#rifampin

[weirdpersonifiedpills]

Rifampicin (and the class of rifamycins as a whole) were named after a French noir film, Rififi (1955). Rifampicin itself stands for Rif-AMP-(m)icin, with AMP referring to its N-amino-N′-methylpiperazine substitution.

Who says we can't have the pharmaceutical equivalent the sonic the hedgehog protein.

That’s hilarious and when I design this med I will absolutely base it on said movie as well. Bros gonna have a fedora or something.

Also Rifa over here is another member of the “biblically accurate angel looking skeletal structure” club along with Vitamin B12

[cavaliersecondary]

i need to restart my probiotics im doing irreparable damage to my guts

[sonjabysonjamorgan]

incredibly proud of myself for the other day at work when i had to write down a medical word someone said and got it right. like i DID spell it wrong but it was phonetically 100% correct and that’s a win

[thatpunnyperson]

Hey, I felt like I might be wrong about something here, so I double checked and yep! I was 100% wrong about it being antivirals: its actually antibiotics. The two antibiotics are rifampin (turns things orange) and isoniazid (damages your liver). And thats just for what's called "latent TB" which is essentially the asymptomatic version of TB where you're not infectious or contagious, but the TB is in you and could reactivate.

For ACTIVE infections, you actually have to take BOTH of those meds, PLUS pyrazinimide and ethambutol, but only for the first few months, and then you take just the rifampin and isoniazid together for the rest of the time.

So sorry for the error, but I hope anyone interested in the correction sees this update. Stay safe out there

the anti-quarantine (a method of disease spread management known to be effective for several thousand years atp) hysteria is so bad that I’ve seen people push back on quarantining mandates for people with active TB infections. I really think we’re heading towards extinction atp.

[3amfanfiction]

MDNI tw: baby trapping and manipulation. GazxReader fluffy-dark one-shot.

Kyle is ready for a baby, so when he sees his chance he just can’t resist. And he knows how he’s going to make you an enthusiastic, albeit unknowing, participant.

He was ready.

It’d been a long time coming; you and he had had your ups and downs and always came out stronger on the other side, together. Always together. It was you and him until the end.

You were such a perfect partner for him, practically handmade to fill in all his rough edges and he never let you forget how much he adored you. He bragged about you any time you came up in conversation and wasn’t shy about crowing your achievements from the rooftop.

Your friends were over the moon at your relationship. Every time you met up for brunch or movie nights you would field at least 3 comments about where they could find their own head-over-heels partner.

You had been sick for a few weeks before you finally went to the doctor.

“Tuberculosis.” you rasp to Kyle on the other end of the phone. “They prescribed me some heavy duty antibiotics called rifampin that are the size of horse pills!” you hold the prescription bottle up towards the light and shake the tablets around in disbelief.

Kyle just laughs into your ear, well aware of how much you disliked needing to take large pills. It had been brought up every time one of you got sick throughout your relationship. You insisted that they got stuck in your throat and stayed there for hours before finally dissolving, no matter what Kyle tried to say. He used it as an excuse to brew your favorite tea and pamper you more than usual whenever you had to take them, so he never tried to argue too hard.

“I miss you . . . wish you were here,” you croak, making your way to the couch to relax and try to catch your breath. Your lungs felt physically tired as you tried to breathe. It was a unsettling feeling. Panting lightly, you pulled the blanket off the back of the couch and cocooned yourself, relaxing back into the cushions.

“I know sweetheart. I wish I was there too. I would make you that soup you like and rub your feet while we watched a movie. You wouldn’t have to get up for anything.” The line crackles and breaks for a few moments before clearing up again. “Just a little bit longer, love, and I’ll be able to come home. It’ll be before you know it.”

“I miss you Kyle.”

“I miss you, sweetheart.”

. . .

When the call ends Gaz immediately looks up the medication you said you were prescribed. Rifampin. He’s never had tuberculosis and he wants to verify that this is the standard treatment and if there are any side effects to watch out for. While he isn’t in the country right now he’d figure something out if you needed him back quickly.

