Pharm Reproduction Exam 1 Flashcards
Vaginal antibacterial
Clindamycin
Metronidazole
Vaginal Antifungals
Butoconazole
Miconazole
Terconazole
Injectable Contraceptives
Medroxyprogesterone (Depo-Provera)
Vaginal contraceptives
Etonogestrel/ethinyl estradiol (Nuva Ring)
Monophasic oral contraceptives
Most common type of Birth control
They are single phase
Means they provide a steady dose of hormones throughout the entire pack
Usually start on low dose of estrogen
Switch to higher dose if they have bleeding or spotting
B-phasic oral contraceptives
Contain 2 types of pills at different strengths
Usually the amount of progestin changes and
the amount of estrogen stays the same the entire pack
until you get to the placebo pills
Tri-phasic oral contraceptives
Pills of 3 different doses
The level of progestin increases as you go through the pack (similar to the body)
Most common pattern is 7 days of one strength 7 days another strength 7 days another strength 7 days of inactive pills
Quad-phasic oral contraceptives
levonorgestrel/ethinyl estradiol
Estradiol valerate/dienogest
Oral progestin only contraceptives
norethindrone
drospirenone
Selective estrogen receptor modulators
SERM
Clomiphene (Clomid)
raloxifene (evista)
Tamoxifen (soltamox)
GYN bleeding (non hormones)
TXA (tranexamic acid (Lysteda)
Labor induction
Misoprostol (cytotec)
Oxytocin (pitocin)
Labor suppressives (tocolytics)
Mag sulfate
Terbutaline
Pregnancy termination meds (abortion)
Misoprostol (cytotec)
Mifepristone (Mifeprex)
Oxytocin (pitocin)
SSRI - GYN
For premenstrual dysphoric disorder
Paroxetine (Paxil)
Fluoxetine (Prozac)
Sertraline (Zoloft)
In GU Section from PAM 640!
Review ED, Infectious processes such as epididymitis, orchitis, STIs.
Review Hypogonadism and Testosterone!
In GU Section from PAM 640!
Review ED, Infectious processes such as epididymitis, orchitis, STIs.
Review Hypogonadism and Testosterone!
Pubertal gynecomastia typically develops at what age?
Ages 10 - 12
With a peak (65%) between ages 13-14
Regression follows in approximately 80% of cases in 6 months - 2 years
Treatment for adolescent boys with severe breast enlargement
Brief trial (3 months) Tamoxifen (10mg BID) for tenderness
Are Aromatase inhibitors effective in the treatment of severe breast enlargement in adolescent boys?
No
Aromatase inhibitors are not effective
For men in whom no cause can be identified and the gynecomastia is tender and persists more than three months
What is the treatment?
Brief trial (3 to 6 months) of a selective estrogen receptor modulator (SERM) for relief of tenderness.
Tamoxifen (10mg BID) for tenderness
Inadequate experience withraloxifene. (not used)
For men with already developed gynecomastia
and are on antiandrogen therapy
What is treatment?
Tamoxifen
If it is a recent onset
and if likely to be in proliferative phase
Gynecomastia Causes
Spironolactone Antiandrogens Cimetidine Ketoconazole 5 - alpha reductase inhibitors
Selective estrogen receptor modulators
SERM
Clomiphene (Clomid)
raloxifene (evista)
Tamoxifen (soltamox)
What does a SERM do to breast tissue?
Selective estrogen receptor modulators
Tamoxifen
Exerts an anti estrogenic effect in breast tissue
It is important in treatment of estrogen/progesterone receptor positive breast cancer
What does a SERM do to bone?
Selective estrogen receptor modulators
Tamoxifen and raloxifene
Have selective agonist activity of estrogen receptors in bone tissue.
They decrease the risk of osteoporosis
What does a Tamoxifen (SERM) do to the uterus?
