STD Phamacology and Therapeutics

Question 1

First line treatment of Gonorrhea

Answer 1

patient less than 150kg= ceftriaxone 500mg IM

patient more than 150kg= 1g IM injection

Question 2

what medication are you giving empirically in someone with gonorrhea?

Answer 2

doxycycline 100 mg BID for 7 days

• this is to cover chlamydia

Question 3

if patient cant use cetriaxone for gonorrhea what else can you prescribe?

Answer 3

cefixime

Question 4

Ceftriaxone

MOA:

Drug class:

Indications:

Contraindications:

Side effects:

Answer 4

MOA: kills bacteria by inhibiting the final stage go cell wall synthesis by binding to specific penicillin binding proteins

Drug class: third generation cephalosporin

Indications: first line for gonorrhea IM; can be used for UTI, pneumonia, endocarditis

Contraindications: if allergic to cephalosporins

Side effects: hypersensitivity rxn, elevated transamination

Question 5

first line treatment for chlamydia:

second line:

Answer 5

first line: doxycycline 100 mg orally BID for 7 days

second line: azithromycin 1gm orally

Question 6

Doxycycline

MOA:

Drug class:

Indications:

Contraindications:

Side effects:

Answer 6

MOA: bacteriostatic- preventing the growth of bacteria by binding to the 30s subunit

Drug Class: Tetracycline

Indications: gram (+) and gram (-) bacteria

Contraindications: pregnancy and children younger than 8

side effects: retards bone growth, stains teeth, photosensitivity

Question 7

Azithromycin

MOA:

Drug class:

Indications:

Contraindications:

Side effects:

Answer 7

MOA: bacteriostatic or bactericidal and inhibits the 50s subunit

Drug class: Macrolide

Indications: gram (-), gram (+), atypical bacteria

Contraindications: arrhythmia, long QT syndrome

Side effects: arrhythmia

Question 8

syphillis treatment-

primary, secondary, latent phase:

tertiary phase:

allergic to first line agent:

Answer 8

primary, secondary, latent phase: penicillin G 2.4 million units IM

tertiary: penicilin G 2.4 million units once weekly for 3 weeks

allergic to penicilin G: doxycycline 100 mg PO twice a day for 15 days

Question 9

Penicillin G

MOA:

Drug class:

Indications:

Contraindications:

Side effects:

Answer 9

MOA: bactericidal; inhibits the final stage of bacterial cell wall synthesis and binds to PBP

Drug class: Beta Lactam

Indications: Syphillis, step infections

Contraindications: IV associated with cardiopulmonary arrest and death

Side effects: Jarisch-Herxheimer reaction

Question 10

what is Jarish-herxheimer reaction

Answer 10

an acute febrile reaction caused by penicillin G it is accompanied by headache, myalgia within the first 24 hrs after therapy

Question 11

pregnant and neurosphyillis patients allergic to penicillin should be _ and treated with penicillin

(syphillis but allergic to penicillin)

Answer 11

desensitized

(bc doxycycline is contraindicated)

Question 12

first line treatment for Trichomoniasis

second line

Answer 12

first line: metronidazole 500mg PO BID for 7 days

second line: single dose of any oral 2mg nitroimidazole

Question 13

Metronidazole

MOA:

Drug class:

Indications:

Contraindications:

Side effects:

Answer 13

MOA: antibacterial and antiprotazoal it intercalates into the DNA and causes breakage and disrupts DNA synthesis

Drug class: Nitroimidazole

Indications: protozoans and anaerobic bacteria

Contraindications: pregnancy

Side effects: disulfiram reaction with alcohol

Question 14

genital herpes treatment options

Answer 14

acyclovir 800 oral 3 times a day for 2 days

OR

valacyclovir 1000g once a day for 5 days

OR

famiciclovir 1000g by moth two times a day for 1 day

Question 15

Cyclovirs

MOA:

Drug class:

Indications:

Contraindications:

Side effects:

Answer 15

MOA: inhibits viral DNA synthesis must be phosphorylated intracellular to be active

Drug class: purine deoxynucleoside analog

Indications: herpes virus and CMV

Contraindications: renal failure

Side effects: nephrotoxicity/renal failure

**can be used in pregnancy