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Endocrine II > Drugs for Sexually Transmitted Infections (STIs) > Flashcards

Drugs for Sexually Transmitted Infections (STIs) Flashcards

1
Q

Treatment of Sexually Transmitted
Infections Most common used drugs to treat STI’s include:

A

• Ceftriaxone
• Penicillin G
• Azithromycin
• Doxycycline
• Gemifloxacin
• Acyclovir, ganciclovir, foscarnet
• Metronidazole
• Fluconazole
• Imiquimod

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2
Q

HSV self-care measures are

A

Acetaminophen (Tylenol) or ibuprofen (Advil, Motrin) may also help relieve the
pain of genital ulcers. Self-care measures include local treatments used to relieve the pain of a herpes
outbreak. Sitting in a few inches of warm water can temporarily relieve ulcer
pain.

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3
Q

Acyclovir Mechanism of Action

A

Acyclovir Mechanism of Action:
• A guanosine derivative that causes DNA chain termination. Activated by viral thymidine kinase
(TK) to a monophosphate form. Host enzymes then convert the monophosphate to di- and then
tri-phosphate (active) form which inhibits the viral DNA polymerase causing chain termination
due to the lack of a 3’ -OH group.

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4
Q

________usually requires more frequent dosing than famciclovir and valacyclovir.

A

Acyclovir

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5
Q

Three antiviral medications are used to treat genital herpes:

A

• acyclovir, famciclovir, and
valacyclovir.

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6
Q

________ has the greatest bioavailability (80%) and is rapidly hydrolyzed to ________ after
its absorption.

A

Famciclovir

penciclovir

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7
Q

________its monophosphate form also incorporates into the viral DNA, resulting in chain
termination.

A

Valacyclovir

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8
Q

Mycoplasma genitalium: Urethritis, Cervicitis tx

A

Two-stage therapy approaches: Doxycycline is provided as initial empiric
therapy, which reduces the organism load and facilitates organism clearance,
followed by macrolide-sensitive M. genitalium infections treated with high-dose
Azithromycin; macrolide-resistant infections are treated with Moxifloxacin.

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9
Q

______________lacks a cell wall, and thus antibiotics targeting cell-wall biosynthesis (e.g., ß-lactams including penicillins and cephalosporins) are ineffective against this organism

A

M. genitalium

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10
Q

Recommended regimens for chlamydial infection among adolescents and adults

A

Doxycycline 100 mg orally 2 times/day for 7 days

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11
Q

Chlamydial Infections alt regimens

A

Azithromycin 1 g orally in a single dose or levofloxacin 500 mg orally once daily for 7 days

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12
Q

___________ is an intracellular pathogen that has a
cell wall, in that it lacks peptidoglycan. (beta
lactam antibiotics not effective)

A

Chlamydia is an intracellular pathogen that has a
cell wall, in that it lacks peptidoglycan. (beta
lactam antibiotics not effective)

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13
Q

Multiple sequelae can result from___________
infection among women, the most serious of
which include PID, ectopic pregnancy, and
infertility

A

C. trachomatis

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14
Q

Lymphogranuloma Venereum (LGV) recommended regimen & alt regimens

A

Doxycycline 100 mg orally 2 times/day for 21 days
Azithromycin 1 gm orally once weekly for 3 weeks or
Erythromycin base 500 mg orally 4 times/day for 21 days

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15
Q

• Are a group of broad-spectrum antibiotic compounds
• They have a common basic structure
•________ molecules comprise a linear fused
_______ nucleus (rings designated A, B, C and D) to
which a variety of functional groups are attached

A

Tetracycline
Chlortetracycline
Oxytetracycline
Demeclocycline
Doxycycline
Minocycline

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16
Q

MOA of Tetracyclines

A

• Tetracyclines bind reversibly to the
30S subunit and are bacteriostatic
• They block the binding of aminoacyl-
tRNA to the acceptor site on the
mRNA-ribosome complex
• This prevents addition of amino acids
to the growing peptide