Selective estrogen receptor modulators
Tamoxifen
A partial estrogenic effect occurs in the uterus
Increases risk of endometrial carcinoma and uterine sarcoma
What does a Raloxifene (SERM) do to the uterus?
Selective estrogen receptor modulators
Raloxifene
Has a antagonistic effect of estrogen receptors on the uterus
Decreases risk endometrial carcinoma and uterine sarcoma
SERM Overview of different tissues
Selective estrogen receptor modulators
Tamoxifen & Raloxifene
Tamoxifen
Treats breast cancer
Increases risk of endometrial carcinoma and uterine sarcoma
Raloxifene
Decreases risk endometrial carcinoma and uterine sarcoma
Both Tamoxifen and Raloxifene
Decrease risk of osteoporosis
Tamoxifen
Soltamox (anti-estrogen)
Treatment of metastatic breast cancer in men & women
Contra
Coumarin anticoagulants, history of DVT/PE, planned pregnancy, nursing mothers
CAT D
Adverse
Hot flashes, Vaginal discharge, altered menses, rash, HA, nausea
Raloxifene
Evista
(SERM) Selective estrogen receptor modulators
Contra
History of DVT/PE/Thrombotic events, nursing mothers, planned pregnancy
CAT X
Interactions
May antagonize warfarin, avoid cholestyramine
Goal of therapy in men with sexual dysfunction
Improve libido
address 2 vital sexual functions
acquire and maintain adequate erection
Treat premature ejaculation
Why are PDE-5 inhibitors recommended
Efficacy
ease of use
favorable side effects
Which PDE-5 inhibitor is best?
Sildenafil, tadalafil, avanafil
All are equally effective
Tadalafil
Contraindicated in men taking nitrates
Who are PDE 5-inhibitors contraindicated in?
Contraindicated in men taking nitrates
What are alpha adrenergic antagonists used for?
BPH
-osin
Terazosin Tamsulosin Alfuzosin Silodosin Doxazosin
What do alpha adrenergic antagonists cause when combined with PDE-5 inhibitors?
Symptomatic Hypotension
If used
Tamsulosin and silodosin are better and less likely to cause hypotension
Treatment for Premature Ejaculation
SSRI’s are first line
Clomipramine is second line
5 P’s of sexual history
Partners Practices Protection from STD's Past history of STD's Pregnancy Prevention
STIs from CDC-
Read on your own and be prepared for questions on Exam
Chlamydia Treatment for Adolescents and Adults. Chlamydia Treatment for Pregnancy Chlamydia Treatment for Neonates Gonorrhea for Adolescents and Adults Bacterial Vaginosis Trichomoniasis PID Epididymitis Primary and Secondary Syphilis Chancroid Herpes Simplex
STIs from CDC-
Read on your own and be prepared for questions on Exam
Chlamydia Treatment for Adolescents and Adults. Chlamydia Treatment for Pregnancy Chlamydia Treatment for Neonates Gonorrhea for Adolescents and Adults Bacterial Vaginosis Trichomoniasis PID Epididymitis Primary and Secondary Syphilis Chancroid Herpes Simplex
Most frequent STD’s among women who have been sexually assaulted
Trichomoniasis
Bacterial vaginitis
Gonorrhea
Chlamydia
Treatment for sexual assaults in men
Empiric ABX for
Chlamydia
Ceftriaxone 500mg IM
Plus Doxy 100mg BID x 7 days
If over 150kg = 1 gram of Ceftriaxone
Treatment for sexual assaults in women
Empiric ABX for
Chlamydia
Gonorrhea
Trichomoniasis
Ceftriaxone 500mg IM
Plus Doxy 100mg BID x 7 days
Plus Metronidazole 500mg BID x 7 days
If over 150kg = 1 gram of Ceftriaxone
Infertility in men
resulting from secondary (hypogonadotropic) Hypogonadism
Treatment
Gonadotropin replacement therapy
Infertility in men
