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314 Cards in this Set

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Fever
<36 degrees C or >39 degrees C
Normal UO
0.5mL/kg/hr
Drugs associated with drug fever
amphoterecin B, antibiotics, phenytoin
Most common pathogens in CAP requiring hospitalizations
1.strep pneumoniae
2.h.influenzae
3.mycoplasma pneumoniae
4.chlamydia pneumoniae
Most common pathogens in outpatient CAP
1.strep pneumoniae
2.mycoplasma pneumoniae
3.chlamydia pneumoniae
4.viruses
MIC of penicillin resistant pneumococcus
>2ug/mL
Pneumococcal resistance to penicillin is a marker of resitance to what antibiotics
macrolides, TCN, cephalosporin, TMP/SMX
Mechanism of resistance
alteration in penicillin binding proteins
H. influenzae beta lactamase production
30-40%
Moraxella catarrhalis beta lactamise production
90%
What can be used for beta lactamase producing h.influenzae and moraxella catarrhalis
2nd gen ceph, bactrim, FQ
What bacteria produce ESBL (extended spectrum beta lactamase)
ecoli, klebsiella
What can be used for ESBL producing bacteria
carbapenems, not cephalosporins
PCN susceptible (MIC <0.1mcg/mL) treatment
PCN or doxycycline, macrolide, cephalosproin, extended spectrum FQ
Intermeidate PCN resistance (MIC=0.12-1.0mcg/mL)
PCN or ceftriaxone 1g IV q24h or extended spectrum FQ
High level PCN resistance (MIC >2.0mcg/mL)
vancomycin 25mg/kg/day or extended spectrum FQ
6 risk factors for penicillin-resistant strep pneumoniae
1.age <2 or >65
2.b lactam treatment w/in 3 months
3. alcoholism
4. medical comorbidities
5. immunosuppressive illness or treatment
6. exposure to a child in a day care center
3rd generation cephalosporin indicated for penicillin resistant S.pneumoniae, b lactamase prodcuing H.influenzae, and MSSA
cefditoren (Spectracef)
cefditoren should be used in caution in who
patients with milk protein hypersensitivity
Protein synthesis inhibitor indicated for gram positive organisms including resistant staphylococcus and streptococcus
linezolid (Zyvox)
Zyvox side effects
thrombocytopenia, leukopenia, diarrhea, abdominal pain
New generation of antibiotic with 2 ribosomal binding sites indicated for mild-moderate CAP
telithromycin (Ketek)
Ketek coverage
enhanced coverage for strep pneumoniae with less resistance than macrolides

-S.pneumoniae
-H.influenzae
-M. catarrhalis
-Strep pyogenes
-C. pneumoniae
-Legionella pneumophilia
-M.pneumoniae
Ketek drug interactions
Strong inhibitor of CYP450 3A4
-digoxin
-theophylline
-sotalol
-rifampin
Ketek warnings and contraindications
warnings: acute hepatic failure
contraindications: myasthenia gravis
Ketek toxicities
-QTc prolongation
-exacerbation of myasthenia gravis
-hepatotoxicity
-visual disturbances
-loss of consciousness
Extended spectrum FQs used for pneumoniae
moxifloxacin (Avelox), gemifloxacin (Factive)
Gemifloxacin spectrum of activity
Staph sp, Strep sp, atypicals
Gemifloxacin adverse effect
phototoxicity
Smoker
H.influenzae, M.catarrhalis
COPD
H.influenzae
Poor oral hygiene
oral anaerobes
HIV
pneumocystis carinii (PCP), TB
Alcoholism
klebsiella
Bird exposure
chlamydia psittaci
Empiric outpatient therapy
doxycycline (DOC), macrolide, FQ, augmentin (suspected aspiration)
Empiric inpatient therapy-Non ICU
ceftriaxone 1g IV qd or cefotaxime
PLUS
macrolide (erythromycin) 500mg IV QID

Beta-lactamase inhibitor
PlUS
macrolide

Extended spectrum FQ (levaquin)
Empiric inpatient therapy-ICU
ceftriaxone 2g IV q24h or cefotaxime 1g IV q8h or b-lactam/lactamase inhibitor (Zosyn) 3.375g IV q6h
PLUS
macrolide or Levaquin 500mg IV qd

