L37 - Drugs Used in Sexually Transmitted Diseases Flashcards
List antibiotics against: cell wall synthesis?
Beta lactams: penicillins, cephalosporins, cephamycins, carbapenems, monobactams
Non-beta lactams: vancomycin, bacitracin
List antibiotics against: cell membrane?
Cell membrane permeability: polymyxins
List antibiotics against: Protein synthesis?
50S subunit: macrolides, linezolid
30S subunit: tetracyclines, aminoglycosides
List antibiotics against: Folate metabolism?
Sulfonamides (inhibits PABA > DHF A)
Trimethoprim (inhibits DHF A > THF A)
List antibiotics against: Nucleic acid synthesis?
DNA: metronidazole, quinolones
RNA polymerase: rifampin
Compare the effects of bacteriostatic and bactericidal antibiotics?
Bacteriostatic (e.g. tetracycline) – inhibits growth of bacteria + rely on immunity, may relapse
Bactericidal (e.g. penicillins) – kills bacteria directly
List narrow and broad spectrum antibiotics?
Narrow = penicillin G, vancomycin
Broad = tetracyclines, amoxillin, augmentin
Give 4 reasons for combination antibiotics?
- Synergistic action for eradication
- Treat mixed bacterial infection
- Overcome resistance
- Reduce toxicity by reducing dose
List 2 diseases caused by Gonococci + one complication?
urethritis (purulent discharge), cervicitis
complication: pelvic inflammatory disease
Treatment regiment for gonococcal infection?
single intramuscular injection of ceftriaxone + single oral dose of azithromycin
** highly effective against penicillin- and tetracycline-resistant strains**
Which antibiotics are no longer effective against gonococcal infections?
Oral cephalosporins (e.g. cefixime) / fluoroquinolones
List 2 diseases caused by Chlamydial infection and outline treatment options? ADR?
urethritis, cervicitis
2 main options***:
Azithromycin (oral)
Doxycycline (oral)
Alternatives:
tetracycline / erythromycin / ofloxacin
ADR: Mild GI disturbance
Treatment option of all stages of syphilis? Treatment for early latent syphilis?
All stages: Penicillin G (IV preferred, oral compliance is low)
Early latent stage:
long-acting preparations (e.g. weekly single IM injection of benzathine penicillin G)
Treatment of STD with multiple pathogens e.g. gonococcal + chlamydial co-infection?
2 options:
1) Single dose of IM ceftriaxone + single dose of oral azithromycin
2) Single dose of IM ceftriaxone + oral doxycycline for 7 days
Causative pathogens of Pelvic inflammatory disease?
Neisseria gonorrhoeae + Chlamydia trachomatis +/- anaerobic bacteria
at Upper female reproductive tract
Describe the route of spread of bacteria causing PID after intercourse with infected male?
Bacteria enter vagina through semen
> > pass through cervix, uterus, fallopian tube, ovaries
> > exit to peritoneal cavity
Inpatient* treatment option for pelvic inflammatory disease?
broad spectrum antimicrobial coverage:
1) IV cefoxitin / cefotetan (= cephamycins) + oral doxycycline (tetracycline)
2) IV clindamycin (inhibits 50S) + aminoglycoside (e.g. streptomycin)
Outpatient treatment option for pelvic inflammatory disease?
single IM dose of ceftriaxone + oral doxycycline ± metronidazole
List 3 vaginal infections?
Bacterial vaginosis
Trichomoniasis
Vulvovaginal candidiasis
Treatment for Bacterial vaginosis?
3 options:
1) oral metronidazole
2) Metronidazole gel applied intravaginally
3) Clindamycin (oral / intravaginal)
Treatment for Trichomoniasis? *caused by Trichomonas vaginalis *
Single dose metronizadole or Tinidazole
anti-bacterial, anti-parasitic