DIP Episode 461 - Floridly HY Antibiotic Review for Step 1-3 (Part 2, final)

All right, welcome. My name is divine. This is episode 461 of the Divine intervention podcasts. Into this podcast, we're going to be continuing the florically high-yield Antibiotic review for step one, step three. Part one was episode 460. If you missed out on that, go ahead and listen to it. We're just going to go on straight and continue, which we always stopped. So the next group of drugs I'm going to talk about are the amino glycosides. So I don't know these things end in my sentence, right? Gentamisen, Tubermaisen, you know, neomycin, things like that. Now these drugs, they're pretty high-yield to know about because there's a bunch of things that they could be useful in exams. For example, Gentamisen is part of the treatment regimen for endometritis. Remember, endometritis is going to show up as a fever and uterine tenderness. Usually it's going to be a few days after a person gets a C-section, usually within the first three days of their about. We treat endometritis with endometritis and entamysin, EC Gs and the monic for that drug. Endometritis treat it with endometritis. So that entamysin covers is very helpful. And that's what we show you where we see gentamysin being used is that gentamysin can certainly be used to treat pseudomonas. In fact, amino glycosides in general covers pseudomonas. There's actually certain people that have cystic fibrosis that take inhaled tuberomycin. Tuberomycin is also on a menoglycoside as perphylaxis against infection.

So that's just something I want to keep in mind because remember people that have CF, especially those over age 20, the most common cause of pneumonia in those people is it's going to be pseudomonas. So gentamysin, the amino glycosides covers pseudomonas very, very beautifully. And remember, amino glycosides you cannot use them for anaerobic infections. They literally need oxygen to get into the cell. So they don't work for anaerobic, they only work for aerobic and then don't forget that gentamysin can also be used sometimes to treat, sometimes it can be used to treat endocarditis. The actually many endocarditis regimens that include vencomysin, gentamysin and rifampin. So gentamysin can be part of that treatment regimen. And then obviously, if you see any question on the USM Ds that kind of talks about rabbits or rabbit exposure. So like to Larinia, to Larinia is actually treated as well with gentamysin. And then if we're going for like a non-microbalology use of gentamysin, you can actually use gentamysin to treat many years disease. It's basically almost like a final solution for many years disease. You pretty much will oblate cranial nerve eight. And after you're oblating cranial nerve eight, there goes the presence of hearing. So you treat the person's many years, but obviously they're going to have like a permanent hearing loss. Remember again, the amino glycosides are nephrod and auto-toxic. They are nephrod and auto-toxic.

That's actually pretty high yield to know for for exams. And then one of these other weird factors with amino glycosides like Neomycin, for example, is that it can cause a hypersensitivity reaction. It can cause like a type 4 hypersensitivity reaction and it's pretty well described, especially with Neomycin. They love to actually test that on exams. And then I think maybe I guess one final thing I can mention is that these amino glycosides actually have the ability to block neuromuscular receptors, they can block the nicotinic acetylcholine receptor. So they can cause muscle weakness, the neuromuscular blocking agent. So many times if that is testable, it will be testable in the context of a person having like some kind of my apathy on neuromuscular disease. For example, gentamysin is maybe not a good idea in people that have a history of like my asteregraphis for example. Or let's say you have ALS, or let's say you have like a mitochondrial disease, remember those things tend to cause muscle problems. You probably should not be taking an amino glycoside on the neural circumstances. Now, the next class of drugs I'm going to talk about right now, the Lyne disease drugs, aka tetracyclins. The tetracyclins, very, very important. The classic ones you will be seeing exams, going to be things like doxycycline, things like aminocycline, those are kind of like the big ones. Remember tetracyclins, they are the drugs of choice for chlamydia infections.

