thesingingstethoscope.substack.com]]>https://thesingingstethoscope.substack.com/podcastSubstackThu, 28 May 2026 22:52:32 GMThttps://api.substack.com/feed/podcast/5621728.rssThe Singing StethoscopeMusic that makes medicine more memorableepisodicThe Singing Stethoscopethesingingstethoscope@substack.comNoDoxycycline is the first line treatment for Chlamydia Rocky Mountain Spotted Fever and Lyme Disease So imagine you’re sitting on a dock by the sea (sounds like Doxycycline) And you’re eating clams (think Chlamydia) and Rocky Mountain oysters (Rocky Mountain Spotted Fever) With a squeeze of lime (for Lyme Disease) Doxycycline is the first line treatment for Chlamydia Rocky Mountain Spotted Fever and Lyme Disease You’re sitting on a dock by the sea (Doxycycline) Eating clams (think Chlamydia) and Rocky Mountain oysters (Rocky Mountain Spotted Fever) With a squeeze of lime (for Lyme Disease) Doxycycline is the first line treatment for Chlamydia Rocky Mountain Spotted Fever and Lyme Disease

This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit thesingingstethoscope.substack.com]]>https://thesingingstethoscope.substack.com/p/doxycyclinesubstack:post:170995131Sat, 06 Sep 2025 14:00:00 GMTThe Singing StethoscopeNo113Hepatitis C is Hepatitis Chronic It’s the most common cause of chronic liver disease It’s diagnosed with an HCV antibody test Followed by an HCV RNA test please It’s mostly transmitted through infected blood so IV drug users may be affected But now that newer antiviral meds are here A full cure is usually possible and expected Hepatitis D is Hepatitis Dependent Cause it requires a co-infection with Hep B So Hep B vaccination can be used for prevention And interferon alpha is how to treat it you see Hepatitis E is Hepatitis Embryo Because it usually resolves on its own Except for patients who are pregnant Then it can be a serious issue that’s full-blown

This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit thesingingstethoscope.substack.com]]>https://thesingingstethoscope.substack.com/p/hepatitis-c-hepatitis-d-and-hepatitissubstack:post:170993748Sat, 30 Aug 2025 14:00:00 GMTThe Singing StethoscopeNo142Hepatitis A for Hepatitis Acute Cause chronic infections are almost never found Hepatitis A for Hepatitis Anus The fecal-oral route is how it spreads around Now let’s talk about serology IgG anti-HAV tests for a past or chronic infection IgM anti-HAV tests for an infection that’s acute And there is a Hep A vaccine that’s used for prevention Hepatitis B for Hepatitis Baby Because vertical transmission is a common road And Hepatitis B for Hepatitis Bodily fluids Because sex and IV drug use are the other common modes IgG anti-HBc indicates a chronic infection Think IgG for gone because IgG anti-HBc Means the acute infection is gone And that’s how it should be IgM anti-HBc indicates an acute infection Think IgM for minute because IgM anti-HBc Means they’ve only had it for a minute And they’re still fighting it acutely Now hang in there, just a little more serology Anti-HBs is the Hepatitis B surface antibody with a B Which indicates either a booster, as in a vaccine or the patient has beat it and the infection has resolved completely HBsAg is the Hepatitis B surface antigen with a G Means the patient’s got it, it’s an active infection Hep B generally can be acute or chronic And there’s a vaccine that’s used for prevention

