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Pharmacotherapy > heme/GU/renal > Flashcards

heme/GU/renal Flashcards

1
Q

what helps increase the absorption of iron? what can decrease absorption?

A

gastric acid and ascorbic acid; milk and tea–take between meals

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2
Q

foods with high iron

A 
Total cereal--most!
Grape-nuts cereal --most!
Instant Cream of Wheat Instant plain oatmeal Wheat germ
Broccoli
Baked potato
Raw tofu
Lentils
Beef chuck
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3
Q

recommended iron per day

A

200 mg of elemental iron per day in 2-3 divided doses (better tolerated) on an empty stomach

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4
Q

what important factor do you have to look at to determine amount of iron in iron supplements?

A

the elemental iron %–the amount of iron patient gets is not equal to mg of dose

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5
Q

AE of iron supplementation

A

GI – discoloration of feces (dark), abdominal pain, heartburn, constipation, N/V

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6
Q

if iron supplementation intolerable how do you take it?

A

Take iron with meals

• Decrease total daily dose to 110-120 mg elemental Fe

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7
Q

modest reticulocytosis after Fe therapy should occur in how many days? how much should hgb increase?

A

7-10; hgb should increase about 1g/dL per week

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8
Q

how long should Fe therapy be continued after anemia resolves to replete iron stores? what are some exceptions?

A

3-6 months; exceptions if acute bleed, may only have to continue for 1 month after anemia resolves, or if chronic negative values (chronic heavy menstruation or malabsorption) requires low maintenance dose qd

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9
Q

indications for parenteral iron therapy

A

Evidence of malabsorption
 Intolerance of oral iron
 Long-term adherence is a problem
 Chronic HD or CAPD

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10
Q

when giving parenteral iron, you should give what first b/c of the risk of anaphylaxis?

A

a test dose of 25 mg IM or IV with epi, diphenhydramine and corticosteroids on hand. watch for 1 hour before giving rest of dose

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11
Q

RFs for VB12 deficiency anemia

A

vegan diet, older age, women, decreased absorption (prolonged h2ra or PPI, metformin?), inadequate utilization

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12
Q

PO dose of B12

A

1-2 mg po qday

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13
Q

if someone has neuro sx, whats the best way to give their B12 for anemia? what’s the dose?

A

Parenteral Vitamin B12 Therapy (IM or deep subcutaneous)
 Cyanocobalamin 1000 mcg qd for 1 week initially to saturate B12 stores and resolve clinical
manifestations, then  to 1000 mcg q week until Hgb/Hct normalizes, then 1000 mcg q month until normalization of sx and hematologic indices;
can then convert to oral (first dose on due date for next injection)

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14
Q

how many days until reticulocystosis in new B12 therapy for anemia?

A

2-5 days

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15
Q

AE of B12 thearpy

A

Hyperuricemia (caution gout)
Fluid retention (more likely in pt with compromised CV status)
 Hypokalemia (check K)
 Anaphylaxis with parenteral administration

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16
Q

sources of folic acid in diet

A

fresh fruits and veggies, yeast, mushrooms, animal organs

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17
Q

rec’d amount of folic acid in non pregnant females, pregnant, lactatign

A

400 mcg/day in non-pregnant females, 600 mcg/day in pg females, 500 mcg/day lactating females

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18
Q

dose of folic acid

A

1 mg po qd x 4 months (if underlying cause is identified and corrected)

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19
Q

dose of folic acid in pregancy

A

400-1000 mcg qd prior to conception and during pregnancy

4 mg/day recommended for high risk pregnancies

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20
Q

when is a low maintenance dose of folic acid indicated?

A

Low-dose folate therapy (500 mcg po qd) can be used for anticonvulsant-induced anemia to avoid
discontinuation of the AED (may  PHT levels)

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21
Q

tx of anemia of chronic disease

A

Treat the underlying disorder and correct reversible causes of anemia
 Red cell transfusions
 Erythropoietin stimulating agents (ESA)
 If endogenous EPO is high (>150), may not respond to exogenous EPO
 Check Hgb q 2 wks: > 0.5 g Hgb predicts + response; no change in Hgb, ↑ EPO dose
 Watch serum iron levels carefully and give Fe supplements if needed
 For chemotherapy-induced anemia, ESA use restricted to anemia without a curative intent due to 
mortality

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22
Q

names of drugs for anemia of chronic renal failure

A 
Epoetin alpha (Epogen, procrit)
Darbepoetin alpha (Aranesp)
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23
Q

what is the black box warning for epo agents?