Fingers which had been swiping steadily, reading warnings and side effects with the same attention to detail as to mission reports providing intel before an operation, slowed and then stopped as he continued to read. After a moment his screen goes dark and your future shifts and locks into place on the other side of the world.

. . .

It was edging into evening just over a week later when the front door swings open and in steps Kyle. You immediately throw yourself into his arms and begin fussing, hugging him and checking for any new injuries at the same time. He just laughs and squeezes you back tightly. “I’m fine love, just happy to be able to hold you again.”

After sorting out the immediate concerns you tumble into bed, cuddling face to face and sharing a pillow, sharing breath. You’re not sure who kissed who first but you’re both tied for ardor. Your tongues tangled together as hands slide under clothes and down pants. Before things got too involved you pulled back to look at him. “You’re going to have to pull out. This medicine can affect my birth control so you can’t come inside me okay?”

He nodded eagerly as he began to pull your shirt up your torso, fingertips dragging along skin in their own version of a kiss. “Pull out, got it.” He said distractedly, glancing down at the skin and softness he was uncovering. Before you knew it you were both naked and he moved his way down your body, taking his time to slowly work you up. Spending time nibbling along your coller bones, sucking a bruise into the hollow of your throat, tonguing around your neck to the other side to continue.

What follows is hours of pleasure and torture in equal measure. Kyle has never been a stingy lover but tonight it’s like he has something to prove. He brings you to your peak again and again and again . . . and then he holds you there.

While the two of you had dabbled in edging before this, it had never been to this extreme. Tonight had been hours of cruel pleasure, the sheets under you were damp with sweat and you were sobbing with your hands buried in his hair.

“Pl-please,” you hiccup on a sob “I need to come. Please let me-let me come.” you beg him, trying to maintain eye contact through your tears. He currently had three fingers buried deep in your cunt and his lips suctioned to your clit.

His lips pop off with a slurp and you yelp.“Do you need it, baby?” He grins with a feverish gleam in his eyes. “You ready to come?” You nod eagerly, blinking and causing the tears to spill over your lash line.

“Please, please I’ve been good. I’ve been so good, please let me come.”

“God you beg so pretty baby. Okay, but I want to come together.” He climbs to the head of the bed and lays on his back. He grabs you by the hips and helps you climb on top, slotting himself back at you entrance. “Come on, up on top love, thats it.” he babbles as you sink to the base and gasp at the feeling of being stuffed full. “Yes, Just like that, just like that.” is wrung from his throat as you squeeze him tightly.

You begin to pump your hips, pulling away from him before bringing yourself back down but you quickly lose steam. It had been hours at this point and you were on your last legs.

“I know.” Kyle coos condescendingly, brushing the back of his knuckles over your cheek, wiping away tears, sweat and drool. “I know sweet thing, you’re so tired. It’s gonna be okay. Look, I’ll help you.”

He reaches both hands down to your hips, digging his fingers into soft skin and plush rolls. His fingertips causing divots where they press into the fat of your hips. He pulls you into a grinding motion, “Doesn’t that feel good baby? Me holding your hips just right, helping you grind back and forth?”

You nod dumbly, brain fried and only able to think of how good he feels inside you. He drops one of his thumbs down to find your clit, giving it steady, smooth circles to help you finish.

“Yeah? Right there? I can tell it’s good just by your face. I love that fucking face that you’re making.” His mouth begins to run, words dropping out with no prior planning. “If I could tattoo it behind my eyes and carry it around with me for the rest of my life I would die a happy man. You make me so damn happy baby.” He grunts as he begins to move your hips faster, grinding you down firmly against him. “I want you forever, do you hear me? Forever. It’s you and me okay? Yeah, you’re getting close? I am too, love. Mmmm fuck. Just like that, keep rocking your hips baby and you’re gonna make me come. God you’re taking me so well. Tucked up, deep inside you.” His jaw clenches and he pulls you as tightly against him as he can.