resulting from secondary (hypogonadotropic) Hypogonadism due to prolactin adenoma
Treatment
Dopamine agonist therapy
Cabergoline
(restores spermatogenesis and fertility)
Infertility in men resulting from
secondary (hypogonadotropic) Hypogonadism
Idiopathic dysspermatogenesis
Idiopathic male infertility
What not to use
Clomiphene citrate
Aromatase inhibitors
Gonadotropin therapy
Off label use Still being used despite up-to-date recommendations
(secondary Hypogonadism)
Clomiphene
anastrozole
hCG injection (Human chorionic gonadotropin)
Clomiphene Side effects
Changes in
Libido, Mood, Energy level
Increased aggression
Male pattern baldness
Enlarged prostate
Breast tenderness
Mild Acne
Clomiphene MOA
Pituitary gland secretes hormones into the blood
Clomiphene increases these hormones
This stimulates the production of testosterone and sperm in the testes
Boosted levels of these hormones will reduce symptoms of hypoandrogenism (low testosterone),
Increase sperm count, improve non obstructive azoospermia
(a blockage that prevent sperm from entering the semen)
Anastrozole MOA
Arimidex
Aromatase inhibitor
Originally for breast cancer
Now used off label for infertility in men
It blocks the enzyme aromatase
which prevents testosterone from changing into testosterone
Anastrozole Side effects
Arimidex
Aromatase inhibitor
Blood clots
cataracts
SJS
Herbs used in male fertility
Coenzyme 10
Infertility
Herbs used in male fertility
Yohimbe bark
ED
Libido
Herbs used in male fertility
Saw Palmetto
Low sperm count
Stress
Libido
Herbs used in male fertility
Maca root
Hormonal balance
Energy
Normal sexual function
Herbs used in male fertility
American Ginseng
Stamina
Immune system
Herbs used in male fertility
Tribulus
Sperm count
Testosterone production
Which of the below medications is known to cause gynecomastia?
Tamoxifen
Acetaminophen
ASA
spironolactone
spironolactone
Which of the below medications is known to treat gynecomastia?
Tamoxifen
Acetaminophen
ASA
spironolactone
Tamoxifen
Which of the following is the most updated antibacterial for the treatment of Gonorrhea?
Ceftriaxone
Doxycycline
Amoxicillin
Benzathine PCN G
Ceftriaxone
Which of the following is the most updated antibacterial for the treatment of Chlamydia?
Ceftriaxone
Doxycycline
Amoxicillin
Benzathine PCN G
Doxycycline
Which of the following is first-line medication for premature ejaculation in men?
Paroxetine
Clomiphene
Sildenafil
Finasteride
Paroxetine
Which of the below vitamins/herbs has shown some efficacy for Male infertility?
Yohimbe bark
Co-enzyme 10
Saw Palmetto
American Ginseng
Co-enzyme 10
Chlamydia treatment
Adults/adolescents
Doxycycline 100 mg PO BID for 7 days
Chlamydia treatment
Pregnancy
Azithromycin 1 g orally in a single dose
Chlamydia treatment
Neonates
Erythromycin base or ethyl succinate
50 mg/kg body weight/day orally
divided into 4 doses daily for 14 days
Gonorrhea Treatment
Adults/adolescents
Ceftriaxone 500 mg* IM in a single dose for persons weighing <150 kg
If chlamydial infection has not been excluded, treat for chlamydia with doxycycline 100 mg PO BID for 7 days.
Epididymitis Treatment
For acute epididymitis most likely caused by chlamydia or gonorrhea: Ceftriaxone 500 mg IM once, plus Doxycycline 100 mg PO BID for 10 days
For acute epididymitis most likely caused by chlamydia, gonorrhea, or enteric organisms (men who practice insertive anal sex): Ceftriaxone 500 mg once, plus Levofloxacin 500 mg PO QD for 10 days.
