Abx

[PAGuy77]

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So I've been looking into which Abx treat which pathologies and why. For instance, why do we love nitrofurantoin for UTI, but we rarely if ever give it for pyelo? I did the research, it seems the same bugs typically are involved with both with the exception of proteus, which has high resistance to nitrofurantoin and is susceptable to bactrim and rocephin. That's the sense I could make out of it anyway. I would love to have a stormer grasp of Abx and their coverage and what to go to in case of allergies etc. I use EMRA which I think is great, and I downloaded bugs and drugs which shows local SMS national resistance. I feel like my attendings have such a strong grasp of Abx and their coverage, I hate giving a med because "that's what we give for pneumonia." I really want a good understanding. Am I on the right track? Anyone know of a good app/website that breaks it down well?

 

[emtthink]

Nitrofurantoin doesn't concentrate well in the kindeys (or the prostate), which is why it isn't given for pyelo. I'm a medical student still, but I've been liking the free Epocrates program/app.

 

[VA Hopeful Dr]

Spend the money to get the Sanford Guide. Don't argue, just do it.

 

[Daiphon]

Hopefully you learned this in M2 pharmacology.

Nitrofurantoin has very poor tissue penetration, but high renal excretion. Thus, good for urine bugs; bad for kidney bugs.

As for "this is what we give for pneumonia," well, sometimes that's what you have to do as places have different antibiotigrams... getting your hands on this from pharmacy may help.

 

[RustedFox]

Hopefully you learned this in M2 pharmacology.

Nitrofurantoin has very poor tissue penetration, but high renal excretion. Thus, good for urine bugs; bad for kidney bugs.

As for "this is what we give for pneumonia," well, sometimes that's what you have to do as places have different antibiotigrams... getting your hands on this from pharmacy may help.

Username: PAguy77.

Look, I'm not trying to bash on your level of competence. But this is the difference between MD school and PA school, and its what I've been saying in several other threads.

MD: Learn drug. Learn mechanism. Understand use and effectiveness. Integrate basic chemistry/physiology.
PA: "That's what drug we give for (this disease)." Period.

 

[Daiphon]

Username: PAguy77.

Didn't catch that. Agree with you on all points.

-d

 

[emtthink]

Hopefully you learned this in M2 pharmacology.

Nitrofurantoin has very poor tissue penetration, but high renal excretion. Thus, good for urine bugs; bad for kidney bugs.

As for "this is what we give for pneumonia," well, sometimes that's what you have to do as places have different antibiotigrams... getting your hands on this from pharmacy may help.

We do learn this in M2 pharmacology (I'm currently an OMS2), and our professor definitely pounded it into our heads

 

[goodoldalky]

Come on y'all.. He's asking a question. No need to turn this into MD vs PA..

 

[Daiphon]

Come on y'all.. He's asking a question. No need to turn this into MD vs PA..

We're not. The OP asked where to learn this - the answer is M2 pharmacology.

One can thus extrapolate that the text for said course - like Lange, Goodman/Gilman, or Katzung - may provide the answer they seek.

-d