UTI, STI Flashcards
symptom relief for dysuria
Phenazopyridine (Pyridium, Rx) (AZO OTC)
AEs: turns urine orange/red, false positive nitrites on UA, mild nausea
Phenazopyridine (Pyridium, Rx) (AZO OTC)
1st line for uncomplicated UTI
Nitrofurantoin 100mg PO BID x 5 days
Trimethoprim/sulfamethoxazole one PO BID x 3 days
Fosfomycin one 3g sachet powder orally once
AEs: GI, rare pulmonary fibrosis
nitrofurantoin
nitrofurantoin cautions
eldery, renal dysfunction
batrim contras
evere hepatic dysfunction, pregnancy, use w/ methotrexate
AEs:
* severe/fatal dermatologic rxns (SJS, TEN), discontinue at FIRSTS occurrence of skin
rash or any adverse rxn
* Hyperkalemia esp when on another medication that promotes retention of K+
bactrim
AEs: N/D, HA, renal dysfunction for multiple doses (no need for renal/hepatic dosign)
fosfomycin
fosfomycin for pyelonephritis?
no
1st line for enteroccoccal UTI
amoxicillin
major drug interaction for cipro
tizanidine
AEs: diarrhea, irritability/agitation/nervousness/excitability, may lower seizure threshold, QT
prolongation, tendinopathy or tendon rupture possible, c. diff risk, increased risk of aortic
aneurysm/dissection in those already at risk
FQs
pyelonephritis tx
Ciprofloxacin 500 mg BID x 7 days
§ Levofloxacin 750 mg QD x 5 days
§ TMP-SMX one double strength tablet BID x 14 days
1st line for UTI in pregnancy
amoxicillin / augmentin / cefpodoxime X 14 days
nitrofurantoin in men?
no
length of tx for male UTI
7-14 days
1st line for prostatitis
cipro, levo, bactrim 2-4 wks
HPVs that cause most cervical cancers
16 and 18
HPVs taht cause anogenital warts
6, 11
what age to give HPV vax
11-12
patient topical tx of genital warts not ok when?
> 5 warts, >1 cm
indication: Podofilox solution or gel, Imiquimod, Veregen
genital warts
Podofilox length of tx
Apply BID for 3 days, then 4 days off
§ Repeat cycle max 4 times until warts resolve (1 month)
Imiquimod length of tx
max 4 months
Sinecatechins (veregen) length of tx
max 4 months
contra: Sinecatechins (veregen)
HIV, HSV
counseling for topical genital warts tx
Cover warts w/ thin layer of medicine
§ Wash hands after use, do not get in eyes, nose, mouth
§ Avoid inside vagina, urethra, rectum
§ Do not occlude warts + medication w/ bandage but underwear/gauze is okay if irritated
§ Do not apply internally or to open wounds
§ May weaken condoms or diaphragms
topical genital wart tx ok in pregnancy?
no
Caustic acid that destroy the wart tissue via chemical coagulation
Trichloroacetic acid (TCA) 80-90%
genital wart removal tx safe in pregnancy
TCA
cuation for acyclovir, valacyclovir, famciclovir
renal failure
counseling for acyclovir, valacyclovir
hydrate well to avoid cyrstal deposition in renal tubules
when to start antiviral for HSV
asap after appearance of lesion and w/in 72 hrs
length of tx for initial HSV
7-10 days
condom use for how long after 1st HSV outbreak
12 months
Most frequently reported bacterial STI
chlamydia
test for chlamydia
NAAT on 1st catch urine OR vaginal swab
chlamydia tx
doxy 100mg PO bid X 7 days OR azithromycin 1g PO OR levo 500mg PO QD X 7d
most common presentation of gonorrhea
aysmptomatic
gonorrhea tx
Ceftriaxone 500 mg IM in single dose for persons weighing <150kg (>150kg, 1 g ceftriaxone)
any PO cephalosporins to treat gonorrhea?
no
gonorrhea or chlamydia causes more severe PID?
gono
cardinal presenting symptom of PID
lower abd pain, bilateral, <2 weeks
inpatient tx for PID
cetriaxone + doxy + metronidazole
trich tx
metronidazole 500mg PO bid X 7d
AEs: unpleasant metallic taste, darkened urine, disulfiram-like reaction w/ alcohol
* Rare: reversible neutropenia, urticaria, rash, flushing, dry mouth
metronidazole
syphillis tx
o 2.4 million units of Benzathine Penicillin G given IM once
§ Benzathine is stabilizer that releases penicillin slowly
o If neurosyphilis diagnosed, give dose weekly x 3