“Fuck. I’m gonna come love. You’re gonna make me come.” His words stutter to a close as you continue to grind, chasing the final edge. You could feel it tingling up your legs, across the backs of your thighs.

“Im so close,” you pant, head tilted back, eyes closed, unable to think of anything accept the feel of his cock bumping into your soft walls, creating sparks of pleasure. “Don’t stop baby. I’m so close. I can’t stop. Please”

A groan punches out of Kyle and his grip turn tight enough to leave fingerprint bruises to find in the morning. “If you don’t want me filling you up, you gotta get off baby. I know you’re close but you’re gonna make me come. You told me to pull out just to, just to be safe. I can’t-i cant hold it baby. You’ve gotta get - get off or it’ll all be inside.”

He starts to stutter and lose rhythm still pulling you into him, rubbing your clit with his thumb.

You don’t hear him. A roar is building in your ears, a white noise type of hum that is blocking out everything else. You can feel your release digging its claws into you down to your bones as it gets ready to wrench you from your body.

Your knees begin to shake from their place beside Kyle’s hips as you finally get what you’ve been working towards for the past however many hours. Your vision whites out and your mind blanks.

You clench around Kyle’s cock. warm gummy walls pulsing around him, drawing him inside. You’re grinding down on him as hard as possible, his tip pressed against the back of your channel.

His eyes hold an unusual gleam right before he closes his eyes and tilts his head back, groaning his release as he pumps everything inside of you.

Later when you’re spooned together, his arms wrapped around your waist and legs tangled together, you don’t notice him cupping his hand around your lower stomach. He falls asleep with a smile on his face as he imagines his future together, with all three of you.

Next || Story Repository

[nerdgirlnarrates]

Medblr, I think we ought to have an antibiotics bracket. Just for fun. Everyone can submit their favorite antibiotic regimens and write propaganda for them (or anti-propaganda for the ones you hate) before we crown the one true antibiotic (regimen). Doesn’t have to be a single medication, it can be a combo. Here’s some of what I’m thinking of including:

vanc/zosyn

Azithromycin

Amp/gent

Rifampin/isoniazid/pyrazinamide/ethambutol

Augmentin

Cephalexin

Vanc/ceftriaxone

Amphotericin

Nitrofurantoin

Vote however you want—what you prescribe most, best side effect profile, most interesting mechanism, vibes, whatever. Let me know what other antibiotics you think I should include!

[askquarantinedredheart]

Volume 1: Isolation

First - Previous - Next - Last

Quick Mod Note: The rifampin turning body fluids side effect is normally noticed when the urine turns that color. I decided not to go that route because, while it's medical in nature, I'd rather not risk having the Tumblr mods/admins/whoever flag the related entry. Also, some people on this hellsite would ask way too many questions about it in the wrong way. Anyway, the body fluid color change side effect is pretty interesting because it actually means the drug is working! More to come about all the "fun" side effects that can occur from multidrug TB treatment.

[rocals]

seems like SOMEONE is experiencing the expected side effects of rifampin

[askpokeeosin]

Has this been killed and subsumed by Ask Quarantined Redheart?

Okay, I do feel like this does need to be addressed. The short answer is not quite but Ask Poke Eosin specific posts continuing forward are going to require a major change in the blog. Keep reading for the very long, probably rambling answer.

When I started the blog, I was on my holiday break after my first semester of my first year of medical school. My mental health wasn't quite in the toilet but it was getting pretty close. I think a lot of it had to do with the fact that I was struggling to get my studying flow down while still maintaining my hobbies, especially drawing. Couple that with getting depressed/burned out right at the end of that semester while binging Firestarter Spitfire/The Sunjackers and the decision to make this ask blog came about mid-ish December 2022. So I have this blog to thank a lot for helping to make my drawing hobby more consistent.

Now comes the part where I have to take an honest look at what I meant for it to be and where I'm at now. The original intent of the blog was to be this sort of educational blog about the current state of evidence based medicine and stuff that happens/happened to me during medical school, training, and onwards. That second part is the biggest problem. Poke is essentially me, the mod. The "Clinical Quiz" arc from a year or so back is something that happened to me and the way I (mostly) present it is how I tell the story to people in real life. While I doubt any of my colleagues care enough to dig deep for this blog, I still am dancing a little too close to doxing myself with the way the blog is currently.

