STI medication Flashcards
syphilis
long acting Benzathine Penicillin G deep IM
what do give for syphilis if patient is allergic to PCN
doxycyline, tetracycline and ceftriaxone (rocephine)
what is the mechanism of PCN for syphilis
prevent cell wall synthesis
chlamydia
Doxycycline 100 mg PO 2xd for 7d
what is the alternate treatment for chlamydia
azithromycin 1g PO
levofloxacin 500 mg PO daily x 7d
doxycycline is best practice treatment
what is the mechanism of action for doxycycline
inhibit bacterial protein synthesis
gonorrhea
ceftriaxone (rocephin) 500 mg in a single does for person weighing 150 kg (330 Ib)
ceftriaxone 1 g for heavier individuals
also treat for chlamydia if cannot be ruled out.
what to give for gonnorhea if patient is allergic to cephalosporin antibiotics?
gentamycin 240 mg IM in single does plus azithromycin 2g PO in single does
mechanmism of order for rocephalin
inhibit cell wall synthesis
MOA for gentamycin and azithromycin
inhibit protein synthesis
Pelvic Inflammatory Disease (PID)
IV therapy for hospitalized patients and PO for 14 days for outpatient treatment
given ceftriaxone 500 mg
1g IV q24 h + doxycycline 100 mg PO or IV for q12h
given IV q12h + metronidazole 500 mg PO or IV q12h
alternative PID treatment
cefoxitin (Mefoxin) 2g q6h
cefotetan 2 g q12h
plus doxycycline 100 mg PO or IV q12h
what is the MOA cefoxilin and cefotetan
inhibit bacterial wall synthesis
Human Papillomavirus (HPV) infection
Ceravrix: 2-valent (2vHPV) that target HPV 16 and 18
Gardasil: 4 valent vaccine (4vHPV) that target HPV type 6, 11, 16 and 18
Gardasil 9: 9 valent vaccine (9vHPV) targets HPV type 6, 11l 18, 31, 33, 45, 52, 58
type 16 and 18 66% of cervical cancer
the five by gardasil 9 accounts for 15%
type 6 and 11 cause >90% of genital warts
gardasil 9 is only available in US
HPV vaccination
routine HPV for all adolescent at age 11or 12 years
administering vaccine start at age 9
catchup vaccine through age 26 for those not vaccinated previously
shared clinical decision-making between patient and provider regarding HPV vaccination is reccomended for certain adult age 27-45 years not previously vaccinated
2-dose vac schedule (at 0- and 6-12month interval) for persons who initiate vaccination before 15th birthday
3 dose-vaccination (0-. 1-2, and 6 month interval) for immunocompromise persons regardless of age of initiation
treatment for genital warts
Imiquimod 3.75% or 5% cream or Podofilox 0.5% solution or sinectechins 15% ointment.
Applied at bedtime for several weeks.
Imiquimod
immune enhancer that stimulate production of interferon and other cytokines.
Pidofilox
causes wart necrosis
sinecatechin
Green tea extract that exhibit an inhibitory effect blocking enzymes needed for tumor cell signaling and growth and increase the rate of cell death
Genital Herpes Simplex Virus for first clinical episodes
acyclovir (Zovirax) 400 mg orally 3xd for 7-10 days
famciclovir (famvir) 250 mg orally 3xd for 7-10 days
valacyclovir (Valtrex) 1 g orally 2xd for 7-10 days
larger does in shorter duration time
suppressive therapy for HSV 2
acyclovir 400 mg PO 2x day
valacyclovir 500mg once a day
valacyclovir 1gm PO qd
famciclovir 250 mg PO BID
MOA for genital wart cream
inhibit DNA synthesis and prevent replication of the virus
HIV
antiretroviral (ARV) therapy durimg acute HIV infection
reduce infection tramsmission to others, improve lab markers of disease, might reduce severity of acute disease, lower viral load and viral plateau levels
reduce size of latent viral cells, decrease rate of viral mutation by suppressing replication and preserve immune function
Pre-exposure prophylaxis (PrEP) with ARV recommended for those at highest risk of contracting HIV.
Seven categories of ARV drug
Bacterial Vaginosis (BV)
metronidazole (Flagyl) 500 mg PO BID x 7d
metronidazole gel 0.75% one full applicator (5g) intravaginally qd x 5d
clindamycin 2% one full applicator (5g) intravaginally at bedtime x 7d
clindamycin 300 mg PO BID x 7d
Trichomoniasis
women: metronidazole (flagyl) 500 mg BID x 7d
men: metronidazole 2g PO x1dose
alternate treatment for both: tinidazole 2g PO x 1 dose
vulvovaginal candidiasis (vaginal yeast infection)
short-course topical formulation (single regimen of 1-3 days) treats uncomplicated VVC
for recurrent infection oral fluconazole (diflucan) 100mg, 150mg, or 200 mg dose weekly x 6 months is indicated maintenance regimen
treatment with azoles results in the relief of symptoms and negative cultures in 80-90% of patient who complete therapy.
MOA of VVC drugs
inhibit critical enzyme that cause a buildup of a toxic substance and increase fungal membrane permeability
HIV prevention
Pre-e;, or preexposure prophylaxis, is preventative medication and very effective in research studies, reduces risk from sex 99% and 74% frin IV drug use.
those at higher risk encourage to take Truvada, descovy, apretude is an injection for pre-ep that is given q2months
HIV prevention drugs MOA
inhibit HIV tansverse transcriptase, preventing transcription of HIV RNA and DNA
Post exposure prophylaxis (PEP)
single tab called truvada adn two tab of raltegravir for 4 weeks. use within 72 hours of exposure
MOA for raltegravir
inhibit activity of HIV-1 integrase, which impedes the insertion of HIV-1 DNA into the host cells genome.
