• Be familiar with the interactive activities throughout course modules. You could see variations of those same questions on your exams.
  • STI/STD | First line drug, dose, route, frequency
    • Chlamydia: Doxycycline 100mg PO 2x day
    • Uncomplicated gonococcal urethritis: IM single dose of ceftriaxone 500mg with or without doxycycline 100mg 2x day for days.
    • Bacterial Vaginosis:
      • Non-pregnant: metronidazole 500mg 2x day for 7 days
      • Pregnant: vaginal metronidazole 2% for 7 days, clindamycin 1% for 7 days
    • Herpes Simplex Virus:
      • 1 clinical episode: Acyclovir 400mg 3x day 7-10 days, famciclovir 250mg 3x day 7-10 days, or valacyclovir 1g 2x day 7-10 days
      • 2 clinical episode: acyclovir 800mg 2x day 5 days, acyclovir 800mg 3x day 2 days, famciclovir 1g 2x day 1 day, famciclovir 500mg once then 250 2x day for 2 days, famciclovir 125mg 2x day for 5 day, valacyclovir 500mg 2x day 3 days, and valacyclovir 1x day for 5 days
    • Trichomoniasis:
      • Woman: Metronidazole 500mg 2x for 7 days
      • Men: single dose of 2 grams single dose
      • Men or women: tinidazole 2g single dose
    • Syphilis:
      • Primary/secondary and Early latent: Penicillin G 2.4 million units IM
      • Late Latent: 3 weekly doses of 2.4 million units
  • Doxazosin: BPH Trmnt (a1 blocker)
    • Side Effects: hypotension, dizziness, & nasal congestions
  • Dutasteride: BPH Trmnt (5a-reductase inhibitors)
    • Patient teaching and response to delayed onset of therapeutic effect: Goal is to relieve urinary symptoms, may take 1 month for it to work
  • Terazosin: BPH Trmnt (a1 blocker)
    • How to know it’s working: “easier to pee”
  • Various routes of administration of estrogen therapy and when each would be used:
    • Implant: Nexplanon, IUD, sterilization, oral, injection (Depot), contraceptive ring, contraceptive patch.
    • Women >35 who smoke: Only diaphragm, progestin-pill, or IUD.
    • Frequent sex: Oral, IUD, or Depot.
    • Limited sex: Use of spermicide, condom, or diaphragm.
  • When is it safe and not safe to prescribe progesterone (AKA: progestin)
    • Side effects of progestin-only oral contraceptives: Lactation only
  • Benefits of prescribing medroxyprogesterone acetate
    • Protects against pregnancy for 3 months or longer by inhibiting the secretion of gonadotropins. Return of fertility is delayed by an average of 9 months. Benefits outweigh the risk, which is no increase in cervical, ovarian, or breast cancer in women, and the risk for endometrial cancer is actually reduced.
  • Testosterone therapy
    • Patient teaching in general and consider teaching specific to different routes:
      • Nasal gel, transdermal patch, transdermal gel, topical solution, buccal tablet, and implantable subcutaneous pellets.
      • Testosterone cypionate: Requires an office visit every 2-4 weeks. Blood levels fluctuate widely.
      • Testosterone enanthate: Requires an office visit every 2-4 weeks. Blood levels fluctuate widely.
      • Testosterone transdermal: Rash at patch site is common.
      • Testosterone gel: It may be difficult to attain adequate levels. Easier to use and better tolerated than testosterone patches. Can transfer to others via intimate contact.