Beta lactam allergy: FQ + clindamycin
Duration of therapy
7-10days

chlamydia pneumoniae: 14d

legionella: 21d
dosing of ceftriaxone in:
a)meningitis
b)osteomyelitis
a)2g q12h
b)1g q12h
Uncomplicated cystitis
a)ecoli resistance <20%
b)ecoli resistance >20%
a)TMP/SMX x 3d
b)FQ x 3d
Complicated cystitis
FQ x 7-14d
Acute pyelonephritis
FQ x 7-14d
Is a nucleoTIDE reverse transcriptase inhibitor
tenofovir (Viread)
Zidovudine
Retrovir
didanosine (ddI)
Videx
stavudine (d4T)
Zerit
lamivudine (3TC)
Epivir
abacavir
Ziagen
lamivudine/zidovudine
Combiver
abacavir/lamivudine/zidovudine
Trizivir
abacavir/lamivudine
Epzicom
emtricitabine/tenofovir
Truvada
nRTI that must be taken with food
tenofovir (Viread)
Non-nucleoside analogues (nnRTI)
nevirapine (Viramune)
efavirenz (Sustiva)
delaviridine (Rescriptor)
Causes autoinduction of its own metabolism
nevirapine (Viramune)
Should be given without food
indinavir (Crixivan)
Should be given with fatty meals
saquinavir (Fortovase)
nelfinavir
Viracept
lopinavir/ritonavir
Kaletra
atazanavir
Reyataz
Not recommended if CrCl <50
Epzicom
Contraindicated if CrCl <30
Truvada
Indicated for adult patients with drug-resistant HIV
tipranavir (Aptivus)
Contains sulfonamide moiety
tipranavir (Aptivus)
Contraindicated HIV drug combinations
-AZT(zidovudine)/d4T(stavudine)=antag
-Indinavir/Saquinavir=antag + difficult dosing
ddI(didanosine/d4T(stavudine)=inc risk neuropathy, CI in pregnancy
Agents associated w/ peripheral neuropathy and pancreatitis
d4T(stavudine)
ddI(didanosine)
ddC(zalcitabine)
Agent associated with fatal hepatotoxicity
nevirapine (Viramune)
Agent associated with nephrolithiasis
indinavir (Crixivan)
Agent associated with severe hypersensitivity reaction
abacavir (Ziagen)
indinavir patient counseling
-take on empty stomach
-drink at least 1.5L fluid/d
-don't administer w/in 2 hours of ddI
nelfinavir patient counseling
-take w/ meals
-treat diarrhea w/ loperamide
ritonavir patient counseling
-keep in fridge
-take w/ food, but no w/in 2h of ddI
saquinavir patient counseling
-take w/ large, high fat meals
didanosine patient counseling
-take on empty stomach
zalcitabine patient counseling
-potential mouth inflammation
amprenavir patient counseling
-avoid vit E supp
tipranavir patient counseling
-contains sulfonamide moiety
PI subrates for what isoenzyme
CYP3A4 isoenzyme
Most potent inhibitor of CYP3A4
ritonavir
PIs not recommended unless boosted
tipranavir
saquinavir
Less effected by ritonavir because it is mostly metabolized by CYP2C19
nelfinavir
pneumocysitis carinii pneumonia treatment
bactrim 15-20mg/kg/d IV/PO x21d in 3-4divided doses

