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Reproductive > STI Drugs > Flashcards

STI Drugs Flashcards

1
Q

-cyclovir/ciclovir

A 
PO: 7-10 days (2-5x daily)
antiviral: inhibits DNA pol
activation: viral thymidine kinase
dose adjust in renal disease
Tx: HSV
HYDRATION (avoid crystalline nephropathy/neuro), cross hyper-sensitivity
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2
Q

(val)acyclovir

A

chain termination
AE: neurotoxicity, seizures (penetrates CNS)
val: prodrug with better oral bioavailability

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3
Q

famciclovir

A

metabolized to penciclovir
NO chain termination
AE: none significant

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4
Q

cervarix

A

recombinant L1 protein
IM: IgG neutralizing Ab
bivalent HPV vaccine: 16, 18
AE: hypersensitivity

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5
Q

gardisil

A 
ages 9-26 yrs
recombinant L1 protein
IM: IgG neutralizing Ab 
quadrivalent HPV vaccine: 6, 11, 16, 18
AE: hypersensitivity 
grown in YEAST
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6
Q

podofilox

A 
topical
MOA: mitotic spindle inhibitor
Tx: HPV genital warts
AE: pruritus
not recommended in pregnancy
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7
Q

imiquimod

A 
topical
MOA: antiviral toll-like receptor activator (immune modifier): stimulates IFN and cytokine production
Tx: HPV genital warts
AE: pruritus
not recommended in pregnancy
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8
Q

sinecatechins

A

topical
MOA: keratolytic: antioxidant
AE: pruritus
Tx: HPV genital (warts?)

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9
Q

beta lactams

A

MOA: binds PBP inducing cell lysis

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10
Q

macrolide

A

MOA: 50s ribosomal inhbitor

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11
Q

quinolone

A

MOA: DNA gyrase inhibitor (topo II) in G-; inhibit topo IV in G+
Tx: chlamydia ALT, cervicitis ALT
AE: TENDONITIS/RUPTURE

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12
Q

cephalosporins

A

MOA: binds PBP inducing cell lysis

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13
Q

amoxicillin

A

PO
beta lactam
CAN be used in pregnancy
adjust dose in renal disease

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14
Q

azithromycin

A 
PO
long T1/2
macrolide
AE: GI
Tx: chlamydia 1st, urethritis ALT, cervicitis ALT
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15
Q

cefixime

A

PO
cephalosporin
false pos. urinary glucose test
Tx: chancroid ALT, gonococcal ALT + azithromycin

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16
Q

ciprofloxacin

A 
PO
quinolone
CYP1A2 inhibitor
CI: pregnancy, lactation
Tx: chancroid ALT (not chlamydia/cervicitis)
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17
Q

ceftriaxone

A

IM
cephalosporin
AE: GI
Tx: chancroid ALT, gonococcal ALT + azithromycin

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18
Q

clindamycin

A 
PO/gel
MOA: 50s ribosomal inhibitor
AE: GI, C. DIFF infection
gel AE: discontinue after 1st trimester (pre-term, low birth weight, ruptured membranes), contact irritation
Tx: vaginosis ALT
19
Q

doxycycline

A

PO
long T1/2
MOA: 30s ribosomal inhibitor
AE: HEPATIC (esp. in pregnancy), PHOTOSENSITIVE
Tx: chlamydia 1st, urethritis ALT, cervicitis ALT

20
Q

erythromycin base

A

PO
short T1/2
macrolide
CYP3A4 INHIBITOR
substrate: P-gp, CYP3A4
AE: HYPERTROPHIC PYLORIC STENOSIS in neonates
Tx: chlamydia ALT, chancroid choice, cervicitis ALT

21
Q

levofloxacin

A

PO

quinolone

22
Q

metronidazole

A 
MOA: disrupts DNA structure
resistance: decreased activation, increase free radical scavenging, increased DNA repair
inhibit: CYP2C9
CI: pregnancy/breastfeeding
AE: DISULFIRAM 
Tx: trichmoniasis ALT, vaginosis ALT
23
Q

ofloxacin

A

PO

quinolone

24
Q

penicillin G

  1. aqueous crystalline
  2. benzathine
  3. procaine
A

beta lactam
1. IV: congenital syphilis (10 days)
2. IM: syphilis 1st (not good for neurosyphilis: no BBB penetration)
3. IM: congenital syphilis (10 days)
AE: HYPERSENSITIVITY (if pregnant, desensitize and Tx), Garish-Herxheimer Rxn

25
Q

-azoles

A

MOA: ergosterol syn. inhibitors (14alpha demethylation of lanosterol)
gel/cream: limited systemic absorption/residual activity for days; oil based weaken condoms
resistance: decreased drug, target mutation/up-regulation, bypass pathways
Tx: candidiasis ALT
avoid in 1st trimester: systemic dose causes abdominal wall defects, cleft palate

26
Q

tinidazole

A

OTC
gel/cream -azole; disrupt DNA structure (oral) inhibiting nucleic acid syn.
metabolism: CYP3A4
Tx: trichomoniasis ALT, vaginosis 2nd ALT
CI: pregnancy, breastfeeding
AE: DISULFIRAM

27
Q

butoconazole

A

Rx

gel/cream -azole

28
Q

clotrimazole

A

OTC

gel/cream -azole

29
Q

fluconazole

A

Rx
PO -azole
CYP2C9 inhibitor

30
Q

miconazole

A

OTC

gel/cream -azole

31
Q

terconazole

A

Rx

gel/cream -azole

32
Q

ticonazole

A

OTC

gel/cream -azole

33
Q

Jarisch-Herxheimer Rxn

A

release of spirochetes (syphilis) antigens with host rxn to products: chill, fever, headache, myalgia, arthralgia, more prominent syphilitic cutaneous lesions (fade within 48 hrs)
do NOT discontinue penicillin

34
Q

HSV Tx

A

acyclovir, famciclovir, valacyclovir

35
Q

Syphilis Tx

A

penicillin G

36
Q

Chlamydia Tx

A

azithromycin (1 day) or doxycycline
ALT: erythromycin, levofloxacin, ofloxacin
everything else: 1 week
ALT in PREGNANCY: amoxicillin

37
Q

Chancroid Tx

A

azithromycin (oral, 1 dose) or ceftriaxone (IM, one dose) or ciprofloxacin or erythromycin base

38
Q

uncomplicated gonococcal infection Tx (cervix, urethra, rectum)

A

ceftriaxone or cefixime plus azithromycin (preferred due to tetracycline resistance) or doxycycline
pharynx infection: same but don’t use cefixime

39
Q

urethritis/cervicitis Tx

A

azithromycin or doxycycline

ALT: erythromycin base, levofloxacin, ofloxacin

40
Q

recurrent Tx for urethritis/cervicitis

A

metronidazole or tinidazole plus azithromycin (if NOT used in original Tx)

41
Q

trichomoniasis Tx

A

metronidazole or tinidazole

42
Q

bacterial vaginosis

A

metronidazole or clindamycin

ALT: tinidazole, clindamycin

43
Q

candidiasis Tx

A

OTC: butoconazole, clotrimazole, miconazole, ticonazole
Rx: butoconazole, terconazole, fluconazole (only oral)

Reproductive (12 decks)

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