STDs Flashcards
MOA of benzathine Penicillin G
bactericidal beta-lactam binds PBPs causing cell lysis.
Poor CSF penetration
ADE of benzathine penicillin G
rapid renal elimination (avoid renal failure)
hypersensitivity and skin rashes.
Jarisch-Herxheimer Reaction with most secondary syphilis patients after first injection: chills fever headache myalgias and arthralgia. Lesions become brilliant in color. Do NOT discontinue penicillin. Aspirin gives relief.
MOA of procaine Pen G?
penicillin mixed with procaine, a local anisthetic. Goal is to reduce pain of large IM injections.
MOA of acyclovir
guanosine analog. Inhibits viral DNA polymerase and competes with deoxyguanosine triphosphate for incorporation into viral DNA.
REQUIRES thymidine kinase phosphorylation.
ADE of acyclovir
neurotoxicity including seizures because it penetrates CSF
Patient must be well hydrated to avoid crystalline nephropathy
MOA of cidofovir
viral DNA polymerase inhibitor. DOES NOT REQUIRE PHOSPHORYLATION BY thymidine kinase.
ADE of cidofovir
nephrotoxicity. Give probenecid (urocosuric) to prevent it.
MOA of famciclovir
Guanosine analog. Famciclovir is metabolized to penciclovir and does not cause chain termination. Inhibits viral DNA polymerase by competing with deoxyguanosine triphosphate.
Requires thymidine kinase phosphorylation.
ADE of famciclovir
no significant issues. FAMcyclovir=Family friendly
Patient must be well hydrated to avoid crystalline nephropathy
MOA of cervarix
recombinant L1 protein (major antigenic protein of HPV capsid).
Protects against HPV 16 and 18 (bivalent)
ADE of cervarix
injection site irritation and pain
MOA of gardasil
recombinant L1 protein (major antigenic protein of HPV capsid).
Protects against HPV 6, 11, 16 and 18 (quadrivalent)
ADE of gardasil
injection site irritation and pain
MOA of azithromycin
macrolide. binds 50S ribosomal subunit: bacteriostatic
ADE of azithromycin
GI upset
vaginitis
MOA of ceftriaxone
cephalosporin. beta-lactam; binds PBPs causing cell lysis. bactericidal
MOA of clindamycin
binds 50S ribosomal subunit to inhibit protein synthesis. bacteriostatic.
ADE of clindamycin
When used intravaginally, increases risk of low birthweight and pre-term delivery.
Excreted in breast milk.
GI upset even when given intravaginally.
vaginal pain
MOA of doxycycline
tetracycline. binds 30S ribosomal subunit: inhibits protein synthesis. bacteriostatic
ADE of doxycycline
GI upset
hepatic damage in high dose (esp in pregnancy)
photosensitivity
Cat. D teratogen
MOA of levofloxacin
fluoroquinolone. Inhibits DNA gyrase (topo II) in gram negative: bactericidal
Inhibits topo IV in gram-positive
ADE of levofloxacin
taste disturbance (levo -> leavened bread taste) BBW of risk of tendonitis and rupture BBW of exacerbation of muscle weakness Contraindicated with myasthenia gravis Cat. C teratogen
MOA of metronidazole
metro–>multi.
amebicidal, bactericidal and trichomonacidal.
Taken up by anaerobic organisms and cells where it is reduced to active form and disrupts DNA helical structures, inhibiting bcterial nucleic acid synthesis.
Equally effective against dividing and non-dividing cells.
ADE of metronidazole
extensive hepatic metabolism. Urine discoloration. Disulfiram-like effect (avoid alcohol) Inhbiits CYP2C9 Avoid in pregnancy and breastfeeding.
MOA of ofloxacin
fluoroquinolone. Inhibits DNA gyrase (topo II) in gram negative: bactericidal
Inhibits topo IV in gram-positive
ADE of ofloxacin
BBW of risk of tendonitis and rupture
BBW of exacerbation of muscle weakness
Contraindicated with myasthenia gravis
Cat. C teratogen
ADE of butaconazole
high doses produce abdominal wall defects and cleft palate in fetus. avoid in 1st trimester.
Can weaken latex condoms because oil based.
MOA of butaconazole
blocks ergosterol synthesis from lanosterol.
interacts with 14-alpha demethylase (CYP) necessary for conversion of lanosterol
What is the Jarisch-Herxheimer Reaction?
occurs in most secondary syphilis patients after first injection of penicillin: chills fever headache myalgias and arthralgia. Lesions become brilliant in color. Do NOT discontinue penicillin. Aspirin gives relief.
