My biggest weakness...

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Gifted Hands

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...Is antibiotics. Ugh I hate them. I've always been hammered whenever I got pimped on which antibiotic I should start with. I'm about to start intern year and I would really like to work on getting a better grip on this before I make an ass of myself on the floors.

Does anyone know a good podcast or resources to read? Any help is appreciated.

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My biggest weaknesses are that I work too hard and that I care too much.
 
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My biggest weaknesses are that I work too hard and that I care too much.

You could say that my biggest weaknesses are my strengths.

Very clever micheal
 
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...Is antibiotics. Ugh I hate them. I've always been hammered whenever I got pimped on which antibiotic I should start with. I'm about to start intern year and I would really like to work on getting a better grip on this before I make an ass of myself on the floors.

Does anyone know a good podcast or resources to read? Any help is appreciated.

You shouldn't be drinking before rounds first of all.

Don't stress antibiotic knowledge comes easily within the first couple of weeks in intern year, it wasn't my strong point either, but its really easy to pick up. Each place has their own AB regimen they use.
 
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You shouldn't be drinking before rounds first of all.

Don't stress antibiotic knowledge comes easily within the first couple of weeks in intern year, it wasn't my strong point either, but its really easy to pick up. Each place has their own AB regimen they use.
It's 5pm somewhere man!
 
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...Is antibiotics. Ugh I hate them. I've always been hammered whenever I got pimped on which antibiotic I should start with. I'm about to start intern year and I would really like to work on getting a better grip on this before I make an ass of myself on the floors.

Does anyone know a good podcast or resources to read? Any help is appreciated.
I really like the EMRA abx guide for empiric treatment. Doesn't have any in dept stuff or guides to antibiotic resistant organisms or anything, but it's enough to get you through the majority of cases and it is a hell of a lot easier to read than sanford.
 
What I've learned/done - whenever you're rotating at a new hospital, you ask the staff pharmacist/intern/etc what bacteriogram they use. Hospitals have different preferences on what to use/what they want to use that isn't the go-to in all cases. Show up - get bacteriogram and be prepared. You'll learn that what they teach you isn't what you use.


All else fails - Vanc/Zosyn/Cefepime with a touch of Zithro.
 
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What I've learned/done - whenever you're rotating at a new hospital, you ask the staff pharmacist/intern/etc what bacteriogram they use. Hospitals have different preferences on what to use/what they want to use that isn't the go-to in all cases. Show up - get bacteriogram and be prepared. You'll learn that what they teach you isn't what you use.


All else fails - Vanc/Zosyn/Cefepime with a touch of Zithro.

The empiric treatment for most things doesn't vary that much based on local resistance patterns. Antibiogram does come in handy for UTIs though.

P.S. Why the cefepime? Unless you have some ridiculously sick VAPs, you rarely need the double coverage for pseudomonas :p
 
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The empiric treatment for most things doesn't vary that much based on local resistance patterns. Antibiogram does come in handy for UTIs though.

P.S. Why the cefepime? Unless you have some ridiculously sick VAPs, you rarely need the double coverage for pseudomonas :p

lol

I figured I'd throw in the 4 most commonly used antibiotics in the ICU I've heard. I could've added Amphotericin B, too. Gotta make sure you're extra broad, right?
 
The empiric treatment for most things doesn't vary that much based on local resistance patterns. Antibiogram does come in handy for UTIs though.

P.S. Why the cefepime? Unless you have some ridiculously sick VAPs, you rarely need the double coverage for pseudomonas :p

Please don't ask about medicine on these forums. A lot of the medicine i read here is questionable. And i usually get shouted at. Also these forums aren't about medicine, its about making fun of people, abusing dermatology residents and @Arkangeloid personal online psychiatric clinic
 
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Make a spreadsheet with drug/class/effect/sidefx/other, and study it. Gotta go ham on the sheets before you go ham on the sloots, namsayin?

92% in Pharma, haters be jelly
 
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you only have one drug, per family, and they aren't even in any order. If it works for you i guess its fine, but i could never learn it like this

Dude, the point of med school isn't to learn medicine, it's to memorize what you're told to memorize and spit it out on the exam, and forget it later. My spreadsheet consolidates what the professors told us to learn, and I write the bare minimum on it.
 
Dude, the point of med school isn't to learn medicine, it's to memorize what you're told to memorize and spit it out on the exam, and forget it later. My spreadsheet consolidates what the professors told us to learn, and I write the bare minimum on it.

This is exactly why he needs help with antibiotics in the first place
 
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This is exactly why he needs help with antibiotics in the first place

Oh.

Well then, I'm at a complete loss as to what to do. I don't know anything about medicine, I just know how to repeat simple word associations on multiple choice exams, and tailor my studying accordingly.
 
Oh.

