Day 1 1000 mg IV over 30 mins Day 8 500 mg IV over 30 mins mlmin day

Day 1 1000 mg iv over 30 mins day 8 500 mg iv over 30

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Day 1: 1000 mg IV over 30 mins Day 8: 500 mg IV over 30 mins CrCl 10-30 ml/min —> day 1: 750 mg; day 8: 375 mg Potential use for hospital avoidance Terminal half-life > 2 weeks Drug Interactions None package insert Adverse Effects Most common: nausea, HA, diarrhea Mean duration of effects = 4 days Potential for osteomyelitis Good cortical bone concentrations with 1000 mg IV day 1 and 500 mg IV once weekly for 8 weeks Animal and Human Bites—Prevention Preemptive antibiotics for 3-5 days appropriate for: Immunocompromised Asplenic Severe liver disease Significant edema Moderate/severe injuries to hand and/or face Joint/periosteum penetrated Rabies postexposure prophylaxis may be indicated Animal and Human Bites — Treatment Purulent wounds often polymicrobial including anaerobes Streptococci Staphylococci Pasturella species Drug of choice —> augmentin Cephalosporin plus metronidazole/clindamycin Moxifloxacin or doxycline
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HIV What is HIV Retrovirus, member of lentivirus genus Enveloped, ssRNA virus HIV-1 more common than HIV-2 Zoonosis from primates Hosts: humans and non-human primates Etiologic agent of AIDS HIV Life Cycle Engages CD-4 receptor Binds and fuses wth cell via chemokine co-receptors Core shell uncoated Reverse transcription Integrated into host genome Viral mRNA Nucleocapsid Virion buds through plasmid membrane Polypeptide cleavage —> functional proteins Hallmark of HIV Persistent, latent infection in long-lived cells established 3 days after infection Continued viral replication if untreated HIV hijacks CD4 cell —> viral replication —> CD4 cell dysfunction and depletion Profound immunodeficiency HIV vs AIDS HIV is the virus that causes HIV infection Damages immune system by killing CD4 cells AIDS Last stage of HIV infection Amount of HIV increases and amount of CD4 decreases Without meds HIV advances to aids in about 10-12 years Transmission Sexual contact Injection drug use Pregnancy, childbirth, breastfeeding Labor and delivery poses highest risk Occupational exposure Blood transfusion/organ transplant HIV Symptoms Acute HIV infection 2-4 weeks after infection Flu- or mononucleosis like symptoms Fever, chills, night sweats Sore throat, mouth ulcers
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Muscle aches, fatigue Rash Swollen lymph nodes Chronic HIV infection Clinical latency Often asymptomatic, but may have mild symptoms May last 10+ years AIDS CD4 cell count < 200 cells/mm3 or AIDS defining illness or wasting syndrome AIDS-defining cancers Symptoms include: Profuse night sweats, fevers Unexplained weight loss Persistent diarrhea Candidiasis Neurologic symptoms May last 2-3 years without ARV Principles of HIV Treatment Goal: suppress virus replication
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  • Fall '19
  • Tetracycline, UTI, Ceftriaxone

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