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REPRO > PHARM-STDs > Flashcards

PHARM-STDs Flashcards

1
Q

name the 3 antivirals used to treat HSV?

A

acyclovir, famciclovir, valacyclovir

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2
Q

how does acyclovir work?

A

prevents further chain elongation (lacks the 3’OH group, and the viral polymerase-associated exonuclease cant remove the acyclovir moiety)

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3
Q

how does famciclovir work?

A

metabolized (de-acetylated) to penciclovir

-doesn’t cause chain termination

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4
Q

you are treating with acyclovir, famciclovir, or valacclovir, what would you need to do with a pt who has renal dysfunction?

A

adjust the dose

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5
Q

which of the antivirals has adverse effects that include neurotoxicity including seizures?

A

acyclovir (also valacyclovir)

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6
Q

which antiviral used to treat HSV can penetrate the CSF?

A

acyclovir

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7
Q

what is the name of the prodrug for acyclovir?

A

valacyclovir

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8
Q

what is the benefit of using valacyclovir?

A

better oral bioavailability

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9
Q

what happens to acyclovir oral bioavailability as the dose increases?

A

the bioavailability decreases as the dose increases

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10
Q

how can you keep the pt from having crystalline nephropathy or neurotoxicity while being treated with antivirals for HSV?

A

keep the pt well hydrated

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11
Q

how does penicillin work?

A

binds PBPs causing cell lysis

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12
Q

why do we treat syphilis with benzathine Penicillin G?

A

IM admin produces a drug depot that frees drug over 2 wks

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13
Q

how is benzathine penicillin G IM eliminated?

A

renal tubular excretion (huge delay in pts w/ renal dysfunction)

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14
Q

can benzathine penicillin G penetrate the CSF?

A

NO

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15
Q

how do you treat early latent syphilis?

A

benzathine Pen G IM

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16
Q

what is the Jarisch-Herxheimer Reaction?

A

seen after treating pts with secondary syphilis after first injection of penicillin

  • release of syphilitic antigens w/ subsequent host reaction
  • chills, fever, headache, myalgias, arthralgias
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17
Q

what happens to the syphilitic cutaneous lesions during a Jarisch-Herxheimer reaction?

A

may become more prominent, edematous, and brilliant in color

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18
Q

how long will a Jarisch-herxheimer rxn last?

A

persists for a few hours; begins to fade within 48 hrs and does not re-occur

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19
Q

what provides symptomatic relief to the Jarisch-Herxheimer reaction?

A

aspirin

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20
Q

do you stop penicillin therapy if you have a pt have a Jarisch-Herxheimer Reaction?

A

NO

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21
Q

Which drugs can you use to treat chlamydia?

A

azithromycin Or doxycycline

Alternates: erythromycin, levofloxacin, ofloxacin

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22
Q

how are the antibiotics against chlamydia administered?

A

oral

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23
Q

which 2 drugs used to treat chlamydia have long half lives with extensive tissue uptake and slow release?

A

azithromycin

doxycycline

24
Q

which 2 drugs used to treat chlamydia undergo little metabolism and mostly eliminated in urine, some in stool?

A

levofloxacin, ofloxacin

25
Q

describe the elimination of azithromycin and doxycycline?

A

little metabolism, most elimination in stool with some elimination in urine

26
Q

what are the adverse effects of azithromycin?

A

GI upset, vaginitis

27
Q

name the anti-chlamydial drug:

AE: GI upset, hepatic damage in high dose esp. in pregnancy; photosensitivity w/ sunlight or tanning bed

A

doxycycline

28
Q

which antichlamydial drug causes taste disturbance?

A

levofloxacin

29
Q

name the 2 antichlamydial drugs that have these adverse effects:
BBW of increased risk of tendonitis & rupture
BBW exacerbation of muscle weakness-avoid w/ myasthenia gravis

A

levofloxacin

ofloxacin

30
Q

which 4 drugs would you use to treat chancroid?