For acute epididymitis most likely caused by enteric organisms only: Levofloxacin 500 mg PO QD for 10 days
Primary and secondary syphilis Treatment
Benzathine penicillin G 2.4 million units IM once
Bacterial vaginosis treatment
Metronidazole 500 mg orally 2 times/day for 7 days
or
Metronidazole gel 0.75% one full applicator (5 g) intravaginally, once daily for 5 days
or
Clindamycin cream 2% one full applicator (5 g) intravaginally at bedtime for 7 days
Trichomoniasis Treatment
Women
Metronidazole 500 mg orally 2 times/day for 7 days
Men
Metronidazole 2 g orally in a single dose
PID Treatment
Ceftriaxone 1 g by every 24 hours
plus Doxycycline 100 mg PO or IV every 12 hours plus Metronidazole 500 mg PO or IV every 12 hours
or
Cefotetan 2 g IV every 12 hours
plus Doxycycline 100 mg orally or IV every 12 hours
or
Cefoxitin 2 g IV every 6 hours
plus Doxycycline 100 mg orally or IV every 12 hours
Chancroid Treatment
Azithromycin 1 g orally in a single dose
or
Ceftriaxone 250 mg IM in a single dose
or
Ciprofloxacin 500 mg orally 2 times/day for 3 days
or
Erythromycin base 500 mg orally 3 times/day for 7 days
Herpes Simplex Treatment
???? (-vir’s)
Most primary breast abscesses are caused by?
Staphylococcus aureus.
Methicillin-resistantS. aureusinfections are increasingly common.
Patients with recurrent breast abscess have an increased incidence of?
mixed flora and anaerobic infection.
Management of primary breast abscess
Consists of drainage and antibiotic therapy.
Which of the following is not part of the 5 P’s in taking a good history?
Practice Pregnancy Passing Past History Partners
Passing
Which of the below medications is not considered a SERM?
clomiphene (Clomid)
raloxifene (Evista)
tamoxifen (Soltamox)
anastrozole (Arimidex)
anastrozole (Arimidex)
Which of the following is considered a aromatase inhibitor?
clomiphene (Clomid)
raloxifene (Evista)
tamoxifen (Soltamox)
anastrozole (Arimidex)
anastrozole (Arimidex)
Should breastfeeding continue during treatment for lactation-associated breast infections?
Yes
We suggest that breastfeeding continue during treatment for lactation-associated breast infections.
If there is difficulty with breastfeeding, hand expression or breast pumping can be effective for maintaining the milk supply until nursing can resume.
In the setting of non-severe infection in the absence of risk factors for methicillin-resistantS. aureus(MRSA),
Treatment
outpatient therapy may be initiated withdicloxacillin(500 mg orally four times daily)
or
cephalexin(500 mg orally four times daily),
pending culture results.
In the setting of beta-lactam hypersensitivity,clindamycin(300 to 450 mg orally three times daily) may be used.
In the setting of non-severe infection with risk for MRSA,
Treatment
outpatient therapy withtrimethoprim-sulfamethoxazole(1 to 2 tabs orally twice daily)
or
clindamycin (300 to 450 mg orally three times daily) may be initiated.
In the setting of severe infection (eg, hemodynamic instability, progressive erythema)
Treatment
empiric inpatient therapy withvancomycin should be initiated
The optimal length of antibiotic therapy is not certain; 10 to 14 days following drainage is likely appropriate.
How to rule out anything bad from fibrocystic breast changes?
Fine needle aspiration
First-line therapy for breast pain It is typically safe but may not be effective.
Some practitioners also endorse therapies such as caffeine abstinence or evening primrose oil (EPO).
Although such therapies have not been proven effective by vigorous placebo controlled trials, they are generally harmless and may provide relief for some patients.
is conservative and typically includes reassurance that this is not a malignancy, physical support, over-the-counter analgesics, and manipulation of hormone-based medications for those who take them.