Perhaps most importantly, I started my third year rotations back in the beginning of August. Pretty much the culmination of all the basic science lectures from the first two years, finally seeing actual patients! I soon realized, though, that I can't present these patients to the masses of the internet, even if they've been redrawn as cute technicolored magical ponies. Not just because of HIPAA issues but just because of the fact that just by going to the doctor and having a medical student like me asking them questions that they'd never answer in any other context. They are vulnerable and I feel like it would be unethical to present them as entertainment. I wouldn't necessarily be against drawing patient presentations but I would seriously need to figure out how to do it without revealing too much.

And finally, perhaps a more selfish reason: I feel like folks like Quarantined Redheart more. The project got its inspiration from a pharmacology lecture about tuberculosis medications during my second year. The fact that TB patients are required to quarantine for at least two months, Rifampin's red/orange body fluid quirk and it causing certain drugs to be metabolized faster, and a third plot point that I won't reveal just yet all came from that lecture. Originally, Quarantined Redheart was supposed to be a side project. The more I worked on it and the more that I fleshed out the plot and its characters, the more I came to love working on it to the point that I'd hesitate to call it a side project anymore. It also gave me the opportunity to say some stuff about the current state of healthcare that I feel like I couldn't do with what is essentially a self insert OC. Seeing that people really do seem to like the story that's being told made turning Quarantined Redheart into the main project a little easier. Is that a great reason to focus one's attentions on a project? Probably not. But it's also the curse of the artist: I draw what I want but the Notes notifications on my dash also lets serotonin stay in the synaptic cleft a little bit longer.

So is Ask Poke Eosin dead? I'm hesitant to say "yes" on that. I think there'll be more shitposts and random educational stuff than any of the full blown patient care stories that I originally thought I'd be doing. But I need to figure that stuff out for sure. Is Ask Poke Eosin dead? Nah. It's just hibernating right now.

[corneliaavenue-ao3]

Sirius black or if you want to practice a pedi ? - how about James Sirius?

Good luck - 🍀

Sirius - TB is a common disease that incarcerated patients obtain. Oh man there is so much to say about TB. Sputum stains acid-fast. There are two tests, the blood test, Quantiferon Gold Assay and the PPD skin test. If a patient has HIV, then an induration <5 then it is positive, At risk (health care workers), are positive <10mm, general population <15 mm. PPD tests are positive in latent, active, and those who have been vaccinated with the BCG vaccine, so a confirmation for an active infection needs to be done with a chest xray. Inactive TB is treated with 7 months of isoniazid and pyrazinamide. Active TB is treated with RIPE - Rifampin Isoniazid, Pyrazinamide, and Ethambutol. Side effects include red piss (rifampin), elevated Liver enzymes, sideroblastic anemia (isoniazid), B6 deficiency, red green colorblindness, and others.

James Sirius has ADHD. Diagnosis needs to be made at 2 different settings for >6 months. So most kids get diagnosed from input from their teacher at school and their parents at home. Hyperactive activity and distractibility. Treatment (which I needed to review!): First line is CBT and stimulants, methylphenidate and amphetamines. Those are considered controlled substances, so if the parent does not want them to have a controlled substance, can treat with nonstimulants like atomoxetine and alpha 2 blockers.

[owlservice]

The medicine was dismal this time around. House is convinced Anica has Cushing’s — and the symptoms did support it — but never checked a cortisol or ACTH level: the tests that prove the condition, no matter the size of the tumor. Rifampin was a poor choice of drug for Cameron to fool the patient with as it has some nasty side effects. There are safer drugs to use to turn someone’s urine orange. Even more damning was the fact that Anica was started on radiation without a bone marrow biopsy to prove that she had aplastic anemia in the first place.

