Antibiotics for STDs Flashcards
Cephalosporins drugs
Macrolide drug
Nitroimidazoles
Regular penicillins
Tetracyclines
ceftriaxone, cefixime
azithromycin
metonidazole
Penicillin G, crystalline/benzathine
doxycycline
Tetracycline drug, forms
bind to __of bacterial ribosome and stop addition of ___ in growing polypeptide
Prevent binding of ___ to the binding site
__ and __
__ dec use
doxycycline (I/O)
30s subunit, next AA
aminoacyl tNA
bacteriostatic, broad spectrum
resistance
common mechanism of resistance is expression of __
expels __
__ not as well expelled
another mech is ___ proteins
these displace tetracyclines from __ on ribosome
steps
1: Tetracycline __ ribosome
2: __ ribosome protection protein forces ___ off binding site
3: __ unbinds, ribosome is __
efflux pumps
tetracycline
tigecycline
ribosomal protection
bidning site
binds
GTP-dependent, tetracycline
protection protein, drug-free
Doxycycline can be used for __ and __ and __ and __
some __
__ and __ are preferred in tx of ___
D has best __ of tetracyclines, interacts w least amount of __
__ elimination via __/__
enters most tissues ___
gram +/-, intracellular, spirochete
anaerobes
doxycycline, azithromycin, chlamydia
oral bioavailability, food
mixed, hepatic/renal
well
Tetracyclines bind __ and __ ions, doxyclcine somewhat __
__ and __ and some __ dec oral absorption, especially more __ tetracyclines
pts should __ these products __ before/after dosing
SE
GI distress such as __
P__, use ___
bind to __ and __ in fetuses/young kids, leading to ___
divalent/trivalent, less
dairy, iron supps, antacids, hydrophilic
avoid, 2hrs
esophageal irritation
photosensitivity, protection
teeth/bone
permanent discoloration
Nitroimidazole drug, preps
drug sensitive organisms like __ and __ can convert metronidazole to ___ metabolite, binding to __ and causing __
__ spectrum, __ AB
can kill __, targets ___
pharmacokinetics allow for __
excellent __
elimated via __/__
Metronidazole, I/O/T/vaginal gel
anaerobes, parasites
cytotoxic reactive, DNA, fragmentation
narrow, bacteriocidal
protozoa, anaerboes
use w variety of infections
oral bioavailability
hepatic/renal
Metro is mostly ___
SE
Inhibits ___, leading to N/V/C w even small amt of __
Darkens __
Peripheral ___, can produce ___
__ neuropathy most likely
Often used for mild to moderate __ infections
likely __ infections, such as __ or __
__ and __
well tolerated
acetaldehyde dehydro, NV, cramps, EtOH
urine
neuropathy
lastign damage
sensory
C diff
anaerobic, orofacial/abdominal
Bacterial vaginosis/trichomonas
Nonresistant trichomoniasis tx w ___ usually __
trichomoniasis only treated w ___
tinidazole may be slightly __ against resistant pathogens
resistance to __ can be overcome by ___ dose
resistance usually due to dec expression of ___ needed for ___
redox proteins can only __ so much, as they are needed for __
metronidazole, oral, single dose
nitroimidazoles
nitroimidazoles, inc
redox proteins, drug activation
dec, energy metabolism
Pt w problems to nitroimidazoles
__ abuse, preexisting __ as this leads to __
metronidazole __
alternative tx have __ cure rate
__ protocol may be considered
ethanol, neuropathies SE hypersensitivity lower desensitization
Primary/secondary/early latent <1 yr syphillis tx w __
latent > 1 yr, or unknown tx w ___
neurosyphillis tx w ___
Penicillin G form MOA: \_\_, bactericidal inhibitor of \_\_\_ \_\_ spectrum including \_\_ \_\_ elim can enter \_\_, \_\_ levels req
__ common, severe
well suited for use w
benzathine PenG
benzathine PenG
crystalline PenG
injection
beta lactam, cell wall synth
broad, spirochetes
renal
CNS, high
hypersensitivity rxn
preg
Crystalline PenG
__ soluble, administered __
t1/2 is __, must be admin __
achieves highest __ of all PenG forms
Benzathine
__ form of PenG, admin __
therapeutic blood levels maintained for __
preferred except when __ expected
Adv of benzathine
__ admin is convenient and has __
prolonged therapeutic blood level ensures __ of slow grow TP
water, IV
few hrs, freq
CNS levels
slow released, IM
2-3 wks
neurosyph
single, pt compliance
eradication
Main issue complicating PenG is __
__ protocols allow short term exposure
___ is alternative AB
development of __ is not an issue w TP
__ Rxn is a post tx __ febrile rxn
seen w/in __ after tx
caused by ___ and __
may be more common in __ than __
hypersensitivity
desensitization
doxycycline
resistance
Jarish Herxheimer, cytokine mediated
24hrs
spirochete lysis/endotoxin release
early than late stages
Ab to chlamydia
Adults/adolescents __ or __
Pregnancy __
most important classes are __ and __
tetracyclines use
Macrolide drug, preps, use
MOA macrolides: \_\_ protein synth inhibitors \_\_ spectrum ,includes \_\_ and \_\_ bacteria \_\_ elim azithromycin has _ t1/2 \_\_ tolerated
azithro/doxy
azithro
macrolides, tetracyclines
chlam, syph
azithromycin, OIT, chalm, gon
bacteriostatic broad, gram -/IC hepatic long well
Avoid __ during preg/nurs/children < 8
azithromycin’s __ and single __ enhances compliance
Doxycycline more active against serovars causing __
doxy
long t1/2, dose
lymphogranuloma venerum
Adults/adolescents w uncomplicated gonoccal infection tx w
if ceftriaxone not available, treat w __ and __
__ cephalosporins, ie __, is drug of choice for Gono
__ also given to combact __ and treat coexisting __
3rd gen cephs include __ and _ to treat __, prep
Ceftriaxone + azithromycin
cefexim + azithro
3rd gen, ceftriaxone
macrolide, resistance, chlam
Ceftriaxone/cefexime, I/O, gonorrhea