They have the drugs of choice for chlamydia. You know, back in the day, we should be like, oh, let's try microlytes for chlamydia. I'm not saying you can only use microlytes, but tetracyclins are just much better, right? Lowering of treatment failures. And actually, believe it or not, tetracyclins can cover merse. Believe it or not, they do actually have the ability to cover merse. So, a person has a chlamydia infection of any sort. Then you want to consider a tetracycline very, very strongly, very, very strongly. If a person has working mountains, spotted fever. Remember those therash on the palms and soles? Tetracyclins is also amazing for that. Tetracyclins is also part of the quadruple therapy for H by lorry. Remember, triple therapy for H by lorry is clarifromycin, amoxicillin and appi. But, quadruple therapy is also something that can be used to treat H by lorry. That's a combination of metronidazole, bismuth, tetracyclins, and appi. So tetracyclins can be used in the treatment regimen, quadruple therapy for H by lorry. So, again, rocking all these spotted fever, russian palms and soles, rickets here, ricketsi, tetracyclins are good for those. And then don't forget that tetracyclins are good for lying disease. Everyone that has lying disease gets a tetracycline. Simple as that. Okay? Everyone that has lying disease gets a tetracycline. Doesn't matter whether you're under a jate, over a jate, when you're using these days, everyone that has lying disease gets what?

Say it after me. Tetracycline, very good. Right? Everyone is going to get tetracycline. Again, in general, the only people that you try to think twice about giving tetracycline to are people that are pregnant. But even pregnant women can't take tetracycline. But, if you see a US Emily question, and you don't put tetracycline as an answer for lying disease in the pregnant woman, you can pick something like amoxicillin or you can pick something like sephiroxin, something like amoxicillin or sephiroxin, something like amoxicillin or sephiroxin. So, you can just kind of keep these things in mind with tetracycline. The thing is tetracycline. One of the things they love to test with them is that they are very powerful key leaders. So, there are certain drugs that will not work as well if you're taking a tetracycline. So, see, for example, like you're taking a fluoroquin... I mean, sorry. Whoops. Tetracycline is not the key leaders. Sorry, sorry. I take a quick step back. Tetracycline is not key leaders. But they can be key-led by antithesis. Yes, that's what I wanted to say. So, they're collected by antithesis. So, tetracycline's, key-led by antithesis, fluoroquinolones, key-led by antithesis, liverthyroxin, key-led by antithesis, bisfosphonites, key-led by antithesis. Those are all things that can be key-led by antithesis. They cannot be key-led by antithesis. Okay? They cannot be key-led by antithesis. And again, remember that tetracycline's associated with photo sensitivity.

There's a little photo sensitivity. You know, just one of those weird things you want to keep in mind, for example. In fact, there are certain drugs that are associated with photo sensitivity where you want to try to avoid the sun if you're taking these drugs. And the harmonic is sat for photo, sat for photo. Photo sensitivity. And then the S stands for sulfonamides, the A stands for the amino glyphoramide, sorry, sorry, for aminode-iron, and then the T stands for tetracycline's, the T stands for tetracycline. And then please also do not forget that tetracycline's can also be to treat acne. They actually be pretty good for the management of acne. But what if our friends at the USML Es give you a question about a person they're taking tetracyclines for acne. And then for the last couple of weeks they've been having like, morning headaches, especially like a obese female, having morning headaches, blurry vision, and everything, think of pseudo tumor cerebride, think of pseudo tumor cerebride. So actually, pretty pretty high yield to know that tetracyclines, they can, they are one of the potential triggers for pseudo tumor cerebride. Remember, at least these we call that idiopathic intracranial hypertension, idiopathic intracranial hypertension. That's pretty pretty high yield to know for, for example. So they can be one of those triggers. Okay? They can be one of those triggers.

Okay, so again, I remember, you know, tetracyclines, they can cause problems with the bones and kids, their teradragents for that reason, right? They can cause tooth dyschloration as well. Okay, now how about the macrelates? Let's go ahead and talk about the macrelates, right? So remember the macrelates? There's a bunch of them, right? There's a rhizromycin, there's a rhizromycin, there's chlarythromycin. I've already talked about chlarythromycin. That it's very, very good. It's part of triple therapy for H by lorry, part of triple therapy for H by lorry. Is it rhizromycin many times? We use it for a bunch of things on exams, right? It's more like a second-line Asian for chlamydia infections, as I've mentioned. And if you also see a walkin pneumonia, so you see like a low grade fever, usually non-productive cough, interstitial pneumonia, the person between ages 20 and 40 on the USMEL exams. And usually they're going to have that pneumonia for days. That's a walkin pneumonia. Remember, the most common cause of walkin pneumonia is microplasma. Is microplasma. Is it rhizromycin is very, very good for walkin pneumonia. It's very, very good for walkin pneumonia. And many times when people come in with a COPD exacerbation and they have like interstitial infiltrates in their lungs and we need to give them an antibiotic, we love giving easy thromycin because easy thromycin is good from the perspective of covering most of these typical organisms.