Alt: pentamidine (dose limiting toxicity =pancreatitis)
CMV
ganciclovir (Cytovene) 5mg/kg IV q12h x14d,then 5mg/kg/d (neutropenia)
or
valganciclovir
or
cidofovir + probenacid before each dose, and at 2,8hours post dose (nephrotoxicity)
Varicella zoster
acyclovir 30mg/kg IV/d or 800mg PO 5x/d x 7d
Cryptococcal meningitis
amp B 0.7mg/kg/d IV x10-14d
plus
flucytosine 100mg/kg/d PO
then
fluconazole 400mg/d PO x8-10wks
toxoplasma encephalitis
pyrimethamine
plus
folinic acid
plus
sulfadiazine
Avoid perinatal transmission
zidovudine (70% reduction)
start week 14-34, IV during laor and delivery, baby takes ZDV liq PO q6h x 6wks
HIV meds to avoid in pregnancy due to birth defects
efavirenz
stavudine (Zerit)
amprenavir (oral liq)
hydroxyurea
Isoniazid MOA
inhibition of mycolic acid synthesis
INH elimination
hepatic
INH effect on CYP
inhibits CYP450 metabolism
Rifampin MOA
inhibits DNA-dependent RNA polymerase inhibiting DNA transcription
Rifampin elimination
hepatic w/ enterohepatic recycling
Rifampin effect on CYP
induces CYP450
Rifampin adverse effects
hypersensitivity
thrombocytopenia
hemolytic anemia
discoloration of secretions
hepatotoxicity
Inactive in neutral medium, best in acidic environement
pyrazinamide (PZA)
PZA metabolism
hepatic
PZA adverse effects
photosensitivity/rash
hepatotoxicity
hyperuricemia
Used for treatment in areas w/ INH resistance >4%
ethambutol (ETH)
ethambutol bacterocidal or static
static
ethambutol distribution
minimal to low CSF penetration
ethambutol elimination
renal
ethambutol adverse effects
hyperuricemia
optic neuritis
ketoconazole brand
Nizoral
itraconazole brand
Sporonox
voriconazole brand
Vfend
azole MOA
inhibition of ergosterol synthesis
azole spectrum of activity
coccidiodes
blastocystis
candida albicans
cryptococcus
tinea
trichophyton
azoles active against Aspergillus spp and fluconazole-resistant Candida albicans
voriconazole
itraconazole
azoles with high bioavailability
fluconazole >90%
voriconazole 96%
Increases in gastric pH decreases oral bioavailability (i.e. give with acidic beverage like coke)
itraconazole
ketoconazole
azole with high CSF penetration
fluconazole 75%
azole with renal excretion
fluconazole
IV itraconazole requires dosage adjustment in renal impairment
all other azoles hepatic excretion
azole common class adverse effects
GI disturbances
increase LFTs
itraconazole adverse effects
dose related hypokalemia
hypertension
edema
voriconazole adverse effects
dose related visual disturbances
azoles effect on CYP
inhibits CYP450
combination azoles and amphoterecin B
not recommended although fluconazole did not result in antagnonism or synergy
itraconazole effect on CYP
potent inhiitor of CYP3A4
posaconazole (triazole) brand
Noxafil
posaconazole activiity
aspergillus
candida
posaconazole adverse effects
hypokalemia
fever
headache
GI (administer with meal)
caspofungin brand
Cancidas
caspofungin MOA
inhibits beta glucan synthetase in fungal cell membranes
caspofungin indication
invasive aspergillosis
mycafungin brand
Mycamine
mycafungin MOA
interferes w/ fungal cell wall synthesis
mycafungin actiivty
fungicidal against most (all?) candida
static vs aspergillus sp
mycafungin adverse effects
histamine mediated reaction (RASH) most common
leukopenia
hepatic/renal dysfunction
amphoterecin class
polyene antifungal
amphoterecin MOA
binds to fungal cytoplasmic memb sterols (ergosterol) which alters structure and increases permeability leading to leaking of intracellular contents and cell death
(also binds to human sterols accounting for toxicity)
amp B acitivy
excellent:
histoplasma
candida albicans
cryptococcus
coccidiodes

