Module 2 Collaborate transcript
Lifespan/Antimicrobials
Speaker 1: A is do a quick review of the antibiotics and highlight a couple of other things that are
important, and then we're going to go through the questions. I'm going to go through
the antibiotics pretty quickly, but you will have the notes to look at. It kind of narrows
down these antibiotics where you can see kind of what I want you to know about them.
But I will tell you about antibiotics: if there's one thing that you can't remember other
than this, is you have to match the bug with the drug. You cannot prescribe an antibiotic
if you don't know what you're treating. And so in an instance where you don't know
what the bug is, then you're going to start broad. And then once the culture comes back,
if you can give a more narrow spectrum antibiotic, then you're going to back off.
Speaker 1: But most of the time we kind of know, like with upper respiratory infections, with
pneumonia, with those types of infections, we know what the most common causative
organisms are. And we know whether they're gram-positive or gram-negative. So this is
what I want you to remember. If you can remember this throughout your prescribing
once you leave this class, then you know a lot about prescribing antibiotics. And that is
there are three main gram-positive bacteria. Everything else is gram-negative. Your
gram-positive bacteria are strep, staph, and enterococcus. And pretty much everything
else is gram-negative.
Speaker 1: There is some atypicals that are gram-positive besides those three. But these are the
three main ones. So if you can remember that, then you already know a lot because you
know that most of the time you're going to be dealing with gram-negative bacteria.
There's only ... Penicillin pretty much covers gram-positive bacteria. So that helps you a
lot if you can just understand that those are your three gram-positive bacteria. Pretty
much everything else is gram-negative. And as we go through the systems, when we
study respiratory, when we do the eye and the ear drugs, those things, then we'll learn
more specifically about the common causative organisms of those.
Speaker 1: Be sure to review [Dr. Rippinger's . But mine as well that I posted in the course because
some test questions come from that and especially some of the questions on the
antimicrobial recall quiz. As for lifespan, just review the lifespan video and you'll do fine
on the questions that are on the test involving lifespan. As you know, we used to use the
A, B, C, D, and X categories for pregnancy. Those are no longer effective June of 2020. All
drug companies have to comply with the new pregnancy lactation and labeling rules. I
go into pretty good detail on that in my lecture. I actually did a presentation on the new
labeling law at TNP Conference this September because a lot of people didn't even know
about it. So review your lifespan. There is a lot of lifespan questions as well on here that
we'll go through.
, Speaker 1: I'm going to do a quick down and dirty review of the antibiotics. As far as the antivirals,
TB, and HIV, if you listen to the lectures, review the transcripts, that's what I recommend
doing is reviewing the transcripts while you're listening to the lectures. Then if you have
questions, then go to the textbook. I don't think it's possible to read every single page of
the reading assignments in this course. We do have a good textbook. I like the Lehne
textbook, but use your time wisely.
Speaker 1: Redo the review quizzes, the practice quizzes that I have posted for the HIV, the STDs, all
of those because you're going to be tested on that. So I would definitely go through
those review quizzes. You can take it as many times as you want. I would try to be honest
when I'm taking it and answer it. And then go back and see what I missed. And if I miss
something, I'd go back and review that in the module because that's how you learn, and
that's how you remember.
Speaker 1: So we're going to start with penicillins. And penicillins are one of the first antibiotics that
ever came out. They work because they weaken the bacterial cell wall. The problem with
penicillins is they have a beta-lactam ring. And these bacteria that produce beta
lactamase slit this ring, and it renders the penicillin inactive.
Speaker 1: So what we had to do is come up with something that prevented the beta-lactamases
from invading that ring. And that's where we came up with the beta-lactamase
inhibitors, such as a Clavulanic acid, Tazobactam, and Sulbactam. So when you use these
in combination with the penicillins to help with the beta-lactam, the producers.
Speaker 1: So Penicillin. One of the first antibiotics. Major problem with penicillin is allergies. But
most people don't have a true allergy to penicillin. A true allergy is anaphylaxis. So most
people can actually get penicillin. You have penicillin G and penicillin B, which are your
narrow spectrum. They work well for Strep and syphilis. You have Amoxicillin and
Ampicillin, which are broader spectrum. They work well for strep, acute otitis media, and
Lyme disease.
Speaker 1: That's for Lyme disease in children under eight. Anybody over eight, Tetracycline is the
medication. Or Doxycycline is medication of choice for the treatment of Lyme disease.
You cannot give Tetracycline to anyone under the age of eight because of the teeth
staining. Macrolides are the drug of choice for patients that have allergies to penicillin.
So if you're treating a patient for strep throat and they're allergic to penicillin, you want
to go to a macrolide. The narrow spectrum penicillins with penicillinase resistance are
Oxacillin, Nafcillin, Dicloxacilin. And these three work for staph aureus and staph
epidermis. Don't need to memorize these. Then the Dicloxacilin, Nafcillin and Oxacillin
can be given PO.
Speaker 1: Then you have Ticarcillin and Piperacillin, and these are effective against Pseudomonas
and Enterobacter, Bacteroides fragilis and Klebsiella. Beta-lactamase inhibitors, we
already went over those. The ones that are combination are Amoxicillin in Clavulanate,
which is Augmentin, Ticarcillin, and Clavulanic acid. Piperacillin and Tazobactam, which
these are effective against Pseudomonas. These do not cover MRSA. Okay? MRSA is
methicillin resistant.