But it also has like some anti-inflammatory properties, so it's actually pretty good for that purpose as well because people that have COPD, they have a lot of inflammation within their lungs. They have a lot of inflammation within their lungs. And remember, through my cell, we actually, the macrolis, we can also use them for pertussis, right? You see a person that has like cough plus, what do I mean by cough plus? You see a person that coughs so hard that they blow the blood vessels in their eyes, so they have like a subconjunctival hemorrhage. We see a person that coughs so hard and the person vomits after they cough, but he coughs so hard and they have a syncopal episode after they cough. Then you want to show that that's pertussis. Macrolis are beautiful, beautiful, beautiful for pertussis. Something we want to keep in mind for exams. And then you see a diabetic that has neuropathy, especially of the stomach like diabetic gastroparesis. Macrolis are very, very good for that purpose. Macrolis are phenomenal for that purpose. They're good because remembering thromycin especially is a mutiny receptor agony. So because he can stimulate mutiny receptors, he can encourage GI motility. You don't remember for diabetic gastroparesis, we can also use metoclopromide. Don't forget metoclopromide and all the potential extraperamidol side effects that he can cause. Okay, all the potential extraperamidol effects it can cause. So remember macrolis are very, very good.

Again, they can cover microplasma, they can cover chlamydia, but again, they are more second line. But the also the treatments of choice for legionella. Again, remember legionella, you're going to see something about water exposure, humidifiers, waterfalls, HVAC systems. You see a person that has interstitial pneumonia, especially in smokers. We can see it as an outbreak in a hospital, believe it or not. Think about legionella. Legionella is treated with macrolis. Okay, legionella is treated with macrolis. Legionella is treated with macrolis. Again, these things, they may seem benign, but I promise you they're very, very high you to know for for example. Okay, they're very, very high you to know for example. And even like you can use a topical, remember like if we're trying to prevent new needle conjunctivitis, we can use topical erythromycin or topical tetracycline.

Although remember, those things only prevent gulococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococ ocococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococ ocococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococ ocococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococococ I guess I should say with Markerless that I forgot to mention is that Markerless can prolong the QT interval.

Okay? Markerless can prolong the QT interval. Just one of those ways is you want to keep at the back of your mind for example. And then Linizolid. Linizolid is another drug I'm going to talk about. The good, actually, clean the mysine covers mercer. I shouldn't forget that. Clean the mysine actually does cover mercer. Linizolid. This next drug I'm talking about. It also covers mercer as well. It also covers VRE. It's a pretty good drug for covering like various histanine infections, mercer VRE. The big thing I just want to know about Linizolid though is that Linizolid is also a monominoxidase inhibitor. It's also an MAOI. So it can boost your levels of serotonin. So if you're taking another serotonin energy drug, believe it or not, Linizolid can trigger. Linizolid can literally trigger serotonin syndrome under the USMELIS. USMELIS exams. So just kind of keep that at the back of your mind for a test. I'll say that's pretty much everything we need to know about Linizolid. Okay, and then the next group of drugs I'm going to go to are the fluoroquino loans. I'm going to go to the fluoroquino loans. The fluoroquino loans. So the fluoroquino loans, they're pretty, pretty high-owned drugs. Although these days we try to avoid using them if possible because they can certainly cause a lot of cutie prolongation. They can cause problems with rupture of the tendons. Remember fluoroquino loans, they all end in floxicin. The only exception to that is a Nali Dixic Acid.