variable:
aspergillus (needs WBC)
amp B oral absorption
poor (9%)
amp B elimination
3% urine, 0.8-14% bile
renal/hepatic failure don't alter levels
terminal half life 15-40d
amp B distribution
everywhere (lung, spleen, liver, kidneys)
Not fat (dose on IW)
95% protein bound (not dialyzed)
amp B adverse effects
nephrotoxicity (premedicate)
infusion effects (fever)
thrombophlebitis
ACD
hypokalemia, hypomagnesemia
amp B nephrotoxicity
reversible or not?
reversible
occurs >80% of patients w/in first 2wks of therapy
2 mechanisms of amp B nephrotoxicity
1.binds to cholesterol cells in kidney
2. prostaglandin mediated renal vasoconstriction
tigecycline brand
Tygacil
tigecycline class
glycylcycline antibiotic
tigecycline MOA
binds to 30S ribosome, inhibits protein translation
tigecycline cidal or static
static
tigecycline benefits
unaffected by two mech of TCN resistance: ribosomal alteration and efflux
tigecycline spectrum of activity
e. faecalis (vanco susceptible)
MSSA and MRSA
citrobacter
enterobacter
streptocooci
tigecycline adverse effects
pancreatitis
photosensitivity
bacteriodes fragilis
metronidazole
chlamydia pneumoniae
doxycycline
enterobacter
imipenem
meropenem
piperacillin + tobra
enterococcus faecalis
penicillin G
enterococcus faecium
quinupristin + dalfopristin (Synercid)
gardnerella vaginalis (bacterial vaginosis)
metronidazole
haemophilus influenzae
a)meningitis, epiglotitis, and other life threat infections
b)non-life threatening infection
a)cefotaxime/ceftriaxone`
b)augmentin or bactrim
klebsiella pneumoniae
ceftriaxone
cipro
moraxella catarrhalis
augmentin
cefuroxime
bactrim
neisseria gonorrhoeae
ceftriaxone
cefixime
cefpodoxime
neisseria meningitidis
pen G
proteus mirabilis
ampicillin
bactrem
pseudomonas aeruginosa
piperacillin
ceftazidime
tobramycin
staph epidermidis
vancomycin
stenotrophomonas maltophilia
bactrim
strep pyogenes
pen G
vibrio cholerae
doxycyclin
strep pneumoniae (pen-sens) CAP
pen G or V
amoxicillin
strep pneumoniae (pen res) CAP
levaquin
vancomycin
H.influenzae CAP
2nd/3rd gen cehp
bactrim
moraxella catarrhalis CAP
2nd/3rd gen ceph
bactrim
augmentin
legionella CAP
FQ
mycoplasma pneumoniae CAP
doxycycline
chlamydia pneumoniae CAP
doxycycline
enterobacteriaceae (Ecoli, klebsiella, proteus, enterobacter)
2nd/3rd gen ceph
FQ
anaerboes CAP
clinamycin
bl/blactamse inhibitor
pseudomonas aeruginosa CAP
antispeudomonal bl (piperacillin, ceftazidime, cefepime, aztreonam, imipenam, meropenam) plus aminoglycoside
cephalosporins that can be used to treat infection with bacteriodes
ceftizoxime
cefixime
cefotetan
Rapid acting insulins
lispro (Humalog)
aspart (Novolog)
glulisine (Apidra) inhalation
Short acting insulins
regular
Intermediate acting insulins
NPH
Lente
Long acting insulins
Ultralente
Very long acting insulins
glargine (Lantus)
detemir (Levemir)
Total daily dose non-resistant patient
0.5-0.7units/kg/day
units of insulin for units above target BG
1-2 units for every 30-50 over
units of insulin and carbohydrates
1 units for every 15-30g carbohydrate
exubera units to SQ regular insulin
1mg=3units SQ regular
3mg=8units SQ regular
insulin in use needs to be refrigerated T or F
F
discard vials after how long
1month
withdraw regular before NPH or lente insulins T or F
T
Sulfonylureas
glimepiride (Amaryl)
glipizide (glucotrol)
glyburide (Micronase)
Glucovance
glyburide + metformin
TZDs
rosiglitazone (Avandia)
pioglitazone (Actos)
TZD adverse effects
fluid retention - avoid in patients with NYHA class III or IV CHF
weight gain
peripheral and macular edema
hepatitis
Biguanide
metformin (Glucophage)
secretagogues-meglitanides
repaglinide (Prandin)
nateglinide (Starlix)
meglitanides adverse effects
hypoglycemia
weight gain
alpha-glucosidase inhibitors
acarbose (Precose)
miglitol (Glyset)
exenatide brand
Byetta
exenatide MOA
incretin mimetic
binds and avtivates human GLP-1 (glucagon like peptide) receptor, increases glucose dependent synthesis of insulin and secretion from beta cells
exenatide dose
5mcg SQ BID 60mins before morning and evening meals
sitagliptan brand
Januvia
sitagliptan MOA
dipeptidyl peptidase (DPP)-4 inhibitor (incretin enhancer)
causes GLP-1 and GIP levels to rise, increasing insulin secretion from beta cells
isoproterenol brand
Isuprel
terbutaline brand
Brethine
albuterol
Proventil, Ventolin
pirbuterol brand
Maxair
levoalbuterol brand
Xopenex
salmeterol brand
Serevent
inhaled anticholinergics
ipratropium (Atrovent)
tiotropium (Spiriva)
Combivent
albuterol + ipratropium
ipratropium vs tiotropium frequency
ipratropium QID
tiotropium 18mcg DPI once daily
Mass cell stabilizing agents
Cromolyn
nedocromil (Tilade)
Cromolyn and nedocromil use
prophylaxis against bronchospasm due to allergies