A

greater risks of death, serious adverse
cardiovascular reactions, and stroke when administered erythropoiesis-stimulating agents (ESAs) to target a hemoglobin level of greater than 11 g/dL.
aka use smallest dose for as little as possible
Current FDA Recommendations for Use in Patients with CKD (Pharmacist’s Letter, 8/11)
 Start treatment only when Hgb is

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24
Q

tx for OI in HIV: candida
propylaxis
tx

A

primary prophylaxis not indicated

tx: fluconazole

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25
Q

tx for OI in HIV: PCP
propylaxis
tx

A

I° Prophylaxis with SMX/TMP initiated at CD4

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26
Q

tx for OI in HIV: toxoplasmosis
propylaxis
tx

A 
I°: SMX/TMP- TOXO IgG seropositives with CD4+ 200
tx: Sulfadiazine
1000-1500 mg qid
\+ Pyrimethamine*
200 mg x 1, then 
50-75 mg qd
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27
Q

tx for OI in HIV:cryptococcal infection
propylaxis
tx

A

primary: not indicated
II°: fluconazole, d/c after ≥3, on ARVTx, and sustained CD4>100
tx: amphotericin B

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28
Q

tx for OI in HIV: CMV infection
propylaxis
tx

A

II° Prophylaxis continued until CD4 count >100 cells/mL sustained for greater than 3-6 months on ARVTx
tx: Ganciclovir or Valganciclovir

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29
Q

tx for OI in HIV: Mycobacterium Avium Intercellulare
propylaxis
tx

A

primary: I°: Azithromycin at CD4+ 3m on ARVTx, and sustained CD4>100
tx; Azithromycin
600 mg qd
+ Ethambutol
15-20 mg/kg/d
± Rifabutin 300 mg qd (different dosing with ARVT)
12m course

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30
Q

entry inhibitor MOAs and AEs: enfuvirtide and maraviroc

A

enfuvirtide blocks viral attachment to GP41; AE ISR, bacterial pneumonia
maraviroc binds to co receptor and prevents conformation change required for virus entry
AE: fever, rash, increased LFTs
both have poor tolerance and aren’t used much

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31
Q

NRTIs: combo pills available

A

Lamivudine-Abacavir (EPZICOM) and Emtricitabine-Tenofovir (TRUVADA)

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32
Q

HIV med with vivid dreams

A

Efavirenz

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33
Q

NNRTI that can prolong qt interval; what is CI with this drug?

A

rilpivirine; CI: proton pump inhibitors

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34
Q

Trade names of these drugs and what class are they in?

A

Efavirenz (sustiva) and rilpivirine (Edurant)

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35
Q

what drug class are these in?
Enfuvirtide
Maraviroc

A

entry inhibitors

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36
Q 
what drug class are these in?
Abacavir** not renal
Lamavudine**
Emtricitabine*
Tenofovir*
Zidovudine
Didanosine
Stavudine
A

NRTIs

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37
Q

what drug class are these in?
Raltegravir
Elvitegravir
Dolutegravir

A

integrase inhibitors

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38
Q 
what drug class are these in?
Atazanavir
Darunavir
Lopinavir/Ritonavir
Fosamprenavir
Ritonavir
Saquinavir
Nelfinavir
Tipranavir
Indinavir
A

protease inhibitors

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39
Q 
what drug class are these in?
Efavirenz
Nevirapine
Etravirine
Rilpivirine
Delavirdine
A

NNRTIs

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40
Q

Are there Major Drug Interactions with NON- Nucleoside Reverse Transcriptase Inhibitors (NNRTIs)?

A

yes

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41
Q

Are there Major Drug Interactions with Nucleoside Reverse Transcriptase Inhibitors (NRTIs)?

A

no not really, all renally cleared except abacavir

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42
Q

which AE go with which INSTI?
• AE: well tolerated, ↑lipids, eosinophilia, increased BGs and ALT, myopathy
• AE: well tolerated, N/D
• AEs: well tolerated, HA, hyperglycemia, elevated lipase and transaminases

A
  • AE: well tolerated, ↑lipids, eosinophilia, increased BGs and ALT, myopathy: RALTEGRAVIR
  • AE: well tolerated, N/D : elvitegravir
  • AEs: well tolerated, HA, hyperglycemia, elevated lipase and transaminases: dolutegravir
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43
Q

what PK booster is commonly added to elvitegravir and why? what are its AE?

