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Prikvačeni tweet
1/ Aminoglycosides have poor activity against gram-positive organisms. So why can they be used in combination with a beta-lactam for some gram-positive infections? “Synergy” has always been my justification, but I’ve never understood the true mechanism….
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The use of daptomycin for infections caused by viridans group streptococci is NOT recommended
VGS can rapidly develop resistance to daptomycin despite in vitro susceptibility
https://www.ncbi.nlm.nih.gov/pubmed/25624330 Hvala. Twitter će to iskoristiti za poboljšanje vaše vremenske crte. PoništiPoništi -
#OTILT The presence of Cushing’s Triad (below) is a sign of increased intracranial pressure. - Bradycardia - Decreased, irregular respirations - Systolic hypertension (wide pulse pressure)Hvala. Twitter će to iskoristiti za poboljšanje vaše vremenske crte. PoništiPoništi -
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#OTILT Hypercapnia in COPD patients receiving oxygen is NOT due to decreased respiratory drive
Rather, it’s due to ventilation-perfusion mismatch and the Haldane effect.Prikaži ovu nitHvala. Twitter će to iskoristiti za poboljšanje vaše vremenske crte. PoništiPoništi -
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5/ When used on their own, neither antibiotic is ideal for IE due to enterococci. Gentamicin has poor entry across the cell membrane and ampicillin is bacteriostatic. In combination, ampicillin helps facilitate intracellular uptake of gentamicin for a rapid bactericidal effect.
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4/ Is gentamicin improving the activity of ampicillin or vice versa? From what I found, the mechanism of aminoglycoside synergy has only been described for enterococci.
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3/ While it may not be preferred in some instances, it’s still an option. In this case, synergy implies that the combination of a beta-lactam and an aminoglycoside (ampicillin + gentamicin) is more effective than either on their own.
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2/ In my (limited) experience, the combination is most commonly used in endocarditis. The IDSA endocarditis guidelines list a gentamicin-containing regimen for the treatment of IE caused by enterococci, viridans group strep, and (prosthetic valve) staphylococci.
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Lastly, Gulf War Illness may be present in a substantial amount of Veterans who fought in the Gulf War. Up to 1/3 of Gulf war veterans (~250,000) show symptoms of Gulf War Illness.
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The cause of Gulf War Illness is still debated. Here are some of the proposed causes: - Low-level exposure to sarin gas - The use of pyridostigmine as an anti-nerve gas agent - Pesticide exposure
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Gulf War Illness is due to chronic CNS inflammation. Symptoms are largely non-specific and may include tremor, memory issues, fatigue, headache, and more.
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I recently heard about Gulf War Illness for the first time. As a VA pharmacy intern, I had learned a lot about Agent Orange exposure, but never Gulf War Illness. Here’s what I learned!
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Cefiderocol has activity against resistant gram-negative organisms including pseudomonas and carbapenemase-producing organisms. It is INACTIVE against gram positives and anaerobes. Lastly, it should be reserved for patients with no alternative treatment options.
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#OTILT Cefiderocol (Fetroja®) is an IV cephalosporin recently approved for complicated UTI, including pyelonephritis. It's mechanism of entry into bacterial cells is very unique! As a siderophore, it binds to iron and uses the bacterial iron transport system for entry.Prikaži ovu nitHvala. Twitter će to iskoristiti za poboljšanje vaše vremenske crte. PoništiPoništi -
Lastly, GPA did NOT have a statistically significant association for invitation to a pharmacy residency interview.pic.twitter.com/jvBbVDfejC
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Cannabis has multiple drug interactions. Pharmacokinetic drug interactions are related to CBD, while pharmacodynamic drug interactions are related to THC. Renal clearance increases in obesity. However, the increase is not proportional to the increase in body weight.
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High dose cefepime may cause neurotoxicity. Despite its labeling contraindication, propofol is likely safe in patients with egg allergies. At high doses, ketamine activates opioid receptors. However, its pain-relieving effects are not reversed by naloxone.
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Voriconazole displays non-linear kinetics. For posaconazole and itraconazole, oral and liquid dosage forms are NOT bioequivalent. Shock Index (SI) may be used to assess blood loss and degree of shock. SI = HR/SBP
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