GYN Pharm STIs
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| DOC for Chlamydia trachomatis | Azithromycin 1gm oral single dose (AE: GI)or Doxycycline 100mg x 7d BID (Sun sensitivity)
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| A person infected with Chlamydia trachomatis is also likely to be infected with Gonorrhea and should be treated with: | Ceftriaxone 100mg IM in a single dose, Azithro 2g x1 (less optimal b/c hard on GI)
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| DOC for Pharyngeal gonorrhea | Ceftriaxone
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| Gonorrhea tx for quinolones | Not recommended due to increasing resistance. Also in pregnant women, Quinolones can cause cartilage defects.
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| Tx of gonorrhea in Pregnancy | Cephalosporin regimen (no quinolones or tetracyclines); Azithro or amoxicillin for presumptive or diagnosed chlamydial infection
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| Tx for Disseminated Gonococcal infection | Ceftriaxone 1g IV or IM q 24 hr. Tx until 24-48 post sx resolution. Need at least 1 week of antimicrobial therapy
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| When treating for PID, cover the likely microbes: | C. trachomatis, N. gonorrhea, Anaerobes (B. fragilis)
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| PID tx | Regimen A: Cefotetan 2gm IV q 12h plus Doxy 100mg IV or po q 12hr. Can d/c parenteral tx 24 hr post clinical improvement. Regimen B: Clindamycin plus Gentamycin. 14 week tx
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| Yeast infection | Topicals: Diclucan, Nystatin. Oral: Fluconazole (not in pregnancy, topicals only)
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| Complicated Yeast infections | pregnant, diabetic. Tx longer: 7-14 days
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| Bacterial Vaginosis Tx | Flagyl BID x 7d. No alcohol (may cuase Disulfram-like Rxn). Educate: metallic taste, urine discoloration, can take with food to minimize GI upset
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| Can you treat STDs in pregnant women? | yes, avoid topicals. Flagyl is category B
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| Trichomonas tx | Flagyl 2g oral single dose. Can also use Tinidazole 2g oral in a single dose
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| Tx of Primary Syphilis | Benzathine penicillin G 2.4 million units in single dose
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| Tx fir Secondary syphilis | Same as primary. Benzathin penicillin G 2.4 million units in a single dose
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| Tx for late latent or latent syphilis of uknown duration | Benzathine penicillin G. 7.2 million units total, administered as 3 doses of 2.4 million units IM each at 1week intervals
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| Tx for tertiary or neurosyphilis | Aqueous crystalline penicillin G. Tx over 10-14 days.
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| In a primary or secondary syphilis pt with a PCN allergy, use | doxycycline 100 mg BID for 14 days
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| Jarisch-Herxheimer Rxn is caused by the tx of which disease? | Syphilis. Occurs 6-12 hours post tx. Will subside in 24 hours and poses no danger
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| Tx for HSV | Acyclovir TID 7-10 days, Valacyclovir 1g orally BID 7-10 days.
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| When should HSV suppressive tx be considered | >/= 6 recurrences/yr
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| Deliver option if a pregnant woman is having an active HSV infection at due date | Needs a C Section
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| Expedited Partner therapy in NC | Status: Possibly allowable
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| For which illnesses is it not recommended to tx the partner? | Vaginal candidiasis, Bacterial vaginosis
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