Acetaminophen or NSAID—Acetaminophenor a nonsteroidal anti-inflammatory drug (NSAID), or both, can be used to relieve breast pain.
How long do you use first line therapies in breast pain
We prefer to treat with first-line therapy for six months before moving onto one of the second-line therapies,
which may be more effective but also have more side effects.
Alternative therapies in breast pain
Although such therapies have not been proven effective by vigorous placebo controlled trials, they are generally harmless and may provide relief for some patients.
Second-line therapy after NSAIDSfor breast pain
Tamoxifen
Physiologic nipple discharge, or galactorrhea, is often caused by
hyperprolactinemia,
which may be secondary to medications, pituitary tumors, endocrine abnormalities, or other medical conditions.
Causes of hyperprolactinemia
may be secondary to medications, pituitary tumors, endocrine abnormalities, or other medical conditions.
Medications associated with galactorrhea
metoclopramide,
phenothiazines,
selective serotonin reuptake inhibitors [SSRIs]
Classes of medications that cause
galactorrhea
Antipsychotics 1st and 2nd gen Antidepressants (cyclic, SSRI, other) Antiemetic and GI Antihypertensive Opioid analgesics
Most episodes of lactational mastitis are caused by?
Staphylococcus aureus.
Methicillin-resistantS. aureus(MRSA) has become an important pathogen in cases of lactational mastitis.
Medication that is used to preventbreast cancerin women and treat breast cancer in women and men.
Tamoxifen(Nolvadex)
SERM that hasestrogenicactions on bone and anti-estrogenic actions on the uterus and breast.
Raloxifene(trade nameEvista)
is an oralselective estrogen receptor modulator(SERM)
Ethinyl estradiol
EE2 is an orally bioactive estrogen used in many formulations of combined oral contraceptive pills and is one of the most commonly used medications for this purpose
Aromatase inhibitors-used in postmenopausal females with breast cancer-Know
Androstenedione is converted to estrone estradiol by the enzyme aromatase
Aromatase inhibitors prevent this conversion
Antiestrogens prevent estrone estradiol from activating
Aromatase inhibitors- in men
Testosterone is converted to estrogen by the enzyme aromatase
Aromatase inhibitors block this
Tamoxifen and estrogen receptors
Tamoxifen blocks the estrogen receptor so estradiol cannot bind
3rd generation aromatase inhibitors
Steroidal
Superselective
Exemestane (aromasin)
3rd generation aromatase inhibitors
Non-Steroidal
Superselective
Anastrozole (Arimidex)
Letrozole (femara)
Letrozole
Femara (aromatase inhibitor)
In postmenopausal women: Adjuvant treatment of hormone receptor positive early breast cancer
2.5mg QD
Contra
Pregnancy
Warnings
Monitor bone mineral density, serum cholesterol. Severe renal or hepatic impairment. Embryo-fetal toxicity;
Adverse
Pain (bone, musculoskeletal, and others), hot flashes, arthralgia, flushing, asthenia, edema,
What are the two most common causes of acute cervicitis.
Neisseria gonorrhoeaeandChlamydia trachomatisare the two most common causes of acute cervicitis.
Mycoplasma genitaliumcontributes to cervicitis, but this organism is likely responsible for a substantial minority of cases.
What is recurrent cervicitis and how is it treated?
Women who present with recurrent symptoms are reevaluated for possible re-exposure or treatment failure.
Treat persistent cervicitis for presumedM. genitaliumwith single-doseazithromycin(1 g orally),
HPV Vaccines
9-valent vaccine (Gardasil 9) quadrivalent vaccine (6, 11, 16, and 18)
9-valent vaccine (Gardasil 9)
targets the same HPV types as the quadrivalent vaccine (6, 11, 16, and 18)
Gardasil 9
Contra
Yeast allergy
Adverse
Inj site reactions (eg, swelling, erythema, pain), headache; post-administration syncope (may be associated with tonic-clonic movements and other seizure-like activity).