Lifespan/Antimicrobials
Speaker 1: A is do a quick review of the antibiotics and highlight a couple of other things that are
important, and then we're going to go through the questions. I'm going to go through
the antibiotics pretty quickly, but you will have the notes to look at. It kind of narrows
down these antibiotics where you can see kind of what I want you to know about them.
But I will tell you about antibiotics: if there's one thing that you can't remember other
than this, is you have to match the bug with the drug. You cannot prescribe an antibiotic
if you don't know what you're treating. And so in an instance where you don't know
what the bug is, then you're going to start broad. And then once the culture comes back,
if you can give a more narrow spectrum antibiotic, then you're going to back off.
Speaker 1: But most of the time we kind of know, like with upper respiratory infections, with
pneumonia, with those types of infections, we know what the most common causative
organisms are. And we know whether they're gram-positive or gram-negative. So this is
what I want you to remember. If you can remember this throughout your prescribing
once you leave this class, then you know a lot about prescribing antibiotics. And that is
there are three main gram-positive bacteria. Everything else is gram-negative. Your
gram-positive bacteria are strep, staph, and enterococcus. And pretty much everything
else is gram-negative.
Speaker 1: There is some atypicals that are gram-positive besides those three. But these are the
three main ones. So if you can remember that, then you already know a lot because you
know that most of the time you're going to be dealing with gram-negative bacteria.
There's only ... Penicillin pretty much covers gram-positive bacteria. So that helps you a
lot if you can just understand that those are your three gram-positive bacteria. Pretty
much everything else is gram-negative. And as we go through the systems, when we
study respiratory, when we do the eye and the ear drugs, those things, then we'll learn
more specifically about the common causative organisms of those.
Speaker 1: Be sure to review [Dr. Rippinger's . But mine as well that I posted in the course because
some test questions come from that and especially some of the questions on the
antimicrobial recall quiz. As for lifespan, just review the lifespan video and you'll do fine
on the questions that are on the test involving lifespan. As you know, we used to use the
A, B, C, D, and X categories for pregnancy. Those are no longer effective June of 2020. All
drug companies have to comply with the new pregnancy lactation and labeling rules. I
go into pretty good detail on that in my lecture. I actually did a presentation on the new
labeling law at TNP Conference this September because a lot of people didn't even know
about it. So review your lifespan. There is a lot of lifespan questions as well on here that
we'll go through.
, Speaker 1: I'm going to do a quick down and dirty review of the antibiotics. As far as the antivirals,
TB, and HIV, if you listen to the lectures, review the transcripts, that's what I recommend
doing is reviewing the transcripts while you're listening to the lectures. Then if you have
questions, then go to the textbook. I don't think it's possible to read every single page of
the reading assignments in this course. We do have a good textbook. I like the Lehne
textbook, but use your time wisely.
Speaker 1: Redo the review quizzes, the practice quizzes that I have posted for the HIV, the STDs, all
of those because you're going to be tested on that. So I would definitely go through
those review quizzes. You can take it as many times as you want. I would try to be honest
when I'm taking it and answer it. And then go back and see what I missed. And if I miss
something, I'd go back and review that in the module because that's how you learn, and
that's how you remember.
Speaker 1: So we're going to start with penicillins. And penicillins are one of the first antibiotics that
ever came out. They work because they weaken the bacterial cell wall. The problem with
penicillins is they have a beta-lactam ring. And these bacteria that produce beta
lactamase slit this ring, and it renders the penicillin inactive.
Speaker 1: So what we had to do is come up with something that prevented the beta-lactamases
from invading that ring. And that's where we came up with the beta-lactamase
inhibitors, such as a Clavulanic acid, Tazobactam, and Sulbactam. So when you use these
in combination with the penicillins to help with the beta-lactam, the producers.
Speaker 1: So Penicillin. One of the first antibiotics. Major problem with penicillin is allergies. But
most people don't have a true allergy to penicillin. A true allergy is anaphylaxis. So most
people can actually get penicillin. You have penicillin G and penicillin B, which are your
narrow spectrum. They work well for Strep and syphilis. You have Amoxicillin and
Ampicillin, which are broader spectrum. They work well for strep, acute otitis media, and
Lyme disease.
Speaker 1: That's for Lyme disease in children under eight. Anybody over eight, Tetracycline is the
medication. Or Doxycycline is medication of choice for the treatment of Lyme disease.
You cannot give Tetracycline to anyone under the age of eight because of the teeth
staining. Macrolides are the drug of choice for patients that have allergies to penicillin.
So if you're treating a patient for strep throat and they're allergic to penicillin, you want
to go to a macrolide. The narrow spectrum penicillins with penicillinase resistance are
Oxacillin, Nafcillin, Dicloxacilin. And these three work for staph aureus and staph
epidermis. Don't need to memorize these. Then the Dicloxacilin, Nafcillin and Oxacillin
can be given PO.
Speaker 1: Then you have Ticarcillin and Piperacillin, and these are effective against Pseudomonas
and Enterobacter, Bacteroides fragilis and Klebsiella. Beta-lactamase inhibitors, we
already went over those. The ones that are combination are Amoxicillin in Clavulanate,
which is Augmentin, Ticarcillin, and Clavulanic acid. Piperacillin and Tazobactam, which
these are effective against Pseudomonas. These do not cover MRSA. Okay? MRSA is
methicillin resistant.
