Hey everyone, I'm embarking on a new way to help myself two fold: practice my brush lettering skills, and keep up to date on my pharmacology while I'm on APPE. It seems silly, but the only way I know how to study is to write it all out, and then write out some more. Even more silly, my recall kind of sucks even as an APPE student. So why not combine studying with my newest hobby and kill two birds with one stone!? For those of you who have never heard of brush lettering, it's a a more modern form of calligraphy, and it's addicting to practice. I'm pretty novice, but again, practice makes perfect!

So this is brush letter pharm! My first drug series will be antibiotics because I'm currently on an emergency department rotation and infectious disease is 85% of what I see!

Vancomycin: a glycopeptide antibiotic that may as well be in the water with how much we use it.

Mechanism of action: It inhibits bacterial cell wall synthesis by binding D-Ala-D-Ala and preventing the cross-linking of peptidoglycan. This makes it bactericidal.

Spectrum of coverage: C.diff (but must be taken orally for this!), gram positive organisms: MSSA, MRSA, strep

ADR: phlebitis, nephrotoxicity, red man syndrome

Fun facts:

• Resistance present in enterococcus (VRE), and S.aureus (VISA and VRSA)
• Red man syndrome may look like an allergic reaction, red rash of the face and upper torso plus pruritis and hypotension but it is actually an infusion reaction. Solution? Slow the infusion rate!
• Therapeutic drug monitoring parameters for Vanco depend on the indication being treated, but are usually either 10-15 mg/dL or 15-20 mg/dL
• Vanco was first isolated in 1953 and was named in the likeness of the word "vanquish"
• Early formulations of the drug were extremely impure and caused a lot of toxicity to the kidney. This led to vanco being nicknamed "Mississippi mud"