Management of Polycystic ovary syndrome
The management of polycystic ovary syndrome (PCOS) requires treatment of individual components of the syndrome, including
menstrual dysfunction and the risk of endometrial hyperplasia,
hyperandrogenism (hirsutism and acne),
metabolic risk factors (obesity, glucose intolerance, and dyslipidemia),
and in some women, anovulatory infertility.
The choice of therapy depends upon whether the patient is pursuing pregnancy or not.
Management of Polycystic ovary syndrome
in women not pursuing pregnancy
and menstrual dysfunction
Menstrual dysfunction–
For women with PCOS, oligomenorrhea, and chronic anovulation we suggest COC therapy.
We typically start with a COC containing 20 mcg of ethinyl estradiol combined with a progestin such asnorethindroneor norethindrone acetate, progestins that have lower androgenicity, but similar VTE risk compared with levonorgestrel-containing COCs.
Management of Polycystic ovary syndrome
in women not pursuing pregnancy
and hyperandrogenic symptoms
Women with hyperandrogenic symptoms–
For most women with hirsutism or other androgenic manifestations such as acne or female pattern hair loss, we also suggest starting with a COC (in addition to lifestyle measures).
We typically start with a COC containing 20 mcg of ethinyl estradiol combined with a progestin such asnorethindroneor norethindrone acetate, progestins that have lower androgenicity, but similar VTE risk compared with levonorgestrel-containing COCs.
COC therapy for Polycystic ovary syndrome
in women not pursuing pregnancy
We typically start with a COC containing 20 mcg of ethinyl estradiol combined with a progestin such asnorethindroneor norethindrone acetate, progestins that have lower androgenicity, but similar VTE risk compared with levonorgestrel-containing COCs.
Management of Polycystic ovary syndrome
in women not pursuing pregnancy
and metabolic disorders
Metabolic disorders–
Weight loss, which can restore ovulatory cycles, improve metabolic risk, and possibly improve live birth rates, is the intervention for most women.
Management of Polycystic ovary syndrome
in women planning to become pregnancy
Anovulatory infertility and ovulation induction–
For women with PCOS and anovulatory infertility, attempts at weight loss should be tried first in those who are obese.
If this does not restore ovulatory cycles, ovulation induction is required.
Letrozole, an aromatase inhibitor, is now the first-line ovulation induction agent overclomiphenecitrate for women with PCOS.
Uterine disorders
Endometriosis
Leiomyoma
Prolapse
Endometriosis with mild to moderate pain
nonsteroidal anti-inflammatory drugs (NSAIDs)
and continuous hormonal contraceptives
rather than either agent alone.
These therapies are low-risk, have few side effects, are low-cost, and are generally well-tolerated compared with other medical therapies.
Women who wish to conceive can use the NSAID alone.
Endometriosis with severe pain
Severe symptoms, symptoms that do not respond to the other therapies, or recurrent symptoms,
Trial of gonadotropin-releasing hormone (GnRH) analog with add-back hormonal therapy rather than surgical resection.
GnRH analog treatment has demonstrated efficacy without the risks or negative impact on ovarian reserve of surgery.
Medical Treatment for endometriosis
Hormonal contraceptives
Gonadotropin-releasing hormone (Gn-RH) agonists and antagonists
Progestin therapy
Danazol
Aromatase inhibitors
GnRH agonist
leuprolide
leuprolide depot 3.75mg
Lupron GNRH Agonist
3.75mg
Contra
Undiagnosed abnormal vaginal bleeding.
Pregnancy.
Nursing mothers.
When co-administered with norethindrone acetate, its contraindications also apply to this combination regimen.
Danazol
Androgen derivative
Indications:
Endometriosis, Fibrocystic breast disease
Orally active
Inhibit ovulation for 4-9 months
Danazol MOA
Weak synthetic androgen that suppresses the pituitary ovarian axis by inhibiting the output of pituitary gonadotropins
Elagolix
Orissa (GNRH antagonist)
Indications
Moderate to severe pain associated with endometriosis.