exercise-induced asthma
Theophylline MOA
methylxanhine that inhibits phosphodiesterase
Antileukotrienes
zileuton (Zyflo)
zafirlukast (Accolate)
montelukast (Singulair)
Zyflo MOA
inhibits 5-lipoxygenase
Antileukotriene indicated for children >12months
Singulair
antileukotriene that must be taken on an empty stomach
Accolate
antileukotriene side effects
Liver damage
antileukotrienes that inhibit CYP 450
Zyflo
Accolate
budenoside
Pulmicort Turbuhaler
DPI
Corticosteroid
Hepatic clearance
>12yo
formoterol
Foradil Aerolizer
long-acting beta2 agonist
>5yo
Advair Diskus
fluticasone + salmeterol
DPI
omalizumab
Xolair
anti-IgE agent
SQ q2-4wks
asthma related to allergies
Medications that contribute to GERD
CCB
Opiods
Oral contraceptives
Nitrates
Theophylline (methylxanthines)
Anticholinergics
food that lower LES tone
peppermint
onions
tomato-based products
aluminum/magnesium brand
Maalox
Mylanta
Antacids drug interactions
FQs, TCNs
ketoconazole, itraconazole
iron
Aluminum hydroxide side effects
constipation
hypophophatemia
nizatidine brand
Axid
cimetidine drug interactions
drugs metabolized by CYP450
H2 blockers patient education
don't take otc h2blockers >2wks
PPI MOA
inhibits H+/K+ ATPase enzyme
PPI that can be given IV
pantoprazole
PPI patient education
administer 30-60mins before meals in morning
Aciphex not indicated for <18yo
Prokinetic agents
metoclopramide (Reglan)
metoclopramide MOA
increases Ach activity in myenteric plexus to increase GI motility

strengthen of force of contraction and LES tone
metoclopramide patient education
may cause sedation
involuntary movements
administer 30mins before meals
sucralfate (Carafate) side effects
constipation
sucralfate patient education
take on empty stomach at least 1hr before meals and at bedtime
PUD treatment strategies
2 week course of triple therapy
2 ABX and acid suppressor
Helidac QID regimen
bismuth 262mg (2tabs)
metronidazole 250mg (1tab)
tetracycline 500mg (1tab)
Alt tx options
MOC x 2wks
metronidazole 500mg bid
clarithromycin 500mg bid
omeprazole/lansoprazole

AOC x 2wks
amoxicillin 1gm bid
clarithromycin
omeprazole/lansoprazole
bismuth adverse effects
dark stool
black tongue
avoid in renal insufficiency
metronidazole advere effects
N/V/D
disulfiram rxn (EtOH containing products like mouthwash, cough/cold medicine)
Tetracycline adverse effects
skin hypersensitivity
dose adjust in renal insufficiency
clarithromycin adverse effects
taste disturbances
H2 antagonists adverse effects
dizziness
headache
N/V
PPI adverse effects
angina
headache
brady/tachycardia
tomoxifen brand
Nolvadex
tomoxifen FDA approvals
tx estrogen rec pos bc
px bc
tomoxifen agonist effects
bone
lipid profile
endometrial tissue
tomoxifen adverse effects
blood clots
stroke
endometrial cancer
cataracts
hot flashes
nausea
SERM
tomoxofen
toremifene (Fareston)
anastrazole brand
Arimidex
anastrazole FDA approval
adjuant tx of hormone-rec pos early bc in postmen women
anastrazole MOA
suppresses estrogen synthesis
anastrazole adverse effects
stroke (less than tomoxifen)
thrombosis
endometrial cancer
letrozole brand
Femara
letrozole MOA
aromatase inhibitor
exemestane brand
Aromasin
exemestane MOA
aromatase inactivator
goserelin brand
Zoladex
goserelin MOA
stops production of estrogen in premen women
goserelin adverse effects
osteoporosis
hot flashes
vaginal bleeding
raloxifene brand
Evista
raloxifene MOA
SERM
raloxifene agonist effects
bone
serum lipid profiles
raloxifene antagonistic effects
endometrial tissue
breast tissue
raloxifene FDA approval
tx and px of postmen osteoporosis
does raloxifene increase risk of endometrial cancer
no
raloxifene adverse effects
venous thromboembolism
hot flashes
bisphosphonates
alendronate (Fosamax)
risedronate (Actonel)
ibandronate (Boniva)
postmen symptoms-hot flashes treatment
-estrogen replacement
conjugated equine estrogen (Premarin)
ethinyl estradiol (Estinyl)
micronized estradiol (Estrace)
-progestin replacement
medroxyprogesterone
norethindrone
progesterone (Prometrium)
-estrogen and progestin combo
Prempro
Combipatch
Femhrt (northindrone + ethyinyl estradiol)
use of premarin and medroxy combination in WHI outcomes
increase in
invasive bc
coronary heart disease
stroke
PE