Well then, I'm at a complete loss as to what to do. I don't know anything about medicine, I just know how to repeat simple word associations on multiple choice exams, and tailor my studying accordingly.

i cant tell if you are joking or being serious
 
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Ignoring the Priapism4tooLong/Arkangeloid circle jerk above and adding one last post on this thread before I'm out:

No one gives a **** on the wards if aminoglycosides bind the 23S subunit, the 50S subunit, or the 291034823905798034275S subunit. Not even ID. The OP is a graduating M4 about to start residency, not an M2 about to take Step 1. The spreadsheet given above is useless and spending time memorizing it expecting it to help you on the wards would be an utter waste of your effort. What you actually need to know is the basics of coverage (does it cover gram +? gram -? anaerobes? pseudomonas? MRSA?), the routes of administration, and some information on whether they penetrate lungs/urinary tract/soft tissue. Combine that with a basic understanding of what organisms cause what kind of infections and you can reason out why we pick the empiric treatments we do. That reasoning sharpens over the course of your clinical time, especially once intern year starts. Duration of treatment is really more of a crapshoot depending on the infection, and is usually a pretty arbitrary expert opinion that you will memorize over time.

That said, having a resource that lists the empiric treatments is useful for day to day activities, which is why I recommended something like the EMRA guide.
 
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If that info is useless, why do they force us to memorize it?
 
Anatomy isn't for a few weeks mang, still doing Cardio atm.

In any case, here's the spreadsheet I made. Kinda disorganized, but you get the idea. You should make your own tho.

https://docs.google.com/spreadsheets/d/1xxXMcJ9hKmcHD6G3P2zm3z0_HsziwYo4EFg-eKoXtr8/edit#gid=0
Uh, why not save yourself the trouble and just use PharmCards? And no offense, but your chart is ugly. By useless, it is "clinically" useless. It does however does make narcissitic medical students feel good about themselves that they think they know more than everyone else.
 
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Ignoring the Priapism4tooLong/Arkangeloid circle jerk above and adding one last post on this thread before I'm out:

No one gives a **** on the wards if aminoglycosides bind the 23S subunit, the 50S subunit, or the 291034823905798034275S subunit. Not even ID. The OP is a graduating M4 about to start residency, not an M2 about to take Step 1. The spreadsheet given above is useless and spending time memorizing it expecting it to help you on the wards would be an utter waste of your effort. What you actually need to know is the basics of coverage (does it cover gram +? gram -? anaerobes? pseudomonas? MRSA?), the routes of administration, and some information on whether they penetrate lungs/urinary tract/soft tissue. Combine that with a basic understanding of what organisms cause what kind of infections and you can reason out why we pick the empiric treatments we do. That reasoning sharpens over the course of your clinical time, especially once intern year starts. Duration of treatment is really more of a crapshoot depending on the infection, and is usually a pretty arbitrary expert opinion that you will memorize over time.

That said, having a resource that lists the empiric treatments is useful for day to day activities, which is why I recommended something like the EMRA guide.
Can you imagine an intern using this to learn antibiotics clinically to his attending? I would be ROFLing.
 
Uh, why not save yourself the trouble and just use PharmCards? And no offense, but your chart is ugly.

Yeah, I lost some of the formatting when I cut/pasted, also I think I was too lazy to label and separate things properly.
 
Can you imagine an intern using this to learn antibiotics clinically to his attending? I would be ROFLing.

Hey, bee nice. Pharm was my highest scoring class, and while I guess that medical school doesn't have much to do with medicine, making the spreadsheets worked for that purpose.
 
Yeah, I lost some of the formatting when I cut/pasted, also I think I was too lazy to label and separate things properly.
Well then no wonder it gets jumbled up in your head when you're memorizing it.
 
Hey, bee nice. Pharm was my highest scoring class, and while I guess that medical school doesn't have much to do with medicine, making the spreadsheets worked for that purpose.
I'm sorry but if an Internal Medicine intern was regurgitating this on the wards, he would get smacked down so fast by his attending it's not even funny. Whether an antimicrobial works on which part of the ribosome is not critical to normal clinical day-to-day medicine.
 
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I'm sorry but if an Internal Medicine intern was regurgitating this on the wards, he would get smacked down so fast by his attending it's not even funny. Whether an antimicrobial works on which part of the ribosome is not critical to normal clinical day-to-day medicine.

Agreed, but then why do they even make us learn that garbage in the first place. :(
 
Agreed, but then why do they even make us learn that garbage in the first place. :(
Bc it's basic science. It's a foundation for medicine. It's not medicine itself. Understanding the mechanism of action of drugs is important when treating for a pathogen. You don't just pick an abx out of a magic hat and see if it works.
 
...Is antibiotics. Ugh I hate them. I've always been hammered whenever I got pimped on which antibiotic I should start with. I'm about to start intern year and I would really like to work on getting a better grip on this before I make an ass of myself on the floors.