A

cobicistat: enhances by inhibiting enzyme pathway that metabolizes elvitegravir
• AE: nausea, loose stools, ↑Scr, cholesterol & triglyceride elevation

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44
Q

booster used with PIs that is limited d/t bad AE. what are the AE?

A

ritonavir

AE: HA, N/V/D, taste perversion, elevated CK, hyperglycemia, elevated LFTs, HLD

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45
Q

Are there Major Drug Interactions with Protease Inhibitors (PIs)?

A

yes: CYP450

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46
Q

preferred PI and PK booster given with it

A

darunavir and ritonavir

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47
Q

NRTI+NRTI+INSTI examples

A
  • Emtricitabine-Tenofovir (Truvada) + Raltegravir (isentress)
  • Emtricitabine-Tenofovir (Truvada) +Dolutegravir (Tidivicay)
  • If HLAB5701 negative: Abacavir-Lamivudine (Epzicom) + Dolutegravir (Tivicay) OR TRIUMEQ=all 3 in 1!
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48
Q

2 NRTIs + INSTI + booster examples

A
  • Stribild QUAD PILL: Emtricitabine + Tenofovir (disoproxil fumarate (TDF) + Elvitegravir + Cobicistat
  • Genvoya QUAD PILL: Emtricitabine +Tenofovir Alafenamide (TAF) + Elvitegravir +Cobicistat
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49
Q

2 NRTIs + PI + PK booster examples

A
  • Emtricitabine-Tenofovir (Truvada) + Darunavir (Prezista) + Ritonavir (Norvir)
  • Emtricitabine-Tenofovir (Truvada) + Darunavir-Cobicistat (Prezcobix)
  • Some alternative combos replace Darunavir with Atazanavir
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50
Q

why do we adjust for renal function?

A

many drugs are cleared renally, if can’t be cleared drug concentrations and toxicity increases

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51
Q

how does decreased GFR affect serum creatinine?

A

increases serum creatinine

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52
Q

normal Scr

A

0.5 to 1.5 mg/dl

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53
Q

creatinine is metabolic by product of what?

A

creatine breakdown in muscle

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54
Q

what is biggest reason for increased creatine?

A

muscle mass

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55
Q

physiologic things that can affect creatinine

A

diet (meat), exercise, dirunal (highest in PM), age, wt, gender, drugs (deceased active tubular secretion and therefore increase SCr)

56
Q

EQ for measurement of LBW in kg for males and females

A

LBW (male) in Kg = 50 + [2.3 x (ht – 60)]
LBW (female) in Kg = 45.5 + [2.3 x (ht – 60)]
only difference is starting weight

57
Q

EQ for measurement of CrCl in males and females

A

CrCl Male = (140-age) x LBW (Kg)
72 x SCr
CrCl Female = estimated Male CrCl x 0.85

58
Q

name of EQs used for estimating creatinine clearance in stable renal function

A

cockroft-gault equation

59
Q

affects of renal disease on drug absorption

A

Decreased gastric emptying  Nausea/vomiting/diarrhea
 Decrease in gastric pH  Gastrointestinal edema
 Examples of changes in absorption

60
Q

how does renal problems influence serum protein binding?

A

decreases it: less albumin to bind to, binding sites can’t bind drugs as well, increases endogenous inhibitors of binding

61
Q

what do you need to measure to get accurate amount of acidic drug in renal failure of a drug with a narrow therapeutic range (i.e. phenytoin)

A

measure free concentration (unbound) because increased uric acid (nitrogen products) are bruisers

62
Q

can renal failure affect CYP450 enzymes?

A

yes

63
Q

how does renal failure affect metabolism of codeine?

A

active metabolite increased and you need smaller dose

64
Q

what’s active metabolite of meperidine that is increased in RF and can cause toxicities?

A

normeperidine

65
Q

when creatinine clearance sucks, how do you change the dose?

A

decrease it

66
Q

aminoglycosides are almost solely eliminated by

A

kidneys

67
Q

what can happen if aminoglycosides not adjusted for poor renal function

A

Nephrotoxic when they accumulate in proximal tubule cells (cause ATN)
 If dose is not adjusted for renal function, accumulation occurs and toxicity results

68
Q

what are steps to adjusting drug dosages for pts with renal insuffieincy

A

1) hx and labs (SCr)
2) cockroft-gault to estimate CrCl
3) review current meds to see which should be adjusted
4) adjust dose
5) monitor
6) revise if necessary

69
Q

factors affecting dialyzability: do the following increase or decrease removal?

