Vaginitis

Question 1

Metronidazole

Answer 1

IND: BV, Trich, anaerobes
MOA:
BOX: Carcinogen in mice
CON: 1st trimester, alcohol (disulfiram)
ADR: Metallic taste, HA, nausea

Question 2

Clindamycin

Answer 2

IND: Gynecological infections (BV)
MOA:
BOX: Risk of C. Diff associated diarrhea. Reserved for treatment resistant or severe infections
CON:
ADR: ABX diarrhea. Topical rxns

Question 3

Fluconazole

Answer 3

IND: Candidiasis, cryptococcal meningitis
MOA:
BOX: n/a
CON: Admin w/CYP3A4 substrates; Fluconazole is a strong inhibitor
ADR: n/a
150mg single dose q2-3 days for 3 doses. Once weekly for recurrence

Question 4

Micanazole

Answer 4

IND: Vuvovaginal Candidiasis, ring worm, athletes foot, jock itch. People that can’t tolerate Fluconazole
MOA: n/a
BOX: n/a
CON: n/a
ADR: Local rash/topical rxns

Question 5

Clotrimazole

Answer 5

IND: Candidiasis, ring worm, athletes foot, jock itch
MOA:
BOX:
CON:
ADR: Topical rxn, Increased LFTs

Question 6

Ceftriaxone

Answer 6

IND: Gonorrhea
MOA: 3rd gen Cephalosporin
BOX:
CON: Hyperbilirubinemic neonates; avoid if under 30 days old
ADR: Tight skin/induration at injection site, ABX diarrhea

Question 7

Azithromycin

Answer 7

IND: Chlamydia
MOA:
BOX:
CON: Hx of cholestatic jaundice or hepatic dysfunction a/w prior azithromycin
ADR: QT prolongation, ABX diarrhea

Question 8

Doxy

Answer 8

IND: Chlamydia. Alternate to Azithromycin
MOA:
BOX:
CON: Kids under 8 discolors teeth. Can use if no other options
ADR: GI disturbances, abx diarrhea