Nali Dixic Acid is a fluoroquino loan, but it's not deemed like the others. Again, you can already see that, oh, if this drug kind of stands out, you can already see that, hmm, afraid that the USMELIS may love that. Again, the USMELIS, sometimes they love to kind of pick on drugs and don't sound like the others in the class. Just FYI, just something to keep in mind. What are some classic drugs that feed this bill? Again, like I said, Nali Dixic Acid is a fluoroquino loan, but it doesn't sound like the floxicin of the other fluoroquino loans. Another classic drug that also feeds this bill is ethycranic acid. Ethycranic acid is a lube diuretic. It's one of these lube diuretic you can use in people that have sulfur allergies because it doesn't have sulfur groups in it for the most part. It's not as such that it's sulfur allergies, right? Because remember all the other lube diuretics like things like fluorosamide, buometanide, the all-ending night, but or I'd. But you notice that, hmm, ethycranic acid doesn't sound like that. So you better believe that something that the USMELIS kind of cares about. Another classic one that kind of falls in that category at the Baviterates. Most of the Baviterates, the Ending Tau or Barbidon, right? Phenobarbidon, Amobarbidon, a phyopentum. But this is where one known as Primidon. Primidon is one of these drugs you can use to treat restless legs syndrome. It's a Baviter, believe it or not.

And it's actually very, very good for treating restless legs syndrome. So I just figured out just maybe kind of smodding some of those. Maybe actually, maybe let me give you one more bonus. Think of your benzodiazepines. Right? The all-ending palm alarm, right? A Prasolam, Lurazapam, blah, blah, blah, blah. But is this where one known as Clodazipoxide? Clodazipoxide. Clodazipoxide. Many of us know it as Libriam in the hospital. It's a long-actin benzodiazepine. Very, very beautiful. For pretty much preventing alcohol withdrawal. So if you know a person is an alcoholic, they come into the hospital and you're like, you know, man, I don't want you to have alcohol withdrawal. You can give them a Clodazipoxide prophylactically. It's actually very good for that purpose. I'm going to go ahead and maybe stop that. Let's go back to Lisa antibiotics. Okay. So the fluoroquino lote. Remember the intubate bacterial DNA chyrids, right? DNA basically tubalized summaries in bacteria. Again, I remember I've said the problem with the Q-team provol. They associated with tendon rupture. But we use them for a bunch of stuff, right? The key thing I would say is that they cover pseudomonas. They actually have very good pseudomonal coverage. But there's a few other things that are kind of associated with these drugs that I think you should know. They're actually really good for many respiratory infections, especially like there are some of them like, for example, like moxifloxicin, level foxicin.

But I would say maybe more like moxifloxicin, very good for covering respiratory infections. Okay. Very, very good for covering respiratory infections. And also don't forget that you can use fluoroquino loses as SBP-perphylaxis. Spontaneous bacterial parotonitis, perphylaxis. So if for example, you know, people that get SBP-perphylaxis, usually people that have either had SBP-perphylaxis before or they've had varicil bleeds. And those people, fluoroquino loses are actually very good as perphylaxis in SBP. Because again, fluoroquino loses can cover ground negatives. I remember like, equal like something like equal like which is one of the more common causes of SBP. Okay. Remember, SBP is going to present as a person that has ascites, mild abdominal pain, fever. And they'll have like some very subtle, altered mental status. But that's a pretty, pretty classy presentation for SBP. Again, just something to kind of keep in mind there. And again, if you like the way that I'm integrating concepts, I will encourage you to consider my review classes. I actually have a bunch of review classes coming up. I have a test-taking strategies class next week, Thursday, which is the 15th of June. 2.5 hours is for step 1 to step 3. I have a biostatistics class next week for ID. It's four hours. It's from 4 to 8 p.m. Pacific Standard Time. And then I also have a social sciences and ethics class. It's a quality improvement, healthcare systems, communications class, next week Saturday, the 17th.