Does anyone know a good podcast or resources to read? Any help is appreciated.
Why not get a Sanford's Guide to help you on the wards with antibiotics?
 
Arghh, why isn't Ark's link to his pharm spreadsheet working for me?!
 
Do an ID consult rotation. You'll pick up at least the basics by the end of the rotation
 
Uh, why not save yourself the trouble and just use PharmCards? And no offense, but your chart is ugly. By useless, it is "clinically" useless. It does however does make narcissitic medical students feel good about themselves that they think they know more than everyone else.

Oh come on, don't you think that "narcissistic" is the last word on earth you would use to describe me?
 
Uh, just click on the link, princess. Don't worry, it's not worth looking at.
Princess already clicked, you genius you. the way you guys are describing it sounds like it gives away all the secrets to Arkangeloid's study habits.

Oh come on, don't you think that "narcissistic" is the last word on earth you would use to describe me?
No. Actually, the only thing you like to talk about is self. You have difficulty proceeding very far without linking yourself in. You aren't able to just get involved without immediately refocusing on yourself. There are even self-hating narcissists, you know? That's not a diagnosis.
 
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Ignoring the Priapism4tooLong/Arkangeloid circle jerk above and adding one last post on this thread before I'm out:

No one gives a **** on the wards if aminoglycosides bind the 23S subunit, the 50S subunit, or the 291034823905798034275S subunit. Not even ID. The OP is a graduating M4 about to start residency, not an M2 about to take Step 1. The spreadsheet given above is useless and spending time memorizing it expecting it to help you on the wards would be an utter waste of your effort. What you actually need to know is the basics of coverage (does it cover gram +? gram -? anaerobes? pseudomonas? MRSA?), the routes of administration, and some information on whether they penetrate lungs/urinary tract/soft tissue. Combine that with a basic understanding of what organisms cause what kind of infections and you can reason out why we pick the empiric treatments we do. That reasoning sharpens over the course of your clinical time, especially once intern year starts. Duration of treatment is really more of a crapshoot depending on the infection, and is usually a pretty arbitrary expert opinion that you will memorize over time.

That said, having a resource that lists the empiric treatments is useful for day to day activities, which is why I recommended something like the EMRA guide.

Please don't make fun of me and arkangeloids circle jerking, i cherish these moments.
and i completely agree.. no one cares about this in real life, i couldn't get to say that because i was in awe of how ridiculous his spread sheet was.

@Arkangeloid I think its time you find more efficient ways of studying. =).
 
No one gives a **** on the wards if aminoglycosides bind the 23S subunit, the 50S subunit, or the 291034823905798034275S subunit. Not even ID. The OP is a graduating M4 about to start residency, not an M2 about to take Step 1. The spreadsheet given above is useless and spending time memorizing it expecting it to help you on the wards would be an utter waste of your effort. What you actually need to know is the basics of coverage (does it cover gram +? gram -? anaerobes? pseudomonas? MRSA?), the routes of administration, and some information on whether they penetrate lungs/urinary tract/soft tissue. Combine that with a basic understanding of what organisms cause what kind of infections and you can reason out why we pick the empiric treatments we do. That reasoning sharpens over the course of your clinical time, especially once intern year starts. Duration of treatment is really more of a crapshoot depending on the infection, and is usually a pretty arbitrary expert opinion that you will memorize over time.

That said, having a resource that lists the empiric treatments is useful for day to day activities, which is why I recommended something like the EMRA guide.

The only (read ONLY) two places I've seen this **** have importance is in ID and Heme/Onc. I don't study this, but I did, which is apparent when during IM case conference an attending randomly asks "*to med students* What's the MOA of Rifampin?"
And I just garbage regurged "RNA Pol inhibitor" out loud not even knowing what I was saying. People looked at me and even I was surprised. Point is; I've only seen it used in pimping. Like asking where Heparin and Protamine Sulfate is extracted from (I mean, once you know where the latter comes from... you remember it forever when you're eating seafood)

Can you imagine an intern using this to learn antibiotics clinically to his attending? I would be ROFLing.

"Well, this Staph shows a resistance to this because it's found a way to mutate it's configuration to bypass the 30s ribosomal inhibitor"

Do an ID consult rotation. You'll pick up at least the basics by the end of the rotation

Or if you REALLY want to have fun; consult ID and say this:
"Yeah, we have this bacteria here and it's showing resistance to X, Y Z so we're just gonna put 'em on Vanc and Zosyn and, well, ya know, hope for the best. K?"

ID people are awesome. I love consulting them for infections because of how excited they get about this. It gets me excited. All like:

giphy.gif
 
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antibiotics are awesome once you've have a patient in front of you that needs you to make a decision on which one to use.
 
i love micro, i just wish it paid :(
 
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