L20-Drugs used in sexually transmitted diseases [2013.09.12]

Question 1

What are the possible treatments for Chlamydial infections?

Answer 1

Azithromycin (single dose) or
Doxycylcin (twice daily for seven days)
Ofloxacin -> alternative

Question 2

What is the treatment for Gonococcal infections?

Answer 2

Single IM injection of ceftriaxone + single oral dose of azithromycin

Question 3

What are the infectious agents of Pelvic Inflammatory Disease?

Answer 3

Neisseria gonorrhoeae, Chlamydia trachomatis, anaerobic bacteria in sexually active female.

Question 4

What is the treatment for Impatient patient for PID?

Answer 4

Cefoxitin or cefotetan + oral doxycycline

Clindamycin + aminoglycoside

Question 5

What is the treatment for Outpatient patient with PID?

Answer 5

Cefftriaxone + oral doxycycline +/- metronidazole

Question 6

What is the treatment for bacterial vaginosis (BV)?

Answer 6

Stardard treatemtn with oral metronidazole

Question 7

What is the treatment for Trichomoniasis (TV, also a vaginal Infections)?

Answer 7

A single dose of metronidazole or tinidazole

Question 8

What is the treatment for vulvovaginal candidiasis (VVC)?

Answer 8

Azole antifungal agents (cell membrane attacking)

Question 9

What is the treatment for syphilis?

Answer 9

Parental penincillin G for all stages of syphilis

a single intramuscular injection of benzathine (stabilise penincillin)

Question 10

What is the infectious agent of Genital warts

Answer 10

Human papillomavirus (HPV)

Question 11

What is the treatment for Genital warts?

Answer 11

Podofilox solution can be applied to visible lesion

Question 12

What is the treatment for recurrence Genital warts?

Answer 12

Intralesional alpha interferon

Question 13

What are the common features of genital herpes?

Answer 13

Painful blisters or open sores in the genital area

Question 14

What are the infectious agent of genital herpes?

Answer 14

Herpes simplex virus (HSV)

Question 15

What are the treatments for Genital herpes?

Answer 15

Suppressive antiviral therapy

Acyclovir, famciclovir and valacyclovir

Question 16

What is the mechanism of action of acyclovir?

Answer 16

Selectively activated in infected cell
Inhibits DNA synthesis by competitive inhibition
More useful in prophylaxis cases

Question 17

What is the advantage of the derivatives of acyclovir (i.e.: famciclovir and valacyclovir)?

Answer 17

Higher bioavailability (15%->55%)

Question 18

What are the treatments for retrovirus?

Answer 18

Entry inhibitors
NRTIs & NNRTIs
Integrase inhibitors
Protease inhibitors

Question 19

List an example of NRTI (nucleoside reverse trasncriptase inhibitor)

Answer 19

Zidorudine

Question 20

What is the mechanism of NRTIs?

Answer 20

Competitively inhibits HIV reverse transcriptase and also act as a viral DNA chain terminator

Question 21

What is the half life of NRTIs?

Answer 21

1 hour

Question 22

What are the adverse effects of NRTIs?

Answer 22

Anaemia and neutropenia

Question 23

Give and example of NtRTIs

Answer 23

Tenofovir

Question 24

Give an example of NTIs and its adverse effect.

Answer 24

Emtricitabine
Lactic acidosis, hepatic steatosis,
lipodystrophy, redistribution of cutaneous fat

Question 25

Give two examples of Non-nucleoside Reverse transcriptase Inhibitor

Answer 25

Nevirapine and efavirenz

Question 26

What is the mechanism of action of nevirapine?

Answer 26

Direct inhibit HIV-1 reverse transcriptase

Question 27

What is the side effect of nevirapine?

Answer 27

Stevens-Johnson Syndrome

Question 28

What is the side effect of efavirenz?

Answer 28

Neuropsychiatric

Question 29

Give two example of protease inhibitors?

Answer 29

Saquinavir and ritonavirs

Question 30

What are the advrse effect of ritonavir?

Answer 30

Hyperlipidemia, insulin resistance and diabetes, lipodystrophy, elevated liver function test, increasing in bleeding risk and drug - drug interaction

Question 31

List two examples of Entry inhibitors?

Answer 31

Enfuvirtide and Maraviroc

Question 32

What are the indicators for initiating anti-retrovirus therapy?

Answer 32

``` History of AIDS CD4 count < 500 cells/ microlitre Pregnant women HIV-associated nephropathy Hepatitis B coinfection ```

Question 33

Associated adverse effects of anti-rectrovirus therapy

Answer 33

``` Lactic acidosis Hepatotoxicity Insulin resistance and diabetes Lipodystrophy Hyperlipidemia Increased bleeding in hemophiliacs Drug-drug interactions Rash ```

Question 34

What are the Dual NRTI component?

Answer 34

tenofovir | emtricitabine

Question 35

What are the key third component?

Answer 35

efavirenz ritonavir-boosted atazanavir ritonavir-boosted darunavir raltegravir