From 3 to 8 p.m. Pacific Standard Time. It's a 5 hour class. Also for step 1 to step 3. And then I have a 20 hour step 2 step 3 review. It's also good for people taking shelf exams. It's going to be taking place from the 19th to the 23rd of June. Although won't be million on the 21st. Again, all these classes, if you like the way I integrate things, if you like the way I use clinical presentations, instead of throwing facts at you, many people love these classes. And honestly, for my biostat class and whatnot, there's almost no lecture. My classes are not lecture-based. They are all scenario-based. They are all practice-problem-based. So you're going to get a lot from those. And again, I'm not very big on just throwing you facts without giving you context, without giving you understanding pathophysiology. If you're interested in any of those things, any of those classes, just ship me an email. Those classes will take place through Zoom. Okay, so let's go ahead and continue. So let's maybe go to metronide.zo. Metronide.zo is actually a pretty important job to know about, for example. Remember, metronide.zo covers an aerobus very, very well. Covers an aerobus very, very well. Back in the day, we used it as first-line for CDF. But we didn't do that anymore because oral vancomaicin or fidaxomycin are pretty good for CDF. So these days, we use metronide.zo for other things. It's more like a second and third-line agent for CDF.

But again, remember, it covers an aerobus very, very well. Covers an aerobus very, very well. And remember, I said that metronide.zo can be used as part of courtable therapy for H. Bylori. Remember, a set courtable therapy is metronide.zo, bismuth, tetracycline, and a PPI. Tetracycline and a PPI, Perton pump, inhibitor. We also use metronide.zo for a bunch of infections in OB-GYN. Like for example, we use it for bacterial vaginosis. Remember those clue cells and the vaginal pH being greater than 4.5, and that fishy smell. We use bacterial vaginosis. We can use metronide.zo. You can also use metronide.zo for, you know, it's close causing teeny-dazole. We can use that for trichomon ISS. Remember, trichomon ISS, you're going to see those motel protists. And again, the vaginal pH is also going to be over 4.5. We use metronide.zo for those purposes. Just something we want to keep at the back of your mind for, for example. And we also use metronide.zo for other things. Actually, there's this famous demonic known as get gap on the metro. Get gap on the metro. So what does that stand for? Well, the G stands for Ganyela vaginalis. The E stands for intamiba histolidica. Remember, E histolidica causes bloody diarrhea. It's one of these protozoan infections that can cause bloody diarrhea. It can also be associated with a liver abscess. We also treat that with metronide.zo. And in the T stands for trichomon ISS. Right? Again, we can also use it for G-RDL infection.

Remember, G-RDL is actually a cause of travelers diarrhea these days. Long-term travelers that are not a couple of days, a couple of weeks of travelers diarrhea. We can use G-RDL. Remember, G-RDL infection is also common in people that have immunoglobulin deficiencies. Like IgD deficiency, or you have like brutons, or you have like a seavid. Because again, if you have a deficiency of IgD, then you can't fight the G-RDL very well. You can get a lot of G-RDL infections. The drug of choice for G-RDL infection is going to be metronide.zo. Okay, it's going to be metronide.zo. It's going to be metronide.zo. Okay, it's going to be metronide.zo. Okay, so you're just going to keep that at the back of your mind as you're studying for your exams. Remember, metronide.zo is also a pseudoididisol from effect. So it has the ability to inhibit enzyme known as acetaldehyde dehydrogeny. So if you're taking metronide.zo, you should not be drinking at the same time. That's not a very smart idea. If you're going to get that diso from like effect. Okay, and then real quick, just grab back, run through a few other antibiotics. Don't forget like your TB drugs, right? Ryefampine, isoniasate, pyrozymenin, ethythamide ethythambutol. Remember, if you're pressing as active TB, they're going to be symptomatic. We're going to give them the right regimen and vitamin B6 because isoniasate can cause a B6 deficiency. Remember, ryefampine is neuron hepato toxic. Same thing with isoniasate.

