Pharm Wk 10

Question 1

STIs are often ? making screening important in their detection

Answer 1

asymptomatic

Question 2

to differentiate the various STIs: it’s characterized into 3 categories

Answer 2

• infections characterized by vaginal discharge
• infections characterized by urethritis and cervicitis
• infections characterized by genital ulcers

Question 3

what are the 3 infections most frequently associated with vaginal discharge?

Answer 3

• vulvovaginal candidiasis
• trichomoniasis
• bacterial vaginosis

Question 4

vulvovaginal candidiasis commonly caused by ?

Answer 4

Candida albicans

Question 5

Trichomoniasis caused by ?

Answer 5

trichomonas vaginalis

Question 6

Bacterial vaginosis caused by ?

Answer 6

a replacement of the normal vaginal flora by an overgrowth of anaerobic microorganisms, Mycoplasma and Gardnerella vaginalis

Question 7

what is recommended for patients with Trichomoniasis?

Answer 7

Metronidazole

Question 8

what are the adverse effects of metronidazole?

Answer 8

GI upset, metallic taste, urethral burning, dark or reddish-brown discoloration of urine

Question 9

for pregnant women with trichomoniasis, what is the preferred treatment?

Answer 9

oral metronidazole

Question 10

What are the treatments for bacterial vaginosis?

Answer 10

oral or topical metronidazole or topical clindamycin

Question 11

for clindamycin, which one is preferred? oral or topical?

Answer 11

topical

Question 12

what are the adverse effects of clindamycin?

Answer 12

When used topically, it may cause vulvovaginitis, when used orally can cause GI upset, C. difficile colitis, diarrhea

Question 13

Uncomplicated vulvovaginal candidiasis can be treated by?

Answer 13

intravaginal axoles or oral fluconazole

Question 14

Is treatment necessary in asymptomatic cases of vulvaginal candidiasis?

Answer 14

no, unnecessary

Question 15

What is the mechanism of action of azole antifungals (includes fluconazole)

Answer 15

work by inhibiting an enzyme necessary for the synthesis of ergosterol which is necessary for fungal membrane function, depletion of ergosterol leads to increased membrane permeability and possibly interferes with membrane-bound enzyme systems

Question 16

what are the adverse effects of azole antifungals?

Answer 16

• oral fluconazole is associated with headache, nausea, abdominal pain, diarrhea, dyspepsia, dizziness
• topical azole antifungals are usually only associated with local hypersensitivity

Question 17

What are the 2 main causes of urethritis and cervicitis?

Answer 17

• gonorrhea
• chlamydia

Question 18

Gonorrhea is caused by?

Answer 18

Neisseria gonorrhoeae

Question 19

Chlamydia is caused by?

Answer 19

Chlamydia trachomatis

Question 20

What is the preferred treatment for chlamydia?

Answer 20

azithromycin or doxycycline

Question 21

What is the preferred treatment regimen for anogenital gonococcal infections ?

Answer 21

a combination of a third-generation cephalosporin (ceftriaxone or cefixime) with azithromycin

Question 22

What is the preferred
treatment for patients with cephalosporin-resistant gonorrhea or a history of anaphylactic reaction to penicillin or allergy to cephalosporins

Answer 22

combination of gentamicin with azithromycin, or gentamicin with doxycycline

Question 23

What is the mechanism of action for azithromycin?

Answer 23

bacteriostatic activity by interfering with protein synthesis

Question 24

What is the mechanism of action of doxycycline?

Answer 24

antibiotics that interfere with protein synthesis by binding to the 30S ribosomal subunity and blocks the binding of tRNA to the A site

Question 25

What generation of cephalsporins are ceftriaxone?

Answer 25

third generation

Question 26

Gentamicin belongs to what class of antibiotics?

Answer 26

aminoglycoside

Question 27

What is the mechanism of action for gentamicin?

Answer 27

they bind to polysomes and cause misreading and premature termination of mRNA translation

Question 28

what is the preferred antibiotic for pregnant women with chlamydial infections?

Answer 28

azithromycin

Question 29

what is the preferred antibiotic for pregnant women with gonococcal infections?

Answer 29

Ceftriaxone

Question 30

the 2 most common STIs associated with genital ulcers in North America are ?

Answer 30

genital herpes and syphilis

Question 31

What is the preferred treatment for syphilis?

Answer 31

benzathine penicillin G

Question 32

What can be used as an alternative for those who are allergic to penicillin and have syphilis?

Answer 32

doxycycline

Question 33

What is the adverse effects of benzathine penicillin G

Answer 33

jarisch-herxheimer reaction: fever, chills, rigors, sweating

Question 34

Which herpes simplex virus (HSV) type is primarily associated with orolabial infections?

Answer 34

HSV-1, though HSV-2 can also infect the orolabial area.

Question 35

Which HSV type is primarily associated with genital infections?

Answer 35

HSV-2, but HSV-1 can also cause genital herpes.

Question 36

What percentage of the North American population carries HSV-1?

Answer 36

Approximately 50%.

Question 37

What percentage of the North American population carries HSV-2?

Answer 37

Approximately 12–14%.

Question 38

What type of drugs are used to treat symptomatic herpes infections?

Answer 38

Synthetic nucleoside analogues.

Question 39

How do nucleoside analogues work against HSV?

Answer 39

They resemble nucleoside bases, get phosphorylated by viral kinases, and halt DNA synthesis.

Question 40

How long are oral antivirals typically used for treating recurrent orolabial herpes?

Answer 40

1–5 days.

Question 41

What is the benefit of initiating oral acyclovir within 1 hour of symptom onset?

Answer 41

It may reduce the duration of pain by about 1 day.

Question 42

How effective is valacyclovir for cold sores?

Answer 42

A 1-day treatment started within 2 hours of symptoms can reduce episode duration by 1 day.

Question 43

How does famciclovir affect cold sore healing?

Answer 43

It shortens the median time to normal skin from 6.2 days (placebo) to 4–4.4 days.

Question 44

What are the symptoms of genital herpes?

Answer 44

Papules, vesicles, and painful ulcers in the genital and surrounding areas.

Question 45

When is suppressive therapy recommended for recurrent genital herpes?

Answer 45

When recurrences happen 4 or more times per year.

Question 46

Does suppressive therapy completely prevent HSV transmission?

Answer 46

No, but it reduces recurrences and transmission risk.

Question 47

Why is valacyclovir often preferred over acyclovir for suppressive therapy?

Answer 47

It can be taken once per day.

Question 48

What is the strategy for deprescribing suppressive therapy?

Answer 48

Interrupt every 3–6 months and reassess based on recurrence frequency.

Question 49

Why is genital herpes a concern in pregnancy?

Answer 49

It can cause neonatal herpes, which can be fatal.

Question 50

How can acyclovir help pregnant women with genital herpes?

Answer 50

Daily use from 36 weeks reduces recurrences, shedding, and C-section risk.