This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit thesingingstethoscope.substack.com]]>https://thesingingstethoscope.substack.com/p/hepatitis-a-and-hepatitis-bsubstack:post:170992494Sat, 23 Aug 2025 14:00:00 GMTThe Singing StethoscopeNo219It’s time to have fun, fun, fun Fun with antifungals With polyene antifungals, let’s begin These are amphotericin B and nystatin Swish and swallow nystatin liquid form For esophageal candidiasis it's the norm Fungal cells’ plasma membrane is made up of ergosterol And basically, these drugs tear holes in that wall They destroy the cell membrane’s structural integrity So just remember that “tear” is in ampho-TEAR-icin B You should also know these are heavy duty medications And heavy duty side effects are the expectation Amphotericin B can cause fever, chills, and other things Am-PH-PH-PH-tericin B, pretend you’re shivering, am-PH-PH-PH-tericin B There’s also the risk of electrolyte abnormalities Decreased potassium and magnesium are potential realities So remember ampho B as in am-FLOW-tericin B To remind you it might lead to nephrotoxicity We’re having fun, fun, fun Fun with antifungals Now the next class of antifungals, we’re on a roll Are the real a-holes also known as the azoles Like clotrimazole, ketoconazole, and fluconazole They simply inhibit the synthesis of ergosterol Also inhibiting ergosterol synthesis are the allylamines A couple of examples are terbinafine and butenafine Then there’s griseofulvin, which works like this It prevents fungal cells’ proliferation by inhibiting mitosis The last class of antifungal drugs are the echinocandins Like caspofungin, anidulafungin, and micafungin They inhibit the synthesis of cell wall beta-glucan So echinocandins, as in, e-kinda-can’t-do that man Hope you had fun, fun, fun Fun with antifungals

This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit thesingingstethoscope.substack.com]]>https://thesingingstethoscope.substack.com/p/antifungalssubstack:post:170291086Sat, 16 Aug 2025 14:00:00 GMTThe Singing StethoscopeNo204There are five generations of cephalosporins And I’ve got some clever ways You can remember them For the first generation we have Cefazolin and Cephalexin Now Cef-hAZ-olin sounds kind of like “has” And Cephalexin contains the word “ale” So the first question you want to ask is, Do you has any ale? That’s the first thing you might ask When you go to a friend’s house Do you has any ale? For Cef-hAZ-olin and Ceph-ALE-xin That’s the first generation Now we’re going to skip altogether The cephalosporins in the second generation There’s no easy way to remember this group So you’ll have to use the process of elimination But fortunately the third generation is easy All you gotta do is remember the number three You can fix things in three days with Ce-FIX-ime And “tri” means three in Cef-TRI-axone Cefo-TAX-ime reminds you people do their taxes Usually in the third month of the year And for Cef-TAZ-idime, just close your eyes And picture three TAZ-manian devils That’s the third generation Along the same lines, for the fourth generation We’ll focus on the number four Cefepime covers Pseudomonas, And that has four syllables: Pseu-do-mon-as So it goes with Ce-FOUR-pime That’s the fourth generation And last but not least, Ceftaroline Ceftaroline is in the fifth generation Think of a star with five points And say Cef-STAR-oline That’s the fifth generation There are five generations of cephalosporins And now you know some clever ways to remember them

This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit thesingingstethoscope.substack.com]]>https://thesingingstethoscope.substack.com/p/cephalosporinssubstack:post:169795933Sat, 09 Aug 2025 14:00:00 GMTThe Singing StethoscopeNo219Cytochrome P450 isoenzymes play a big role In the metabolism of certain medications They’re found in the liver and throughout the body And they’re the star of this song today, so congratulations Drug interactions are what you have to watch out for ‘Cause these enzymes’ activity can be affected By certain drugs and compounds, inducers or inhibitors And the effect of this on other meds is connected This mnemonic is all you need to remember The inducers of Cytochrome P450 “This CRAP GPS induces my rage” “This CRAP GPS induces my rage” — pretty nifty Now let’s break it down: C for Carbamazepine R for Rifampin A for Alcohol, chronic use P for Phenytoin G for Griseofulvin P for Phenobarbital S for Sulfonylureas These inducers increase the production and activity of the Cytochrome P450 isoenzymes This increases drug metabolism Which can cause a sub-therapeutic effect oftentimes This mnemonic is all you need to remember The inducers of Cytochrome P450 “This CRAP GPS induces my rage” “This CRAP GPS induces my rage” — pretty nifty Now let’s break it down: C for Carbamazepine R for Rifampin A for Alcohol, chronic use P for Phenytoin G for Griseofulvin P for Phenobarbital S for Sulfonylureas And on a test if a drug or compound isn’t an inducer Then it's likely an inhibitor by process of elimination Inhibitors decrease Cytochrome P450 activity Which can lead to toxic drug levels and higher concentration But just memorize the inducers And then you’ll be good to go “This CRAP GPS induces my rage” Now you're a pharmacology pro