A

azithromycin or ceftriaxone or ciprofloxacin or erythromycin base

(ACCE got Chanked!)

31
Q

all the antibiotics used to treat chancroid are oral except ceftriaxone which is ___________-

A

IM

32
Q

ceftriaxone MOA

A

bactericidal beta-lactam; binds PBPs causing cell lysis

33
Q

how is ceftriaxone eliminated?

A

eliminated in urine mainly by GF, w/ lesser amounts in stool

34
Q

which antibiotics are used to treat uncomplicated gonococcal infections of the cervix, urethra, and rectum?

A

Ceftriaxone (IM) or cefixime Plus Azithromycin or Doxycycline (po)

(COCADO)

35
Q

which antibiotics are used to treat uncomplicated GC infections of the pharynx?

A

ceftriaxone (IM) or azithromycin (oral) or doxycycline (oral)

36
Q

which abx treat urethritis-cervicitis?

A

azithromycin or doxycycline

-alternatively (erythromycin base or levo- or ofloxacin)

37
Q

which drugs do you use for recurrent treatment of urethritis-cervicitis?

A

metronidazole or tidazole plus azithromycin (if not used for original episode)

38
Q

how do you treat trichomonas?

A

metronidazole or tinidazole

39
Q

metronidazole/tinidazole MOA

A

amebeicidal, bactericidal, trichomonacidal

  • unionized drug taken up by anaerobic organisms & cells where it is reduced to its active form which disrupts DNA’s helical structure, thereby inhibiting bacterial nucleic acid synthesis.
  • equally effective vs. dividing and non-dividing cells
40
Q

describe the elimination of metronidazole

A

extensive hepatic metabolism w/ elimination in urine (DISCOLORATION) & stool

41
Q

metronidazole inhibits which CYP enzyme?

A

CYP2C9

42
Q

what are some of the adverse effects of metronidazole and tinidazole?

A
  • avoid in pregnancy & breastfeeding
  • candidiasis
  • DISULFURAM-like effect (don’t drink EtOH)
  • secondary malignancies in animal model
43
Q

what drugs do you use to treat bacterial vaginosis?

A

metronidazole (oral) or clindamycin (gel) or tinidazole (oral) or clindamycin (oral)

44
Q

clindamycin MOA

A

binds to 50s ribosomal subunit to inhibit protein synthesis; bacteriostatic

45
Q

describe the elimination of clindamycin

A

short half-life

  • extensive metabolism w/ elimination of products in urine and stool
  • 30% of vaginally instilled drug becomes systematized
46
Q

the CDC recommends intravaginal use of clindamycin only during what time period of pregnancy?

A

only in 1st trimester (low birth wt, pre-term delivery)

47
Q

local delivery of what drug is also rarely associated w/ contact toxicity like vaginal erythema, vulvovaginal pruritus, vaginal discharge, vaginal swelling, vaginal bleeding and vaginal pain

A

clindamycin

48
Q

what are the OTC options for treating candidiasis?

A

butoconazole or clotrimazole or miconazole or tioconazole

49
Q

what are the prescription options for treating candidiasis?

A

butoconazole or terconazole or fluconazole

50
Q

how do the conazoles work?

A

blocks ergosterol synth. through interacting w/ 14-alpha demethylase, a CYP necessary conversion of lanosterol to ergosterol; essential membrane comonent

51
Q

how the azoles mostly eliminated?

A

in stool

52
Q

high systemic doses of azoles produce what adverse effects in fetus and mom?

A

abdominal wall defects & cleft palate in fetus & maternal stress
-avoid in 1st trimester

53
Q

the oil-based topical products of what class of drugs can weaken latex condoms or diaphragms?

A

conazoles

54
Q

what is the major antigenic protein that is in Gardasil and cervarix vaccine?

A

L1 protein

55
Q

Gardasil covers which HPV viruses?

A

6, 11, 16, 18

56
Q

Cervarix covers which HPV viruses?

A

16, 18

REPRO (13 decks)

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