Treatment of STDs

Question 1

HSV treatment

Answer 1

Acyclovir, Famciclovir, or Valacyclovir

Question 2

acyclovir adverse effects

Answer 2

neurotoxicity, including seizures; patient needs to be well-hydrated to avoid crystalline nephropathy or neurotoxicity

Question 3

syphilis treatment

Answer 3

benzathine Penicillin G, IM

Question 4

Penicillin G distribution

Answer 4

poor CNS penetration, not good for neurosyphilis

Question 5

penicillin elimination

Answer 5

renal tubular excretion, delayed in renal disease

Question 6

chlamydia treatment

Answer 6

azithromycin or doxycycine; alternatively erythromycin, levofloxacin, or ofloxacin

Question 7

amoxicillin effects on infants

Answer 7

does not pass across placenta; preg. cat. B; some in breast milk, may cause diarrhea, candidiasis, and rash

Question 8

azithromycin, clindamycin, and erythromycin MOA

Answer 8

binds 50S RSU; bacteriostatic

Question 9

doxycycline MOA

Answer 9

binds 30S RSU; bacteriostatic

Question 10

levofloxacin and ofloxacin MOA

Answer 10

inhibits DNA gyrase (topo II) in gram neg. and topo IV in gram pos.; bactericidal

Question 11

amoxicillin moa

Answer 11

bactericidal beta lactam; binds PBPs causing cell lysis

Question 12

azithromycin adverse effects

Answer 12

vaginitis

Question 13

doxycycline adverse effects

Answer 13

hepatic damage in high dose, especially in pregnancy, photosensitivity

Question 14

erythromycin adverse effects

Answer 14

increases toxicity of CYP3A4 substrates; estolate preparations may cause cholestatic jaundice; risk of sudden cardiac death with CYP3A4 inhibitors

Question 15

levofloxacin, ciprofloxacin, and ofloxacin adverse effects

Answer 15

BBW: increased risk of tendonitis and rupture and exacerbation of muscle weakness, avoid with myasthenia gravis
taste disturbance

Question 16

chancroid treatment

Answer 16

axitromycin or ceftriaxone or ciprofloxacin or erythromycin

Question 17

ceftriaxone and cefixime MOA

Answer 17

bactericidal beta lactam; binds PBPs causing cell lysis

Question 18

ciprofloxacin distribution

Answer 18

distributes into breast milk and crosses placenta; no adverse effects

Question 19

uncomplicated GC infections of cervix, urethra, or rectum treatment

Answer 19

ceftriaxone (alternative cefixime) plus azithromycin or doxycycline

Question 20

uncomplicated GC infections of pharynx treatment

Answer 20

ceftriaxone + azithromycin or doxycycline

Question 21

urethritis, cervicitis treatment

Answer 21

azithromycin or doxycyline; alternatively erythromycin, levofloxacin, or ofloxacin

Question 22

trichomoniasis treatment

Answer 22

metronidazole or tinidazole

Question 23

metronidazole and tinidazole moa

Answer 23

amebicidal, bactericidal, and trichomonacidal; unionized drug taken up by anaerobic organisms and cells where it is reduced to its active form which disrupts DNA’s helical structure, therey inhibiting bacterial nucleic acid synthesis

Question 24

metronidazole and tinidazole adverse effects

Answer 24

avoid in pregnancy and breastfeeding; GI upset, candidiasis, disulfiram-like effect (avoid alcohol for 24-72 hours after completing therapy)

Question 25

bacterial vaginosis treatment

Answer 25

metronidazole (alt. tinidazole) or clindamycin

Question 26

clindamycin adverse effects

Answer 26

adverse neonatal effects if used intravaginally after 1st trimester, excreted in breast milk

Question 27

conazoles adverse effects

Answer 27

high systemic doses produce abdominal wall defects and cleft palate in fetus and maternal stress; oil based topical products can weaken latex condoms

Question 28

conazole moa

Answer 28

blocks ergosterol synthesis through interacting with 14-alpha demethylase, a CYP necessary conversion of lanosterol to ergosterol

Question 29

podofilox moa

Answer 29

mitotic spindle inhibitor, blocking micro tubular activity in keratinocytes

Question 30

imiquimod moa

Answer 30

an immune response modifier

Question 31

sinecatechins

Answer 31

green tea extract antioxidant for genital warts