This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit thesingingstethoscope.substack.com]]>https://thesingingstethoscope.substack.com/p/cyp-450-drug-interactionssubstack:post:169604817Sat, 02 Aug 2025 14:00:00 GMTThe Singing StethoscopeNo233When you write a prescription There’s a lot you need to know So sing along to avoid the most common mistakes And get it right from the get-go These are the ten rights of prescription writing 1. Right patient 2. Right date 3. Right drug 4. Right dose 5. Right frequency 6. Right route 7. Right number of refills 8. Right duration of treatment 9. The Right to informed consent 10. The Right to refuse treatment These are the ten rights of prescription writing If you want to be a hero Check your decimal points and zeros They always lead and never trail Always lead and never trail Point one milligrams (.1 mg) can look like one milligram (1 mg) So add a leading zero and write zero point one (0.1 mg) And one point zero milligrams (1.0 mg) might look like ten milligrams (10 mg) So drop the trailing zero and just write one milligram (1 mg) Here are the ten rights of prescription writing 1. Right patient 2. Right date 3. Right drug 4. Right dose 5. Right frequency 6. Right route 7. Right number of refills 8. Right duration of treatment 9. The Right to informed consent 10. The Right to refuse treatment These are the ten rights of prescription writing When you write a prescription Take your time and double check your work Always keep an eye out for patients’ allergies And be clear to avoid any guesswork

This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit thesingingstethoscope.substack.com]]>https://thesingingstethoscope.substack.com/p/the-10-rights-of-prescription-writingsubstack:post:169413295Sat, 26 Jul 2025 14:00:00 GMTThe Singing StethoscopeNo128Pharmacology is ever evolving So keep in mind that what you learn today Might be slightly out of date By the time you graduate When safety signals start to show Sometimes medications have to go Darvocet, an opioid was widely prescribed for years But fatal heart issues led to lots of tears Post-marketing surveillance is key We keep watching drugs even after they're released Phase IV never really ends Cause we're always tracking adverse events Cylert was a stimulant for treating ADHD But it was withdrawn because of severe hepatotoxicity Vioxx nearly doubled the risk of heart attack or stroke So it was pulled too cause that’s no joke But not every risky drug goes away completely Especially if it provides benefits uniquely Sometimes a strong warning is given instead So everyone’s informed about the risks ahead A black box warning was added for Celebrex Cause this COX-2 inhibitor increases the risk of GI events As well as the risk of heart attacks and strokes So the FDA decided they should warn folks Post-marketing surveillance is key We keep watching drugs even after they're released Phase IV never really ends Cause we're always tracking adverse events New data and updates can easily accrue So staying current is what you gotta do Post-marketing surveillance is key We keep watching drugs even after they're released Phase IV never really ends Cause we're always tracking adverse events

This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit thesingingstethoscope.substack.com]]>https://thesingingstethoscope.substack.com/p/when-drugs-get-withdrawnsubstack:post:169412768Sat, 19 Jul 2025 14:00:00 GMTThe Singing StethoscopeNo184The process of drug development Is something that’s quite relevant It has a lot of different steps And it’s kind of long and complex Preclinical studies are what happen first So starting here let’s get immersed Cell cultures or animals are used to check If a drug seems safe and has the wanted effect Then clinical studies, they come next Four phases take place with human subjects For Phase I the volunteers are healthy and strong Twenty to a hundred of them for several months long About two thirds of drugs make it to the next phase Because these are the ones that seem to be safe Phase II involves hundreds of folks with the target condition Checking for effectiveness is the primary mission It takes several months to two years to see And only 45 percent of these drugs move on to Phase III In Phase III it takes 1 to 4 years to collect data like a detective Confirming if a drug is both safe and effective Hundreds to thousands of patients participate But only five to ten percent of these drugs will graduate Phase IV begins after a drug hits the market To post-marketing surveillance we’ve gotta commit Monitoring for rare adverse events in the population To protect public health across the nation