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17
Q

Adverse effects of Tetracyclines

A

• Teeth: permanent brown discoloration & ill formed teeth
• Stunted bone growth
• Phototoxicity on exposure to UV light- demeclocycline,
doxycycline
• Super infections: Diarrhea, Candida
• Epigastric pain, abdominal distention, nausea, vomiting
• Hepatic injury
• Nephrotoxicity- doxycycline safe
• Fanconi’s syndrome: A from of renal tubular acidosis is
attributed to use of outdated tetracyclines

18
Q

Macrolides he prototype drug is

A

erythromycin

19
Q

The main macrolide and related antibiotics are

A

erythromycin, clarithromycin and azithromycin

20
Q

MOA of Macrolides

A

• Bind reversibly to the 50S subunit
• Protein synthesis is inhibited
because aminoacyl translocation
reactions are inhibited

21
Q

Fluroquinolones examples are

A

•Examples are Norfloxacin, Ciprofloxacin, and Levofloxacin

22
Q

MOA of Fluroquinolones

A

FQs inhibit Bacterial Topoisomerase II (DNA gyrase) and
Topoisomerase IV
• These are responsible for separation of replicated DNA during cell
division
• DNA gyrase has 2 subunits A and B
• Subunit ‘A’ Nicks the double stranded DNA
• Subunit ‘B’ Introduces negative supercoils
• Subunit ‘A’ Reseals the nicked ends
• FQs act by inhibiting bacterial DNA gyrase, after binding to subunit ‘A’ interferes with strand cutting and resealing

23
Q

Tx of Syphilis

A

• Treatment: Penicillin G, administered parenterally, is the preferred drug for treating persons in all
stages of syphilis. The preparation used (i.e., benzathine, aqueous procaine, or aqueous crystalline),
dosage, and length of treatment depend on the stage and clinical manifestations of the disease.
• Alternative therapy: Doxycycline

24
Q

Proctitis, Proctocolitis, and Enteritis

A

Treatment: Acute proctitis. Ceftriaxone + Doxycycline

25
Q

Epididymitis recommended regimens for epididymitis

A

For acute epididymitis most likely caused by chlamydia or gonorrhea:
Ceftriaxone 500 mg IM in a single dose + Doxycycline 100 mg orally 2 times/day for 10 days
MSM give Ceftriaxone 500 mg IM in a single dose + Levofloxacin 500 mg orally once daily for 10 days

26
Q

β-Lactam MOA

A

Binds to transpeptidase active site PBP
Block of transpeptidase activity interrupt cross-linking & cell wall synthesis

27
Q

PID tx regimens

A
28
Q

Recommended regimen for uncomplicated gonococcal infection of cervix, urethra, or rectum among adults and adolescents

A
29
Q

Chancroid (Haemophilus ducreyi) tx regimens

A
30
Q

Anogenital Warts (Condylomata
acuminate) tx regimens

A
31
Q

Imiquimod MOA of Anogenital warts

A

Toll-like receptor 7

32
Q

Bacterial Vaginosis tx regimens

A
33
Q

Trichomoniasis tx regimens

A
34
Q

VCC tx regimens

A
35
Q

Metronidazole MOA

A

MOA: Metronidazole is a low molecular weight that diffuses across the cell membranes of
anaerobes  reduced by pyruvate ferredoxin oxidoreductase system  reduced state of drug
promotes formation of intermediate compounds and free radicals toxic to the cells  reduced
intermediate particles interacts with DNA  DNA strand breakage.

36
Q

Metronidazole Uses:

A

Uses: Gardnerella vaginalis, Trichomonas vaginalis, Bacteroides fragilis, Clostridium perfringens,
Entamoeba histolytica, Giardia lamblia

37
Q

Metronidazole A/E

A

Nausea, anorexia, vomiting, diarrhea, abdominal cramping, constipation, metallic taste, furry
tongue, glossitis, seizures, peripheral neuropathy, dizziness, vertigo, confusion and insomnia

38
Q

Metronidazole drug interactions

A

Ethanol - Disulfiram like reactions
Promotes renal retention of lithium —->increase lithium toxicity

39
Q

Fluconazole
Mechanism of Action:

A

Mechanism of Action: A triazole that is a highly
selective inhibitor of fungal cytochrome P-450
sterol C-14 alpha-demethylation.

40
Q

Pediculosis tx regimens

A

Endocrine II (16 decks)

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