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Medicine (MD/DO)
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First Aid
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First Aid for the USMLE Step 1 (2021)
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First Aid for the USMLE Step 1 (2021) | Medicine (MD/DO) School Study Aid

Page 190 -
5 Picmonics to Learn | 11 mins
Imipenem and Meropenem (Carbapenems)
Mechanism
Carbapenems
Broad-spectrum Antibiotic
Bactericidal
Indications
Gram Positive and Gram Negative Infections
Side Effects
GI Distress
Suprainfections
Seizures
Considerations
Penicillin Allergy
IV or IM Route
Imipenem Combined with Cilastatin
picmonic thumbnail
3 mins
Imipenem
Mechanism
Resistant to Beta-Lactamases
Broad Spectrum
Indications
Anaerobes
Gram-Negative Rods
Gram-Positive Cocci
Must Administer with Cilastatin
Cilastatin is Inhibitor of Renal Dehydropeptidase I
Side Effects
Diarrhea
Skin Rash
Seizures
Considerations
Meropenem
Stable to Dehydropeptidase I
Reduced Risk of Seizures (Non-Seizure Causing)
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2 mins
Aztreonam
Monobactam
Resistant to beta lactamases
Binds to penicillin binding protein (PBP)
Inhibit cell wall synthesis
No Activity on Gram-Positives or Anaerobes
Gram-Negative Rods
Non allergenic to penicillin
Synergistic with aminoglycosides
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2 mins
Vancomycin Mechanism
Bacteriostatic and Bactericidal
Gram-Positive
Inhibits Cell Wall Mucopeptide
Binds to D-ala D-ala
Resistance with Change to D-ala D-lac
Staphylococcus aureus
Orally for Clostridium difficile
Enterococci
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2 mins
Vancomycin Side Effects & Toxicity
Side Effects
Thrombophlebitis
Nephrotoxicity
Ototoxicity
Diffuse Flushing Called Red Man Syndrome
Prevent with Antihistamine
Prevent with Slow Infusion
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2 mins

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