This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit thesingingstethoscope.substack.com]]>https://thesingingstethoscope.substack.com/p/drug-development-processsubstack:post:169411943Sat, 12 Jul 2025 14:00:00 GMTThe Singing StethoscopeNo153Some drugs have the potential for dependence and abuse These controlled substances are consequential And Schedules I through V are used to help prevent misuse Schedule I is the most restrictive Cause these drugs like LSD and heroin Are highly, highly addictive So there’s no situation you’d prescribe them in Now something that might surprise you Is that at the level of the federal government Marijuana is considered Schedule I it’s true So “no accepted medical use” is what’s meant Controlled substances are a delicate dance Weighing risks and benefits in every circumstance From Schedule I to V, they're all clearly defined To help protect patients in both body and mind Schedule II includes drugs like oxycodone and Vicodin The potential for abuse is still pretty high Cocaine, Dilaudid, fentanyl, Adderall, and Ritalin Drugs like these aren’t always people’s ally With Schedule III like ketamine and testosterone The risk of dependence is moderate That’s what the research has shown So you still need to be smart about it Controlled substances are a delicate dance Weighing risks and benefits in every circumstance From Schedule I to V, they're all clearly defined To help protect patients in both body and mind Schedule IV drugs are ones like Xanax And its potential for abuse is relatively low So this doesn’t need to get too complex Then there’s Ambien and Valium too you know Schedule V is the least restrictive Because meds like Lyrica and Robitussin A.C. Are much less likely to be addictive So their potential for abuse is the lowest you see Controlled substances are a delicate dance Weighing risks and benefits in every circumstance From Schedule I to V, they're all clearly defined To help protect patients in both body and mind

This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit thesingingstethoscope.substack.com]]>https://thesingingstethoscope.substack.com/p/controlled-substancessubstack:post:169411405Sat, 05 Jul 2025 14:00:00 GMTThe Singing StethoscopeNo226Pharmacology as we know it today Was shaped by a lot of people along the way Around the fifteen hundreds this guy named Paracelsus Was a Swiss physician and alchemist He spoke with knowledge not yet widespread, “The dose makes the poison," he famously said This laid the groundwork for modern toxicology And he shifted things from plants toward chemistry In 1906 the Pure Food and Drug Act was passed It required ingredients to be accurately labeled at last Misbranded foods and drugs could no longer be sold Between states in the U.S. that’s how this story unfolds In 1912 Congress added the Shirley Amendment An early attempt to regulate drug labels’ content Fraudulent claims about cures were made illegal But it was still hard to prove the fraudulent intent of people Pharmacology as we know it today Was shaped by a lot of policies along the way The Federal Food, Drug, and Cosmetic Act was passed in 1938 Leading to the drug approval process we still use today Manufacturers are now required to prove drug safety Before they market products that could cause a tragedy This was a response to what happened with sulfanilamide An antibiotic that killed over a hundred far and wide A liquid version was released with children in mind But the medication and a toxic chemical were combined A couple decades later there was another tragedy Thalidomide affected over ten thousand babies When pregnant women were nauseous they took the medication But it caused severe birth defects and major deformations This triggered the Kefauver-Harris Amendment of 1962 And Good Manufacturing Practices were established too Proving drugs were safe and effective became the priority And the FDA was given a lot more authority Pharmacology as we know it today Was shaped by a lot of policies along the way In 1970 a new system for controlled substances was created Classified into five schedules so they could be better regulated Its name is kind of a mouthful, now that’s a fact The Comprehensive Drug Abuse Prevention and Control Act By 1997, some more updates were needed And the call for reform was finally heeded When the FDA Modernization Act passed It created a fast-track approval process at last The goal was to bring beneficial drugs to market more quickly Of course without compromising patient safety Companies could also share off-label use information Which changed drug advertising across the nation Pharmacology as we know it today Was shaped by a lot of policies along the way

This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit thesingingstethoscope.substack.com]]>https://thesingingstethoscope.substack.com/p/a-brief-history-of-pharmacologysubstack:post:169410665Sat, 28 Jun 2025 14:00:00 GMTThe Singing StethoscopeNo248When studying feels like too steep a slope Sing along with us at The Singing Stethoscope Keep learning even when you're on the go And ace those exams with all the songs you know

This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit thesingingstethoscope.substack.com]]>https://thesingingstethoscope.substack.com/p/trailersubstack:post:169404538Sat, 21 Jun 2025 14:00:00 GMTThe Singing StethoscopeNo39