Contraindications:
Pregnancy. Osteoporosis. Severe hepatic impairment.
Leiomyoma treatment
Treatment of fibroids is aimed at resolving or reducing the symptoms associated with the lesions.
Common symptoms include prolonged or heavy menstrual bleeding (HMB), bulk symptoms, pain, and impaired fertility. Symptoms can be present in isolation or combination
Leiomyoma symptoms
Common symptoms include prolonged or heavy menstrual bleeding (HMB), bulk symptoms, pain, impaired fertility.
Symptoms can be present in isolation or combination
Treatment or patients with all other types of fibroids
(ie, not exclusively submucosal)
who do not desire pregnancy
(Leiomyoma)
Initial treatment with a combined estrogen-progestin contraceptive
(oral pills, transdermal patch, or vaginal ring).
Alternatives treatments
levonorgestrel-releasing intrauterine devices,
tranexamic acid
progestin-only pills
Alternatives treatments for patients with all other types of fibroids
(ie, not exclusively submucosal)
who do not desire pregnancy
(Leiomyoma)
Alternatives treatments
levonorgestrel-releasing intrauterine devices,
tranexamic acid
progestin-only pills
For patients whose symptoms persist despite trial of one or more first-tier therapies for
(Fibroids/Leiomyoma)
Second-tier medical treatments for fibroid-associated HMB include
gonadotropin-releasing hormone (GnRH) agonists and antagonists
Last line for (Fibroids/Leiomyoma)
Surgery
Most common types of vaginitis
The most common infections,
bacterial vaginosis (BV),
Candidavulvovaginitis,
trichomoniasis,
account for over 90 percent of infections.
Bacterial vaginosis (BV) treatments
Metronidazole 500 mg orally 2 times/day for 7 days
or
Metronidazole gel 0.75% one full applicator (5 g) intravaginally, once daily for 5 days
or
Clindamycin cream 2% one full applicator (5 g) intravaginally at bedtime for 7 days
Candida treatment
OTC
Clotrimazole
Nystatin
Miconazole
Prescription Terconazole Tioconazole Butoconazole Fluconazole Ibrexafungerp
Treatment of complicated vaginitis
Severe or recurrent
Oral Fluconazole 150mg Q72h
Treatment of complicated vaginitis
and pregenant
Topical
Clotrimazole
Miconazole
for 7 days
Trichomoniasis
It is the most common non-viral sexually transmitted disease (STD) worldwide.
Women are affected more often than men
The most common non-viral sexually transmitted disease (STD) worldwide.
Trichomoniasis
Women are affected more often than men
Treatment of Trichomoniasis for both symptomatic and asymptomatic females and males.
(Non-pregnant)
For nonpregnant females and their sex partners, we suggest a seven-day course ofmetronidazole, 500 mg twice daily.
The single-dose regimen is a reasonable alternative for those who are unable to complete a seven-day treatment regimen or who prefer single-day treatment.
Oral administration is significantly more effective than topical administration.
Treatment reduces the prevalence ofT. vaginaliscarriage in the population, relieves symptoms, and reduces the risk of sequelae (including acquisition/transmission of HIV).
Treatment of Trichomoniasis for both symptomatic and asymptomatic pregnant females
We prefer the seven-day regimen and reserve the single-dose regimen for patients who are unable to complete a seven-day treatment course.
7-day course ofmetronidazole, 500 mg twice daily.
We recommend treating symptomatic pregnant females with confirmedT. vaginalisinfections.
In addition, we suggest treating asymptomatic pregnant individuals with confirmed infection.
Tinidazole vs metronidazole
Trichomoniasis treatment
Tinidazolegenerally causes fewer gastrointestinal side effects, but the cost is higher compared withmetronidazole
