STD Pharm Flashcards by Matt McCulloch

HSV drugs

FAV (HSV is my FAV)
Famciclovir
Acyclovir
Valacyclovir

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HSV tx regiment

7-10 day oral

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What’s that enzyme needed by some agents that phosphorylates them

thymidine kinases

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Famciclovir is metabolized to:

penciclovir

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Acyclovir toxicity

Neurotoxic inc. seizures

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Valacyclovir toxicity

neurotoxic

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Why is valacyclovir better than acyclovir

better oral bioavailability

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Syphilis drugs

Benzathine-Penicillin G (IM)
Poor CSF penetration
rapid renal tubular excretion

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Congenital syphilis tx course

10 days; if more than one day missed, start again

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What is the Jarisch-Herxheimer reaction?

Flu-like symptoms a few hours post-penicillin for syphillis

Lesions may become more powerful

Do NOT discontinue
ASA for symptoms

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Chlamydia drugs

Azithromycin or Doxy
Erythromycin, Levofloxacin, Ofloxacin are alts

Pregnancy: Amoxicillin (doesn’t cross placenta Cat B)

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Azithromycin MOA

50S static

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Doxycycline MOA

30S static

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Erythromycin MOA

50S static

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Levofloxacin and ofloxacin MOA

DNA gyrase II and topo IV inhibitors

bactericidal

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Amoxicillin MOA

beta lactam binds PBPs - cell lysis

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Levo and ofloxacin ADME

Renal excretion (dose dec)
Taste disturbance (levo)
GI
BBW for tendonitis and rupture
BBW make myalgias worse (avoid with MG)

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Doxy AEs

Hepatic damage in HD esp pregnancy

Photosensitivity

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Erythromycin ADME and AEs

Inactivated by gastric acid
CYP3A4 inhibitor

GI upset

Chancroid drugs

Azithromycin, Ceftriaxone, Ciprofloxacin, Erythromycin

Cipro C/I pregnancy

Cipro mechanism

DNA gyrase / topo IV, bactericidal

GC genital uncomplicated drugs

Ceftriaxone, Cefixime + Azithro or Doxy

GC pharynx drugs

Ceftriaxone + Azithromycin or Doxy

Cefixime AEs

GI, increase clotting time, false positive urinary glucose in diabetics

Urethritis and cervicitis drugs

Azithromycin or Doxy, alt Erythromycin or levo of ofloxacin

Recurrent urethritis/cervicitis drugs

(metronidazole or tinidazole) plus Azithromycin (If azithro not tried yet)

Trichomoniasis drugs

Metronidazole or tinidazole

Metronidazole / tinidazole MOA

Amebecidal, bactericidal, trichomonacidal | Taken up, reduced to active form, disrupts DNA helical structure (dividing and non)

Metro/tinidazole ADME

Extensive hepatic metabolism

Metro/tinidazole issues

Avoid in prego and breastfeeding GI upset Candidiasis Disulfiram-like effect (no alcohol few days after therapy!)

Bacterial vaginosis drugs

Metronidazole plus tinidazole, or | clindamycin plus tinidazole

Clindamycin MOA

50S, static

Clindamycin issues

Intravaginal use only in 1st trimester bc of AEs like low birth wt, pre-term delivery, etc.

Candidiasis drugs

A conazole

Conazoles MOA

block ergosterol synthesis by binding 14-alpha demethylase

Conazoles ADME

Limited systemic abs | Fluconazole widely distributed in tissues/fluids

Conazoles AEs

High doses may produce abdominal wall defects and cleft palate (avoid in 1st trimester)

Gardasil strains

6, 11, 16, 18

Cervarix strains

16, 18

HPV vaccine target

L1, the major antigen of capsid

Genital warts strains?

HPV 6 and 11

Genital warts drugs

Podofilox, imiquimod, sinecatechins

Podofilox MOA

mitotic spindle inhibitor blocking MT activity in keratinocytes

Imiquimod MOA

Immune response modifier

Sinecatechins MOA and AEs

Green tea extract antioxidant | Application site discomfort