A 
high  Molecular weight-decreases
 Water solubility--increases
 Protein binding--decreases
 Volume of distribution--decreases

70
Q

system used to estimate hepatic function–what does it include?

A

child pugh classification: ascites, encephalopathy, serum albumin, serum bilirubin, prothrombin time

71
Q

how can hepatic insufficiency affect first past effect and bioavailability?

A

if decreased flow through liver, less blood and drug getting metabolized= decreases 1st pass effect and increases bioavailability

72
Q

how can hepatic insufficiency affect protein bound state of drugs?

A

it will decrease it b/c unhealthy liver making less proteins= more free and gets metabolized

73
Q

how does hepatic insufficiency affect metabolism/

A

CYP450 can’t work as well in cirrhosis (decreases metabolism)

74
Q

pharmacokinetic effects of hepatic insufficiency on drugs

A

Increased drug sensitivity can result from
o Altered affinity of the drug to its target
o Altered binding to the target
o Alteration in the target itself
o Altered permeability of the BBB
o Increases in GABA receptors or GABA-ergic activity ( benzos)

75
Q

4 systems necessary for erection

A

Vascular system
Nervous system
Hormonal system
psychogenic

76
Q

what are some chronic medical conditions associated with ed?

A 
Hypertension
Diabetes mellitus
Inflammatory conditions of the prostate
Coronary & peripheral vascular disease
Neurologic disorders (e.g. PD, MS)
Endocrine disorders
Psychiatric disorders
Dyslipidemia
Renal failure
Liver disease
Penile disease
77
Q

surgical procedures that can cause ED?

A

Perineal surgery
Radical prostatectomy
Vascular surgery

78
Q

lifestyle factors that can cause ED

A 
Age
Smoking
Excessive alcohol consumption
Obesity
Poor overall health &  physical activity
79
Q

T OR F: trauma can cause erectile dysfunction

A

T: pelvic fractures or spinal cord injuries

80
Q

drugs that can cause ED

A

antihypertensives, lipid meds (gemfibrozil), antidepressants, histamine antagonists (cimetidine), antipsychotics, anticonvulsants (CBZ, PHT), antiandrogens and hormones, recreational drUGS (etoh, cocaine, marijuana, opiates)

81
Q

why do you have to consider partner issues with ED?

A

post menopausal women can have vaginal dryness

82
Q

before starting someone on tx for ED, what do you have to make sure?

A

that they are fit to safely perform sexual activity (i.e. cardiac disease)

83
Q

possible interaction of ED drugs

A

CYP450

84
Q

shortest acting ED drugs

A

sildenafil (viagra) and vardenafil (levitra)

85
Q

how long before sexual activity should each ED drug be taken?

A

avanafil 30 minutes
sildenafil 60
vardenafil 60 min
tadalafil 30 min

86
Q

AE of ED drugs

A

Headache, facial flushing, dyspepsia, nasal congestion, dizziness, abnormal vision (S&V)
 Rare reports of prolonged erections (> 4 hrs) and priapism (> 6 hrs) reported
 Decrease in BP (8-10 mmHg systolic, 5-6 mmHg diastolic) 1 hr after dose, lasting 4 hrs (S&V)

87
Q

who should get eye evals before taking ED drugs?

A

those with glaucoma, macular degeneration, diabetic retinopathy, previous eye surgery or eye trauma b/c of r/o nonarteritic anterior ischemic optic neuropathy

88
Q 
trade names of:
avanafil
sildenafil
vardenafil
tadalafil
A

avanafil (steward)
sildenafil (viagra)
vardenafil (levitra or staxyn ODT)
tadalafil (cialis)

89
Q

CI of ED drugs

A

nitrates use(vasodilator of coronary arteries=syncope, angina), alpha blockers (vasodilators–HOTN, falls), patients with high CV risk, conditions that propose to priapism like sickle cell, multiple myeloma, leukemia

90
Q

T or F: if someone has angina you shouldn’t rx ED med

A

not true, mild, stable angina is a low risk

91
Q

with what factors is an ED drug CI for a pt?

A

Has unstable or symptomatic angina, despite treatment
Has uncontrolled hypertension
Has severe congestive heart failure (NYHA class III/IV)
Had a recent myocardial infarction or stroke within past 2
weeks
Has moderate or severe valvular heart disease
Has high-risk cardiac arrhythmias
Has obstructive hypertrophic cardiomyopathy

92
Q

who should get a full cardio workup before taking ED meds?