Just another day at the medical malpractice factory

[mcatmemoranda]

The value of monitoring lamotrigine concentrations remains unestablished to date. Due to the pharmacokinetics between lamotrigine and other drugs and their effect on lamotrigine concentration, clinical judgment must be exercised during concomitant use if there are concerns regarding lamotrigine levels. Dofetilide can have a severe interaction with lamotrigine, and the combination is strongly discouraged. Other drugs with potential serious interactions include valproic acid, rifampin, estrogen-containing contraceptives, and estrogen replacement therapy medications, as well as certain barbiturates.

Labs should include pertinent serum levels of concurrent anticonvulsants, liver function testing, and renal function assessments. Clinical team staff should spend ample time educating patients on monitoring themselves for hypersensitivity, particularly rashes or other skin changes occurring near or on the mucosa. Patient education should also include discussing how to monitor for changes in seizures and their frequency and duration. Patients should also monitor for changes in suicidality, including suicidal thoughts and increased desire to commit suicide. Finally, patients should receive counsel on how to watch for signs/symptoms of aseptic meningitis.

[teachingrounds]

MSSA = Methicillin-Sensitive Staphylococus Aureus. Staphyloccocci are Gram Positive Cocci (ball-shaped bacteria that grow in clumps like grapes). "Aureus" ("gold," Latin) refers to this bacterium's gold-colored halo when it grows on agar in petri dishes. MSSA often lives on the skin; an infection can be treated with a first-generation cephalosporin such as cefazolin, or a blood-stream infection with nafcillin or oxacillin.

MRSA = Methicillin-Resistant Staphylococcus Aureus. Methicillin is no longer available commercially in the US, so this Gram-positive infection is diagnosed in vitro with oxacillin or cefoxitin and treated with vancomycin, linezolid, rifampin, and/or sulfamethoxazole-trimethoprim, sometimes in combination.

[thatpunnyperson]

The antiviral drug Rifampin causes orange urine, as well as orange bodily fluids in general! Not to drag them into this for no reason but @moggat had to do a course of rifampin a few years ago and would text me pictures of, like, the toilet after they'd peed and tissues after they'd blown their nose, and it was always this bright-ass almost fluorescent orange. Peak comedy, tbh.

Also if you eat a shit-ton of asparagus or broccoli, your urine sometimes gets a green tint to it.

[leanstooneside]

Body avalanche (TYPHON-HX)

• hips and legs

• clothes and books

• support but she

• bars and theaters

• friend and we'll

• flares and star

• fevers and brain

• politics and death

• scalp and hands

• driftwood and jellyfish

• emotions to habit

• Dapsone and Rifampin

• raincoat before they

• Zamora and Easy

• machines and lozenges

• me how you're

• tunnels but squatters

• days before Jonny

• bundles and circuit

• apartment so you'd

• phage but it

• flame and molten

• Virtue to tip

[nerdgirlnarrates]

Welcome to the Antibiotic Tournament!

It's about time we had a showdown between our favorite antibiotic regimens. First round start tomorrow (3/8): I'll post two polls a day, and they'll be open for a week. You can find the list of antibiotics below, but it's not too late to submit more--just reply to this post! You can also write propaganda for why your antibiotic should win, and I'll include it in the poll.

Vote however you want: best coverage, coolest mechanism of action, easiest dosing, best side effect profile, etc. You can find all the polls under the tag antibiotic tournament.

Let the games begin!

Current list of competitors:

Amikacin

Rifampin/isoniazid/pyrazinamide/ethambutol

Bedaquiline

Meropenem

Cephalexin

Ceftriaxone

Vanc/zosyn (pip-tazo)

Amp/gent

Vanc/ceftriaxone

TMP-SMX

Ceftriaxone/flagyl (metronidazole)

Fosfomycin

Ciprofloxacin

Levofloxacin

Tigecycline

Clindamycin

Azithromycin

Fidaxomycin

Erythromycin

Nitrofurantoin

Metronidazole

Linezolid

Augmentin

Penicillin

Flucloxacillin

Zosyn (Pip/tazo)

Doxycycline

Clofazimine