gynae tx Flashcards
Bacterial vaginosis Tx
Topical metronidazole/clindamycin cream
Thrush Tx
Oral fluconazole single dose
Clotrimazole intravaginal pessary 2nd line or in pregnancy
Chlamydia treatment (1st, 2nd line)
1st - Doxycycline 5 days
2nd - Azithromycin 5 days with large stat dose (erythromycin in pregnancy)
Neisseria Gonorrhoea Tx
Stat IM ceftriaxone
Syphilis Tx (1st and 2nd line)
Benzanthine penicillin 1st line
Azithromycin/doxy 2nd line
Genital herpes Tx
Usually none.
Aciclovir if lots of Sx on reactivation
Trichomoniasis Tx
Systemic metronidazole.
PID Tx
PID is MID
oral Metronidazole
IM ceftriaxone
oral Doxycycline
TOP medical Mx
Mifepristone (antiprogesterone) then 36-48hrs later misoprostol (PG)
Miscarriage medical Mx
Vaginal misoprostol (PG)
Endometriosis Mx fertility desired/not
Fertility not desired:
1st line - Analgesia (NSAIDs, paracetamol)
2nd line - Hormonal to stop cycles/reduce oestrogen
- 1st - continuous COCP
- 2nd - Progesterone (mirena ideally, POP)
3rd line (2o care) - GnRH analogues (Goeserelin) causes reversible menopause. Can reduce SE with HRT
Surgery - laparoscopy -> hysterectomy options
Fertility desired:
- Analgesia -> laparoscopy.
Adenomyosis Tx
Similar to endo - Mirena, COCP, NSAIDs.
Hysterectomy often required.
PCOS mx (just Sx and if fertility desired)
Just Sx - 1st line weight loss/diet
2nd line - COCP to regulate menstruation and treat hirsutism. Can use Mirena.
Other options to treat hirsutism - anti-androgens (cyproterone acetate/spironolactone), metforim.
Fertility desired - options are clomifene, metformin, letrozole. 2nd line options are laparoscopic ovarian diathermy, clomifene/metformin dual therapy, gonadotrophins.