Isoniasate is also neuron hepato toxic. Remember, I mentioned I think in the first podcast in this series that ryefampine can be used as close contact perphylaxis. If you've been around the present, the hadmaline gochoco infection. Remember, ryefampine can also cause your urine to look red. It can cause your secretions, not just your urine, your icy creations, your ear secretions. They can look red, they can look orange. Okay, just keep that in mind. And again, ryefampine occasionally is used in the treatment of endocratitis. Especially again, I said that many endocratitis regimens, whatever bizarre reason, have been comisin, gentomisin, and ryefampine associated with them. Okay, so again, something you want to keep in the back of your mind, for example. Although remember, lithin TB. Lithin TB is treated differently from active TB. Lithin TB is going to be a person that has a positive TB skin test or a positive interval gamma release assay. And then you notice that the long, the chest texture is fine. That's going to be lithin TB. You're going to treat that with just isonizing and b6. The other regimens, but again, the estimated is love to focus a lot on isonizing and b6. I'm not going to discuss the other regimens. They don't really make sense as much or far any discussion in this podcast. And then don't forget ryefampine can also use your treat to a leprosy. And for pricy, it has micro-bacterium leprosy. Usually those people are going to get a bunch of drugs.

I think they take you for almost like two years. It's a pretty crazy regimen. I think it's like dapsone ryefampine and adrogonone as clophazamine. For leprosy, dapsone ryefampine and clophazamine. Again, ryefampine is a pretty, pretty good drug. It's actually a pretty, pretty good drug. So that's something I want to keep at the back of your mind for, for example. I can also use ryefampine, believe it or not. If you've been around a person that has heech flu, he more flows influence the infection. Ryefampine is actually also pretty good for perphylaxis. Again, remember I said ryefampine is also good as perphylaxis. If you're around a person that has a misermin and jaidis infection. Especially if you're, again, encounter those people's droplets. Because remember, misermin and jaidis is transmitted by its respiratory droplets. I can just something I want to keep in mind for exams. I soize it really. I used only for TB. I used pretty much only for TB. Again, remember I can cause peripheral neuropathy. Again, it can cause B6 deficiency pretty much. It inhibits the enzyme that activates B6. You're not going to have active B6 in your body, so you're going to have a B6 deficiency. So you're just going to keep that in mind. And then don't forget, you know, pure xenomide. There's no real side effect that we're going to talk about. I didn't really test that on the exams. But I thumb you to tell you, definitely want to know the association of ethymbutyl.

You want to know the association of ethymbutyl with optic neuropathy. You can cause a red-green column blindness. So one of these weird, bizarre things that you want to keep in mind. Remember, dejuoxing is a drug. It's not an antibody, but it can also cause problems with the eye. These drugs that cause eye problems are pretty high, you'll know for exams. Like, dejuge and it's yellow vision that it can cause. Ethymbutyl, the red-green column blindness, it can cause. And then hydroxychloroquine. Hydroxychloroquine can cause a red-nopathy. Believe it or not. In fact, people that tick hydroxychloroquine, they need to get an MRI exam. Because it can cause some kind of a red-nopathy. Something you want to keep out the back of your mind as you study. Again, sorry, I'm not just kind of speeding out the remaining things here, but I want to wrap this podcast up here. I don't want to go to a series three for this stuff where we're going to be done here pretty soon. And then, don't forget, drugs like your cell phone amines. Your cell phone amines, they're pretty important drugs to know about. Actually, maybe let me say one more thing about ethymbutyl. Ethymbutyl, one of the high-yield things to know about ethymbutyl is that you can use it to treat mycobacterium marinum infection. You can also use it to treat mycobacterium-avium complex. For a person who has a mark infection, ethymbutyl is actually really good. So, actually, let me just cause this.

You want to treat mycobacterium marinum or you want to treat mycobacterium-avium. You use the triple drug regimen of chlorythromycin ethymbutyl and rifampin. Chlorythromycin ethymbutyl and rifampin. Again, something you want to keep in mind for, for example. And then, remember, it's cell phone amines, right? Like, try methyprinxyl and phoxes all. We use it for many, many different things. We can use them to treat like, you know, like neurosis, it's your Vecti-TMP-SMX. It's pretty good for that. We can also use TMP-SMX to treat myrsa. Especially like myrsa skin infections. TMP-SMX is pretty good for that, for that purpose as well. For not for that purpose, for those purposes as well. I remember Toxoplasmosis T-Gondii can also be treated. Remember those ring and the hands-in lesions in the brain of a HIV patient. TMP-SMX is good as prophylaxis, right? Many, maybe, make a fine distinction here. Just look at me, Mosisis-Drovetsi. Mosisis-Drovetsi, you can treat that and you can prophylaxis against it with TMP-SMX. Okay? Backtrick, TMP-SMX. But, if you want to prophylaxis against Toxoplasmagondii, you also use TMP-SMX. Especially if your city floor is under 100. Remember, for PCP, city floor under 200. But, to treat Toxoplasmosis infection, we do not use TMP-SMX. We use the drug known as a pyramidamine and so forthodizing. It also is also a sulfonamide, basically works like a sulfonamide. But pyramidamine and so forthodizing is what we used to treat Toxoplasmagondii.

