Simvastatin at 80 mg Dose No Longer Recommended

The FDA recently put out this recommendation regarding simvastatin at the 80 mg dose. I rarely ever go that high anyway (since going from 40 mg to 80 mg rarely helps to bring down the LDL very much). But it's still good to know.

Typical STABLE (and unstable) Follow-up Intervals

Here are some typical follow-up intervals we use at our residency. Note that these intervals are obviously not set in stone (and the clinical context will dictate the right thing to do):

Recurrent Yeast Infections (Vulvovaginal Candidiasis)

This is an awesome tip that I learned from Dr. Jennifer Keehbauch (who is the Associated Director here at Florida Hospital Family Medicine Residency). This tips was given as part of our "Learning Center" teaching series which our faculty personally do for our residents. Enjoy!

Recurrent vulvovaginal candidiasis (VVC) is defined as infections that occur greater than 4 times a year. The most common agent is C. Glabarata which causes 40% of the infections and is associated with increased burning and older aged females. There is usually less discharge and burning with candidiasis caused by C. Glabarata. Also, this organism is less susceptible to "azoles".

The treatment for recurrent VVC is with:

1. Induction - which is 2 x normal therapy. Can use Diflucan 200 mg on day #1 and #3. Or you can use Topical azoles for 7-14 days.
2. Maintenance - which is weekly dose for 6 months. You can use Diflucan 100 mg weekly or clotrimazole 500 mg PV weekly.