic,
Protein synthesis now on the docket.
Aminoglycosides, gram negatives can mop it
Moxie with doxy, atypicals knock it, rock it,
now we're getting nerdy, I'll tell you something nifty, thrifty,
Buy at thirty and sell at fifty!
Buy at thirty and sell at fifty!
FLUOROQUINOLONES*
Now to buy those you might need a loan,
So we turn now to fluoroquinolones.
They run their zone through,
that's topo four and two,
Cover negatives and Pseudomonas too.
Remember side effects, don't forget:
Tendons unmet, QT stretched,
sun's a mess, GI's a wreck!
METRONIDAZOLE*
Before we head off, gotta find a ride,
So let's get GAP at the metro and slide.
Head below the diaphragm where anaerobes are slicker,
No liquor on this ride where disulfiram sicker.
OUTRO
Now you memorize and spread the vibes.
Shoutout Strudel Med please like and subscribe!
MNEMONICS*
PENICILLINS
SNAP = Sulfonamides, Nocardia, Actinomyces, Penicillins. Pen G is IV, Pen V is oral.
BETA-LACTAMASE INHIBITORS
Clav = clavulanate, a beta-lactamase inhibitor often co-administered with amoxicillin (brand name Augmentin)
ANTI-STAPH
Nafcillin is interchangeable with oxacillin. Works for MSSA (methicillin-sensitive staph aureus), not MRSA.
CEPH GEN 1
"faz and flex" = ceFAZolin + cephaLEXin. PEcK = Proteus, E. coli, Klebsiella. Gen 1 = gram positives mostly, surgical prophylaxis.
CEPH GEN 2
"Fox" = ceFOXitin, "fur" = ceFURoxime. "hen to peck" = HEN (H flu, Enterobacter, Neisseria) added to gen 1 PEcK coverage.
CEPH GEN 3
SHIN = Strep pneumo, H influenzae (the I), Neisseria. All encapsulated organisms. Gen 3 = serious gram negative infections, meningitis.
CEPH GEN 4
Gen 4 = everything in gen 3 plus Pseudomonas coverage.
CEPH GEN 5
Only cephalosporin that covers MRSA. Trades away Pseudomonas coverage.
CARBAPENEMS
"venom" = broadest beta-lactam spectrum. ESBLs (extended-spectrum beta-lactamases) can't break carbapenems. "seizures be pendin'" = imipenem lowers seizure threshold.
VANCOMYCIN
"turn red" = Red Man Syndrome from fast infusion (histamine release). "kidney's online" = nephrotoxic, monitor troughs.
DAPTOMYCIN
"surfactant says no" = inactivated in lungs, never use for pneumonia. "muscles pay" = check CPK for rhabdomyolysis.
LINEZOLID
"fifty S" = blocks 50S ribosomal subunit. "watch serotonin" = MAO inhibitor, risk of serotonin syndrome with SSRIs.
PO MRSA
Oral MRSA options. Bactrim = TMP-SMX, Clinda = clindamycin, Doxy = doxycycline.
PROTEIN SYNTHESIS
"Buy AT 30, CCEL at 50." 30S inhibitors: Aminoglycosides, Tetracyclines. 50S inhibitors: Chloramphenicol, Clindamycin, Erythromycin (macrolides), Linezolid.
FLUOROQUINOLONES
"topo 4 and 2" = topoisomerase IV (gram+) and II/gyrase (gram-). Side effects: tendon rupture, QT prolongation, photosensitivity, GI upset.
METRONIDAZOLE
GET GAP at the Metro(nidazole). G = Giardia, E = Entamoeba histolytica, T = Trichomonas, G = Gardnerella vaginalis, A = Anaerobes (Bacteroides, C. diff), P = H. pylori (with PPI + clarithromycin). Use for anaerobes below the diaphragm (vs clindamycin above). AE: disulfiram-like reaction with alcohol.