But, we prophylaxis against Toxoplasmagondii with TMP-SMX. A lot of these weird factoids kind of seems low-yield, but it's actually pretty high yield to know, for example. And then, don't forget that we also use TMP-SMX to treat, I mean, many UT Is, right? So, like, cystitis, pylon and fritis, you can certainly use pymethybromesopharmethoxis all for those purposes. You can certainly, certainly use TMP-SMX for those purposes. They actually cover ground negatives pretty well. So, that's something I keep in mind for example, if I were you. Remember, tri-mythrolyphyrinsophyrinthoxis all works like an inechannel blocker. It actually kind of works like a myriad of tri-mythroid. So, you can cause hyper-kelimia. You can cause hyper-kelimia. And remember, it's a very powerful oxydicein agent. So, maybe not the best idea in a person that has G6 PD deficiency. You can certainly trigger crises in those people. And don't forget that tri-mythrolyphyrinsophyrinthoxis all as well. I don't know, there's one more thing that's kind of coming to mind here than I want to talk about. Yes! So, phonymites. So, phonymites can cause a drug-induced lupus. Remember, they are a little drug-induced lupus because remember, there are a bunch of drugs that can cause drug-induced lupus. Remember them with the, you know, sulfonamides, they're hydralazine, they're isonizine, which I've talked about as well.

There's a phanytoin, there's perkinamide, there is etanersept, etanersept is a TNF inhibitor, some of those decoy receptors, right? Again, just all these weird things where factors to keep in mind. Again, one of these, this podcast is as high as possible. I want you to listen to this, this is like episode 460 and 461, and just get a ton of questions right on your exams. Okay, and then let's see, they need all their antibiotic and want to talk about. Honestly, if you're like, you know, maybe Vorikonazol, or Iconazol is now good for, in Vcvasperginosis, pretty good for that perspective, it's actually the first line treatment for in Vcvasperginosis. Second line is monvotericin B. Remember, I prefer tericin B, we can use it for basically very serious fungal infections. Many times, we're going to use it to treat like mucomaricosis, it's the drug of tericin macrosis. We can use it as a second line treatment for in Vcvasperginosis, or in Vcvcaldidol infections. Remember, you can also use anvotericin B. If a person has, you see a HIV patient meningitis from like cryptococcus neiformins, and for B is also pretty good for that purpose, right? It's also pretty good for that purpose when people have meningitis, right, from cryptococcus neiformins, we're going to give five flu sideosin and anvotericin B as treatment. And then long term, for like nine to 12 months, we give them flokonazol to reduce the risk of recurrence.

And then, another thing I guess I want to see in terms of antibiotics, I don't forget drugs like paromomizing and mitosoxamlite, they're used to treat diarrhea in HIV patients, especially from cryptosporidium paromom. And then don't forget it's traconazol, we love, love, love, intraconazol, because we can use it's traconazol to treat many of these termarophyte infections. Although we can also use it for these, you know, these endemic fungal respiratory problems, like histoplasmosis or coxidiumicosis in this intraconazol is pretty good for that purpose. It's traconazol is pretty good for that purpose, okay? It's traconazol is pretty good for that purpose. And then don't forget that we can use like topical permetrein to treat like scabies, for example. Remember, you can also use like a topical, like actually this like porcelain photorecine B to treat cutaneous lishmaniasis, okay? Remember, cutaneous lishmaniasis can be treated with liposomalamphotorecine B, just something you want to keep in mind, for example. Again, at this point, I'm just talking about miscellaneous antibiotics. Remember, you can also use oral terbenafino-grisio-fulvin to treat tiniya, but only tiniya of the head, tiniya capetes, or tiniya of the nails, which is onychomaicosis. In general, for all the tiniya, like tiniya corpore is that involve the skin, you typically can use a topical isle, and that's going to be fine.

