STI Pharm Flashcards
Tx of Chlamydia (3)
- **Azithromycin single dose
- Doxycycline x 7 days oral
- Amoxicillin during pregnancy oral
Tx of Gonorrhea
Ceftriaxone
Tx sexual partner in what infections?
Chlamydia, gonorrhea, syphilis, trichomonas, lice/nits
Tx of syphilis
Benzathine penicillin G**, IM.
– Primary (Secondary,early latent) Syphilis
If someone with syphilis (or any bacteria) is tx with penicillin - what are two guidelines that must be followed?
- do NOT interrupt the process
- desensitized this time only - if reinfected, give abx course again.
Three types of vaginitis
- Fungal - vulvovaginal candidiasis
- Protozoan - trichomonas
- Bacterial - gardnerella, mycoplasma
Tx vulvovaginal candidiasis with?
- Fluconazole single dose oral
- Miconazole … vaginal application (immediate sx relief)
Tx trichomonas with?
- Metronidazole* 2 gm x 1 oral (same recommendation for pregnant)
- Tinidazole 2 gm x 1 oral
Tx bacterial vaginosis (gardnerella, mycoplasma) with?
- Metronidazole - bid x 7d oral
- Clindamycin vaginal Cr x 5-7 d (or metronidazole vaginal)
Tx of pubic lice, crabs, scabies
- Permethrin**** - Apply at bedtime, wash well in morning (wash bedding!)
- Ivermectin (oral, topical)
Spermicides are associated with what lesions?
genital lesions
Refrain from intercourse during what stages of HSV?
prodrome and active lesions
Multiple lesions, shallow, heaped border, clean margins - what?
Herpes
Tx genital herpes with what?
Instruct pt to do what with along with treatment?
No cure - suppressive therapy: acyclovir, famciclovir, valacyclovir. Must drink water with to avoid crystallization in renal tubules!
Condoms are better for what type of infections?
Prevention of STDs transmitted by fluids (GC, CT, trichomonas, HIV)»_space;> STDs transmitted by skin-skin (HSV, HPV, syphilis, chancroid)
tx first episode of genital herpes v. recurrent episodes?
First episode = tx for 7-10 days
Recurrent = tx 5 days
Herpes with difficult to heal bed sores or pressure ulcers and/or prolonged extensive genital or perianal disease - think what?
HIV infection
Describe primary, secondary, tertiary, latent syphilis
- Primary: Painless ulcers at inoculation site
- Secondary: Rash and adenopathy
- Tertiary: Cardiac, neurologic, ophthalmologic and gummatous manifestations (condylomata lata)
- Latent: no sx, but + serology
Rash associated with secondary syphilis presents how on hands (and feet?)?
Crosses lines on palm
Punched out, well demarcated, clean edge, slightly heaped edge in sphilis - what is this?
syphilitic chancre
describe syphylitis lesions of the mouth
- Palate - soft, fleshy lesions
- Tongue - perfectly demarcated lesions
- Very common
- Often asymptomatic in women
- Men have urethritis
- Women-dysuria, vaginal discharge, postcoital bleeding
- May present with PID
Chlamydia
Describe discharge in chlamydia
thick milk
Describe expedited partner therapy
for chlamydia/GC (only?)
• Allows practitioner to treat a potentially infected partner
• No existing patient-practitioner relationship need exist
• State law governs whether the script has to have a name
• Can be designated by disease type (Chlamydia or GC) or by type of practitioner
Chlamydia screening guidelines:
• Annual screening of sexually active women ___ age with ____
• Sexual risk assessment may indicate ____ screening for some women
• Rescreen women ___ months after ___ due to high prevalence of repeat infection
- Annual screening of sexually active women 25 yrs with risk factors
- Sexual risk assessment may indicate more frequent screening for some women
- Rescreen women 3-4 months after treatment due to high prevalence of repeat infection
What is this? • Less common than Chlamydia • May be asymptomatic in women • Or present with dysuria, yellow discharge, vaginal bleeding, vaginal pain • May present with PID
Gonorrhea
Extra genital manifestations of? • Septic arthritis • Purpuric skin lesions • Pharyngitis (esp aggressive strep throat in young person) • Endocarditis • Fitz Hugh Curtis syndrome
Gonorrhea
Describe septic arthritis of gonorrhea
GC will eat the joint
Bilster over joint - think?
gono
Young person with gallbladder issue and guck under diaphragm - what is this and its infectious association
Fitz Hugh Curtis syndrome, gono
Describe difference between male/female gono discharge.
- Men: Dysuria and discharge appear in men within 2-5 d -95% symptomatic
- Women: 65% have dysuria or abnormal discharge
- Women present with malodorous, frothy yellow discharge
- Strawberry cervix
- See flagellated organisms on wet prep
Trichomonas
Tx of papillomavirus (HPV)
• Primary goal for treatment of visible warts is the ____
• Therapy may reduce but probably does not _____
• Difficult to determine if treatment reduces transmission
- Primary goal for treatment of visible warts is the removal of symptomatic warts
- Therapy may reduce but probably does not eradicate infectivity
- Difficult to determine if treatment reduces transmission
HPV vaccine against what serotypes. Curative?
16, 18
not curative