beneficial
decrease in
colorectal cancer
hip fracture
estrogen only risks
endometrial cancer
breast cancer
ovarian cancer
HRT summary
don't start in pts w/ CAD
short term use in pts w/out CAD for menopausal sxs
estrogens MOA in oral contraception
prevents formation of follicle
prevents release of FSH from anterior pituitary
ovulation inhibited by low FSH levels
High androgenic activity
norgestrel
levonorgestrel
progestins MOA in oral contraception
in combo: inhibit LH surge required for ovulation

alone: endometrial atrophy which inhibits egg implantation and thickening mucus
Yasmin
ethinyl estradiol 30mcg/drospirenone 3mg
monophasic
progestin structually similar to aldactone (for women who experience water retention)
hyperkalemia
Ortho Evra Patch
ethinyl estradiol 20mcg/norgestimate 150mcg)
apply to buttock, upper outer arm, or upper torso on 1st d of mens cycle
new patch each week x3 then 1 wk off
IUDs
copper-containing
progestasert (Progesterone)-12mo
levonorgestrel (Mirena)-5yr
IUD adverse effects
PID
irregular bleeding
Vaginal contraceptive ring
ethinyl estradiol 15mcg/etonogestrel 120mcg (Nuvaring)
nuvaring instructions
insert by 5th day of cycle, leave in place x3wks, remove x1wk
Intramuscular injcetions
medroxyprogesterone (Depo-Provera) 150mg IM q3months
depo provera pt instructions
1st injection must be given w/in 5 days of menstruation
depo provera adverse effects
decrease bone mineral density
weight gain
irregular bleeding
Subcutaenous injections
medroxyprogesterone (Depo-SubQ Provera) 104mg sq q3months
deposubq provera MOA
prevents ovulation
thins endometrium
estrogen deficiency effects
early cycle spotting
hot flashes
amenorrhea
vaginal dryness
estrogen excess effects
HTN
breast tenderness
migraine
N/V
weight gain
progestin deficiency effects
late cycle spotting
dysmenorrhea
progestin excess effects
acne
weight gain
hirsutism
HTN
fatigue
estrogen containing BCP contraindications
smoker >35
liver disease
breastfeeding
hx MI, stroke, DVT, PE, CVA, CAD
Atrial fibrillation
surgery <4wks
decreases enterohepatic recirculation of BCP
pen
ampicillin
tmp/smx
minocycline
tetracycline
griseofulvin
Missed BCPs
miss 1
take as soon as remembered -no BUM
miss 2 in wk 1 or 2
take 2 x2d + BUM x7d
miss 2 in wk 3
a)day 1 starter
b)sunday starter
a)begin new pack that day + BUM x7d

b)one daily until sunday, start a new pack on sunday + BUM x7d
miss 3 in 3 weeks
same as miss 2 in wk 3
S/Sx of BCP problems
ACHES
abdominal pain
chest pain
headache
eye pain
severe leg pain
Most common cause of vaginitis
candida
vaginal yeast infections treatment
clotrimazole crm x7-14d
miconazole crm x7d
nystatin vaginal tab x7d
terconazole cm x 3 or 7d
fluconazole 150mg PO x1d
cervical cancer vaccine approved by FDA
Gardasil
9-26yo
HPV 6,11,16,18
treatment of HPV genital warts
imiquimod 5% crm
podofilox 0.5%sol or gel
cryotherpay
surgery
treatment for cervical and internal vaginal warts
thiotepa
FU
trichomoniasis treatment
metronidazole 2g PO once
tinidazole 2gm PO x1
treat sexual partners
chlamydia treatment
zithromax 1g PO once
or
doxycycline 100mg PO bid x7d
treat sex partners
in pregnancy: azithromcyin 1gm PO once or erythromycin base or amoxicillin
when is suppressive therapy indicated for genital herpes
6 or more recurrences per year
therapy for one year
gonorrhea treatment
treat simultaneously for chlamydia

ceftriaxone 125mg IM once or
cefixime 400mg po once or
cipro 500mg po once or
levofloxacin 250mg po once
plus
azihtromycin or doxycycline
hepatitis B treatment
interferon alpha and lamivudine
prevention w/ vaccination
primary, secondary or early latent syphilis
benzathine pen G 2.4MU IM once
late latent, latent syphilis of unknown duration or tertiary syphilis w/o neurosyphillis
benzathine pen G 2.4MU IM qwk x 3doses
neurosyphilis
aq crystalline pen G 18-24MU/d given as 3-4MU IV q4h or cont infusion x10-14d