But if you're dealing with tiniya of the head, tiniya capetes, or tiniya of the nail, so nichomaicosis, you want to use an oral drug, drugs that can penetrate keratin, like oral terbenafino, remember, grizzio-fulvin is actually something that activates at a cronp 450, so you can increase the rate of metabolism of a drug. It's one of those drugs that operate at cronp 450. Remember, the Cp450 users are drugs like risio-fulvin, carburetum isa-pin, feint-toin, babituris, rifampin, so that's underplug for rifampin. St. John's word as well can also do that. So again, I think I kind of hit on many of these antibiotics. Honestly, I'm telling you, I say this with all humility, but episodes 460 and 461, if you master the information in these two podcasts. Most of the antibiotics you need to pick on your exams, for the right indications and what not, you're gonna pick them out very quickly, if you know these two podcasts code. Honestly, it's a lot of information, but I really hope that I've kind of helped you organize many of them pretty, pretty well. Again, I guess some antibiotics I did not talk about, obviously, yes. But again, those are probably more on the lower yield end of the spectrum. Okay, so thank you for joining me today. Again, I do offer one or one two to the end for step one to step three, preclinical med school exams, 30-ish-off exams, I have review courses for step one, step two, and step three.

I have these podcasts on the major apps, Apple Podcast, Google Podcasts on Spotify, and then I also have a You Tube channel, Divine Intervention, US Mly Podcasts and Videos. Just check that out. That's where I post the videos that I make. And then I also have a new website called Divine Intervention Lifelesses.com. That's where I post life lessons. Many people say, wow, I love the life lessons that you make. Yes, I do have a website that, you know, from a biblical perspective, I post two podcasts every week. I really have more than 180 podcasts on there. When I just talk about a life lesson, usually it's a 10 to 20-minute podcast from a biblical perspective. And I even have an Apple Podcast dedicated to that. It's called the Divine Intervention Lifelesses Podcasts. So check those out. Again, if you're interested in any of my review courses, shoot me an email through the website, and I'll give you some more information. So thank you for joining me today. Have a wonderful rest of your week. God bless you. I will see you next time. Thank you.

Nephrotoxic, ototoxic, and they can cause Type IV hypersensitivity reactions (especially Neomycin).

Tetracyclines.

Legionella pneumonia and Pertussis (whooping cough).

Alcohol consumption, due to the disulfiram-like reaction.

Tetracyclines (along with fluoroquinolones and bisphosphonates).

PCP prophylaxis (if CD4 < 200) or UTI treatment.

Aminoglycosides and Fluoroquinolones.

They require oxygen (aerobic environment) to enter the cell.

Ethambutol, Tetracyclines, and sometimes Chloramphenicol (though not explicitly listed as such in this transcript, it is a common association). Focusing on the text: Ethambutol and Tetracyclines are mentioned for vision issues.

Pseudotumor cerebri (Idiopathic Intracranial Hypertension).

Macrolides (e.g., Erythromycin); they stimulate muscarinic receptors, improving GI motility.

Clarithromycin, Ethambutol, and Rifampin.

Rifampin.

Aminoglycosides and Fluoroquinolones.

They require oxygen (aerobic environment) to enter the cell.

Ethambutol, Tetracyclines, and sometimes Chloramphenicol (though not explicitly listed as such in this transcript, it is a common association). Focusing on the text: Ethambutol and Tetracyclines are mentioned for vision issues.

Pseudotumor cerebri (Idiopathic Intracranial Hypertension).

Macrolides (e.g., Erythromycin); they stimulate muscarinic receptors, improving GI motility.

Clarithromycin, Ethambutol, and Rifampin.

Rifampin.