A

Has 3 risk factors for cardiovascular disease
Has moderate, stable angina
Had a recent myocardial infarction or stroke within the past
6 weeks
Has moderate congestive heart failure (NYHA class II)

93
Q

ED drug that is intracavernosally injected or intraurethrally inserted

A

alprostadil (PGE1)

94
Q

when and why would testosterone be given?

A

Important for general sexual function and libido; only for patients with
documented low serum testosterone levels

95
Q

AE of testosterone

A

gynecomastia, dyslipidemia, polycythemia, acne; weight gain, HTN, edema and HF
exacerbation may occur due to sodium retention

96
Q

CI of testosertone

A

 Prostate cancer, breast cancer

 Caution with BPH

97
Q

which therapies should you start first for organic ED? second line/

A

oral phosphodiesterase inhibitor (or vacuum erection device), if PD5 inhibitor ineffective, try intracavernosal therapy, then should try intraurtheral therapy lastly, a penile prosthesis

98
Q

Subjective: RZ is a 55-year-old male with a history of erectile dysfunction for the past 6 months. PMH
is significant for HTN and cigarette smoking. He takes ramipril 5 mg qd and has NKDA.
Objective: VS: BP 160/95, HR 88, ht 72 in, wt 190 lb. Prostate exam reveals a mildly enlarged
prostate. Scr 1.2, BUN 18.
assessment;
what do you need to address?

A

assessment: ED d/t HTN
BP: adherence? add new med? smoking cessation

99
Q

peak incidence of BPH

A

63-65

100
Q

complications of BPH

A

Acute, painful urinary retention ARF
 Persistent gross hematuria when tissue exceeds blood supply
 Overflow UI or unstable bladder
 Recurrent UTI due to urinary stasis
 Bladder diverticula, stones
 CRF due to long-standing bladder outlet obstruction

101
Q

drugs that may aggravate BPH

A

tesosterone, anticholinergics (antihistamines, Phenothiazines, TCAs), sympathomimetics ( pseudo ephedrine, oxymetazoline, phenylephedrine) increases bladder tone)

102
Q

T or F: you should start everyone who has BPH immediately on meds

A

F: for mild disease just watch and wait

103
Q

general tx approaches for moderate sxatic BPH, severe sxatic BPH

A

modeate: pharm; severe: surgery

104
Q 
alpha 1 blockers:
MOA
onset:
AE
pt ed
dosing:
A 
MOA: blocking alpha relaxes smooth muscle
 onset in 2-4 wks
AE: Orthostatic
hypotension (must
initiate at lowest
dose and titrate at 2-
7 day intervals to
minimize HOTN, not
necessary for
tamsulosin)
pt ed: get up slowly, hang on to something
dosing: start low, give at bedtime to reduce r/o orthostasis
105
Q

1st line for patients with moderate BPH

A

alpha 1 blockers

106
Q 
5 alpha reducaste inhibitors
MOA
onset:
AE
dosing:
monitoring:
A

MOA: decrease conversion of testosterone
onset: 6 months! (long)
AE :  libido ,ED
dosing:qd
monitoring: baseline PSA and every year (decreases PSA levels by 50%)

107
Q

when are 5 alpha reeducates inhibitors indicated?

A

Most effective for
patients with  prostate
size (> 30 g)
Inability to take alpha blockers

108
Q

what drug should you give someone with ED and mild bph/

A

tadalafil (PDE5 inhibitor)

109
Q

likely safe, likely effective herbals for BPH

A

beta-sitosterol, pygeum, saw palmetto

110
Q

examples of alpha 1 blockers; alpha 1 a blockers

A

alpha 1
alfuzosin (uroxatral)

Doxazosin
(Cardura)

Terazosin
(Hytrin)

Prazosin
(Minipress)

alpha 1 a
Tamsulosin
(Flomax)

Silodosin
(Rapaflo)

111
Q

example of 5 a reductase inhibitors

A

finasteride (proscar), dutaseride (avodart)

112
Q

what is the triad of things you should ask about?

