Doxycycline

Good for you.

Doxycycline is the, like, you had irresponsible gay sex drug.

[laughs]

[laughs]

If you look at even the Hopkins data, it's probably closer to 33%, even more up to 48% that have chronic symptoms.

So Doxycycline will work early on, so will some penicillins.

But there's a group of patients that clearly go on to have chronic symptoms.

And of course, this has been one of the debates in medicine going on for, at this point, it's 50 years.

What do you think is going on here? That's right.

Doxycycline is a classic cause of pill esophagitis.

Very good.

Pill esophagitis occurs when a pill stays in contact with the esophageal lining and causes local irritation or ulceration.

And I don't even want to call it an insecurity.

It's just like something you like go through.

But like your face is part of your identity.

know you it's different about like oh i'm kind of insecure that my hair is thin i'm kind of insecure that like my arm you know looks this way when it's put like there's little insecurities that you can have but then it's one thing when the way that you meet people and present yourself is your biggest insecurity it's literally the worst feeling and i would just sob and sob and sob and i would literally always have to be in makeup like i literally felt like if i was going anywhere if anyone was going to see me i had to be wearing makeup and again this was kind of like a constant battle that i had while i was in college especially like freshman year because there'd be times where it wasn't that bad, and I'd be like, okay, you know what, maybe I could take my makeup off a little bit, wear a little less, then there'd be times it would flare up.

Even when I came to school as a freshman, yes, I was eating a little bit more processed food, but like I said, my skin flared up the summer before freshman year.

So I was like, okay, I really don't think it's my diet.

people were telling me that it was all the energy drinks i was drinking etc which again i'm not saying that it's not but keep in mind i have been drinking energy drinks pretty much every day since like my freshman year of high school so i was like why would the energy drinks just now start making my skin freak out which again i'm not an esthetician i'm not a dermatologist maybe that can happen i don't know but to me it just didn't make sense like i was like i don't think it's my diet i don't think it's the energy drinks like nothing really changed my body just changed like my my skin just freaked out then it is the summer after freshman year and I'm like my skin is just still not where I want it to be I want to be so freaking confident I want to wear no makeup because the thing is is I hate wearing makeup and I honestly love how my face looks like feature-wise I love my face and it was just the most frustrating thing to like not love how it looks not because of my actual face but because of what was on it that was just so frustrating to me and i was like i know my skin i know my body i know i can get it back to being clear so i went back to the doctor told him again i was like look i tried your other stuff it kind of worked but i want more i want this to work better and i don't want to take accutane because for me accutane has always just been a little bit scary i know that people have had really really amazing experiences on accutane So many people were DMing me saying like it will change your life, etc But to me it's just always been scary because I know that your skin dries out your joints can hurt I'm someone that likes to stay very very active and that was just something that was like, oh, that's a really last resort option for me So I went back to my doctor and I was like, please what's the next step? And so he gave me doxycycline and that also really helped again did not get my skin to where I wanted it to be But it definitely did significantly decrease the cysts for a while and help with the active breakouts.

So So that was like kind of leading into my sophomore year again, definitely not super confident without makeup, but it was manageable.

IV ceftriaxone is generally reserved for more serious disseminated disease, such as hospitalized Lyme carditis, central nervous system involvement, or Lyme arthritis that fails initial oral therapy.

Doxycycline is especially useful because it also covers a lot of other tick-borne infections, although doxycycline should be avoided for pregnant women and nursing mothers due to potential fetal growth suppression and tooth discoloration.

Now let's say that a patient removes a tick but has no signs or symptoms or any rash.

Should every tick bite receive antibiotics? That's right, we do not give prophylactic antibiotics for every tick bite.

Trimethoprim sulfamethoxazole can cause hyperkalemia, bone marrow suppression, kidney injury, and severe skin reactions.

Macrolides can prolong the QT interval and have important drug interactions due to their ability to inhibit certain CYP liver enzymes.

Doxycycline is extremely useful for tick-borne diseases, atypical respiratory pathogens, and MRSA, but is generally avoided during pregnancy and historically in children under 8 years old due to its effects on both groin suppression and teeth discoloration.

Doxycycline can also cause photosensitivity and pill esophagitis, and so patients should be advised to take it with plenty of water and avoid lying down immediately afterward.

For severe BKC in children under 12 years old, you use oral macrolides, erythromycin or azithromycin.

You strictly avoid doxycycline.

Because of the calcium binding, right? Doxycycline binds to calcium orthophosphate in developing teeth.

Yes, it causes permanent, irreversible yellow-brown dental staining.

You only utilize oral tetracyclines in older patients.

And these ones are board favorites, tetracyclines.

Doxycycline, tetracycline.

Because the use, especially when you're talking about acne and you're talking about chlamydia, these are two uses that affect a specific population.

The reason why I'm saying this with sexually active and acne is because in female patients, this is a teratogen.

we have to.

for sex workers

or sex volunteers.

Taking it as a preventative kind of thing.

Yeah.

Doxycycline for sex workers or sex volunteers is formally recommended post-exposure.

Prophylaxis, especially in high-risk situations.

So that's propanolol, a beta blocker.

Doxycycline, which is an antibiotic.

Now, of course, we're not using it as an antibiotic, but just context.

When you think of right back into the beginning of evolution, the mitochondria were separate bacteria that another cell came along and instead of eating it, it actually took it in.

Okay.

Next is doxycycline.

Doxycycline has only one strength, hundred.

How much can be given for doxy? Two hundred mg single dose and then hundred mg daily.

If not, twenty four hours, that is once once a daily.