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HIV PEP – Non-occupational

Preferred Regimen For Non-Occupational Post-Exposure Prophylaxis Raltegravir 400mg PO Twice Daily (Isentress®; RAL) Plus Truvada™,1 PO Once Daily [Tenofovir DF (Viread®; TDF) 300mg + emtricitabine (Emtriva™; FTC) 200mg]   Summary of CDC Guidelines: When care is sought ≤72 hours after a potential nonoccupational exposure that presents a substantial risk for HIV acquisition. Obtain screening labs. Test exposed patient AND source

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HIV PrEP – Pre-Exposure Prophylaxis

Pre-Exposure Prophylaxis (PrEP) has been recommended by the CDC since 2014 as one option for prevention of HIV transmission in adults at high risk. There is only one FDA approved drug for this indication.   Truvada 200mg/300mg, 1 tab PO daily [emtricitabine (FTC) 200 mg and tenofovir disoproxil fumarate (TDF) 300 mg] PrEP is recommended for the following populations: Sexually-active adult MSM (men

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HIV PEP – Occupational

HIV Occupational Post-Exposure Prophylaxis Regimen:   Raltegravir 400mg PO Twice Daily (Isentress®; RAL) Plus Truvada™,1 PO Once Daily [Tenofovir DF (Viread®; TDF) 300mg + emtricitabine (Emtriva™; FTC) 200mg] CDC Recommended approach: 1) Evaluate exposure: Exposures posing risk of infection transmission : Percutaneous injury Mucous membrane exposure Non-intact skin exposure Bites resulting in blood exposure to either person involved Substances posing risk of infection transmission:

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Pediatric Fever Protocols

There have been several attempts at building protocols for pediatric fever in order to determine what children 3 months and younger can be discharged home. The most commonly used protocols include the Rochester, Philadelphia, and now Step-by-Step. Although there is an exceptional comparison of these protocols (Step by Step not included) from Hui et al in 2012, the most important

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Varicella & Pregnancy

Treatment in pregnancy: Chicken Pox Infection Immunized or Hx of past infection: exposure: nothing to do. simple rash: acyclovir 800mg PO 5x/day for 7 days severe infection or pneumonia, admit for IV acyclovir and supportive care. Not Immunized: exposure: consider VZIG, give first dose within 96 hours if possible, and up to 10 days from exposure. simple rash: acyclovir 800mg

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Lyme Disease

Treatment:  PO – for rash, cranial nerve palsy, carditis, or arthritis Doxycycline 100mg PO BID x 14 days Amoxicillin  500mg PO TID x 14 days (use if pregnant) Cefuroxime 500mg PO BID x 14 days IV – for meningitis Ceftriaxone 2gm qD x 14 days Cefotaxime 2gm TID x 14 days Cause: Borrelia burgdorferi spirochete in the USA Borrelia afzelli,

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