A

ED, BPH (urinary problems) and urinary incontinence

113
Q

4 mechanisms of urinary incontinence

A

Urge Incontinence (bladder overactivity): Detrusor hyperactivity
 Stress Incontinence (urethral underactivity): Sphincter incompetence
 Overflow Incontinence (urethral overactivity and/or bladder underactivity): Detrusor hypoactivity,
urethral sphincter obstruction
 Functional Incontinence: Not caused by bladder- or urethra-specific factors

114
Q

pneumonic for causes/RFs of urinary incontinence

A

DIAPPERS:
delirium, infection, atrophic urethritis or vaginiitis, pharmaceuticals, psychological, excessive urine output, restricted mobility, stool impaction

115
Q

non pharm management methods for urinary incontinence

A 
 Make toilets more accessible
Higher toilets
Well lit floors
Change bedroom to be close to bathroom
Consider bedside commode
 Wear clothes that are removed easily
 Use moderation in fluid intake
 Lose weight (if obese)
 Smoking Cessation
 Avoid Diuretics
Avoid alcohol
Avoid caffeine
116
Q

best tx of urinary incontinence

A

*non pharm stuff is best! bladder training, bladder control strategies, floor muscle training, fluid management

117
Q

anticholinergic drugs that can treat urge incontinence

A

oxybutynin (well established, inexpensive), tolterodine (more expensive but less doses per day)

118
Q

first line therapy for urge incontience

A

anticholinergics/antispasmodics

119
Q

rec’d tx for urge incontinence + depression or neuropathic pain

A

TCAS

120
Q

indications for topical estrogen in urge incontinence

A

women with urethritis or vaginitis

121
Q

duloxextine
indications
MOA
AE

A

indications: not technically indicated for stress incontinence but used first line
MOA: inhibits reuptake of HT/NE in spinal cord
AE: Nausea most common adverse effect;
may also cause dry mouth, constipation,
↓ appetite, fatigue, somnolence, 
sweating, sexual dysfunction, ↑ BP

122
Q

alternative firs line therapy for stress incontinence

A

pseudo ephedrine only in those with no HTN, DM, CHD

123
Q

tx of functional incontinence

A

scheduled bathroom breaks

124
Q

tx of overflow incontinence, what are CIs?

A

cholinomimetics (bethanechol)

CI: asthma, heart disease

125
Q

T or F: only try pharm tx if non pharm fails for urinary incontinence

A

T

126
Q

most likely pathogen in chronic and acute prostatitis

A

e. coli

127
Q

abx capable of reaching therapeutic concentrations in prostatic fluid

A

FQS, trimethoprim

128
Q

T or F: in acute prostatitis, More antibiotics penetrate due to inflammation

A

T

129
Q

tx of acute prostatitis with r/o STD

A

Ceftriaxone 250 mg IM x 1 then
Doxycycline 100 mg po bid x 10
days

130
Q

options for txing prostatitis (acute) with low risk of STD

A 
FQs or TMP-SMX
Levofloxacin 500-750 mg IV/po qd
or
Ciprofloxacin 500 mg po bid or 400
mg IV bid
or
TMP/SMX 1 DS po bid
x 10-14 days (minimum)
131
Q

pharm tx of chronic prostatitis

A 
Cipro 500 mg po bid x 4-6 weeks
or
Levofloxacin 750 mg po qd x 4 wk
Alt: TMP/SMX 1 DS bid x 1-3 mo
long duration--may need longer
132
Q

most common pathogens of epididymitis in men

A

gonorrhea, chlamydia

133
Q

non pharm epidydimitis tx

A

Analgesics prn
 Rest in bed with legs slightly apart
 Elevate testes on a towel roll
 Scrotal support when sitting, standing or walking

134
Q

when is expedited partner tx for prostatitis or epididymitis ok?

A

CDC recommends for heterosexual partners of patients diagnosed with chlamydia or gonorrhea
when it is unlikely the partners will seek timely evaluation and treatment

135
Q

why is expedited partner tx not rec’d for MSM in prostatitis/epidydmitis?

A

Not routinely recommended for MSM because of a high risk for coexisting infections, especially
undiagnosed HIV infection, in their partners and because data are limited regarding the
effectiveness of this approach in reducing persistent or recurrent chlamydia among MSM

136
Q

what needs to be included with rx of expedited partner tx?

A

Treatment instructions
 Appropriate warnings about taking medications (if the partner is pg or has med allergies)
 General STI health education and counseling
 Statement advising that partners seek personal medical evaluation, particularlywith PID sx

137
Q

F/U for prostatitis and epididymitis

A

Abstain from intercourse for 7 days after both have completed treatment, (to prevent
reinfection)
 Seek retesting for infection about 3 months after finishing treatment, due to the high risk of
reinfection

Pharmacotherapy (9 decks)

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