Pharmaceutical Care of STDs

Question 1

What is the risk of untreated STI?

Answer 1

Complication in pregnancy
Neonatal + infant infections
Cardiovascular damage
Neurological damage
Increased resistance to antimicrobials

Question 2

What does STDs increase the risk of + why?

Answer 2

Getting HIV
= sores + lesions = easier for HIV to enter body
= STDs increase viral load = increase HIV transmission

Question 3

What is the aetiology of chlamydia?

Answer 3

C. trachomatis attaches to mucosal surface to induce a strong inflammatory response

Question 4

What are the symptoms of chlamydia?

Answer 4

Most asymptomatic
Cause bleeding after sex/between periods
Discharge

Question 5

What are the complications of chlamydia?

Answer 5

Pelvic inflammatory disease (PID) in females
Epididymitis in males

Question 6

What is the test for chlamydia?

Answer 6

1st-catch urine sample
Or vaginal/urethral swab

Question 7

What is 1st line treatment for chlamydia?

Answer 7

Doxycycline 100mg 2x a day for 7 days

Question 8

What is 2nd line treatment for chlamydia?

Answer 8

Azithromycin 1g orally for 1 day, then 50mg 1x daily for 2 days

Question 9

What is the aetiology of gonorrhoea?

Answer 9

N. gonorrhoeae to mucosal surface + resists phagocytosis

Question 10

What are the symptoms of gonorrhoea?

Answer 10

Less asymptomatic than chlamydia
Bleeding after sex/between periods
Discharge
Pain on urination

Question 11

What are the complications of gonorrhoea?

Answer 11

PID in females
Epididymitis in males
Passed from mother to baby during childbirth

Question 12

What is the test for gonorrhoea?

Answer 12

1st-catch urine sample
OR vaginal/urethral swab

Question 13

What is 1st line treatment for gonorrhoea?

Answer 13

Ceftriaxone 1g IM as single dose

Question 14

What is 2nd line treatment for gonorrhoea?

Answer 14

Ciprofloxacin 500mg as single dose

Question 15

What is the aetiology of syphilis?

Answer 15

Helical structure of T. pallidum allows it to move through mucosal surface or enter breaks in the skin

Question 16

What are the symptoms of syphilis?

Answer 16

Initial contact = primary chancre (small sore)
Primary syphilis = swollen glands in neck, groin + armpits
Secondary syphilis = small skin growths red rash, flu-like symptoms
Latent syphilis = infection dormant
Tertiary syphilis = meningitis, stroke, dementia symptoms, numbness

Question 17

What is the test for syphilis?

Answer 17

Blood sample
OR virology swab from active lesion

Question 18

What is the treatment for syphilis?

Answer 18

Initiated at GUM clinic as unlicensed in UK

Question 19

What is the aetiology of genital warts?

Answer 19

Replicated within basal cells of epithelium

Question 20

What are the symptoms of genital warts?

Answer 20

Swelling + warts in genital area
May appear over year after infection
Bleeding after sex/between periods
Discharge
Pain when urinating

Question 21

What is the test for genital warts?

Answer 21

Visual diagnosis

Question 22

What is the treatment of genital warts?

Answer 22

NO cure for HPV
Warts tend to disappear within 6 months

Question 23

What is the aetiology of genital herpes?

Answer 23

Direct skin to skin contact, exposure to infected saliva, semen, vaginal fluid or fluid from herpetic blisters

Question 24

What are the symptoms of genital herpes?

Answer 24

Headache, fever, dysuria or tender lymph nodes in groin
Painful ulcers
Discharge
Pain in urination

Question 25

What is the test for genital herpes?

Answer 25

Visual diagnosis
Swab of lesion
Polymerase chain reaction (PCR)

Question 26

What is the 1st line treatment for genital herpes?

Answer 26

Aciclovir 400mg 3x a day for 5-10 days
OR 200mg 5x a day for 5-10 days

Question 27

What is the 2nd line treatment for genital herpes?

Answer 27

Valaciclovir 500mg orally 2x a day for 5-10 days
OR Famciclovir 250mg 3x a day for 5-10 days