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Flashcards in STI Drugs Deck (43)
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1

-cyclovir/ciclovir

PO: 7-10 days (2-5x daily)
antiviral: inhibits DNA pol
activation: viral thymidine kinase
dose adjust in renal disease
Tx: HSV
HYDRATION (avoid crystalline nephropathy/neuro), cross hyper-sensitivity

2

(val)acyclovir

chain termination
AE: neurotoxicity, seizures (penetrates CNS)
val: prodrug with better oral bioavailability

3

famciclovir

metabolized to penciclovir
NO chain termination
AE: none significant

4

cervarix

recombinant L1 protein
IM: IgG neutralizing Ab
bivalent HPV vaccine: 16, 18
AE: hypersensitivity

5

gardisil

ages 9-26 yrs
recombinant L1 protein
IM: IgG neutralizing Ab
quadrivalent HPV vaccine: 6, 11, 16, 18
AE: hypersensitivity
grown in YEAST

6

podofilox

topical
MOA: mitotic spindle inhibitor
Tx: HPV genital warts
AE: pruritus
not recommended in pregnancy

7

imiquimod

topical
MOA: antiviral toll-like receptor activator (immune modifier): stimulates IFN and cytokine production
Tx: HPV genital warts
AE: pruritus
not recommended in pregnancy

8

sinecatechins

topical
MOA: keratolytic: antioxidant
AE: pruritus
Tx: HPV genital (warts?)

9

beta lactams

MOA: binds PBP inducing cell lysis

10

macrolide

MOA: 50s ribosomal inhbitor

11

quinolone

MOA: DNA gyrase inhibitor (topo II) in G-; inhibit topo IV in G+
Tx: chlamydia ALT, cervicitis ALT
AE: TENDONITIS/RUPTURE

12

cephalosporins

MOA: binds PBP inducing cell lysis

13

amoxicillin

PO
beta lactam
CAN be used in pregnancy
adjust dose in renal disease

14

azithromycin

PO
long T1/2
macrolide
AE: GI
Tx: chlamydia 1st, urethritis ALT, cervicitis ALT

15

cefixime

PO
cephalosporin
false pos. urinary glucose test
Tx: chancroid ALT, gonococcal ALT + azithromycin

16

ciprofloxacin

PO
quinolone
CYP1A2 inhibitor
CI: pregnancy, lactation
Tx: chancroid ALT (not chlamydia/cervicitis)

17

ceftriaxone

IM
cephalosporin
AE: GI
Tx: chancroid ALT, gonococcal ALT + azithromycin

18

clindamycin

PO/gel
MOA: 50s ribosomal inhibitor
AE: GI, C. DIFF infection
gel AE: discontinue after 1st trimester (pre-term, low birth weight, ruptured membranes), contact irritation
Tx: vaginosis ALT

19

doxycycline

PO
long T1/2
MOA: 30s ribosomal inhibitor
AE: HEPATIC (esp. in pregnancy), PHOTOSENSITIVE
Tx: chlamydia 1st, urethritis ALT, cervicitis ALT

20

erythromycin base

PO
short T1/2
macrolide
CYP3A4 INHIBITOR
substrate: P-gp, CYP3A4
AE: HYPERTROPHIC PYLORIC STENOSIS in neonates
Tx: chlamydia ALT, chancroid choice, cervicitis ALT

21

levofloxacin

PO
quinolone

22

metronidazole

MOA: disrupts DNA structure
resistance: decreased activation, increase free radical scavenging, increased DNA repair
inhibit: CYP2C9
CI: pregnancy/breastfeeding
AE: DISULFIRAM
Tx: trichmoniasis ALT, vaginosis ALT

23

ofloxacin

PO
quinolone

24

penicillin G
1. aqueous crystalline
2. benzathine
3. procaine

beta lactam
1. IV: congenital syphilis (10 days)
2. IM: syphilis 1st (not good for neurosyphilis: no BBB penetration)
3. IM: congenital syphilis (10 days)
AE: HYPERSENSITIVITY (if pregnant, desensitize and Tx), Garish-Herxheimer Rxn

25

-azoles

MOA: ergosterol syn. inhibitors (14alpha demethylation of lanosterol)
gel/cream: limited systemic absorption/residual activity for days; oil based weaken condoms
resistance: decreased drug, target mutation/up-regulation, bypass pathways
Tx: candidiasis ALT
avoid in 1st trimester: systemic dose causes abdominal wall defects, cleft palate

26

tinidazole

OTC
gel/cream -azole; disrupt DNA structure (oral) inhibiting nucleic acid syn.
metabolism: CYP3A4
Tx: trichomoniasis ALT, vaginosis 2nd ALT
CI: pregnancy, breastfeeding
AE: DISULFIRAM

27

butoconazole

Rx
gel/cream -azole

28

clotrimazole

OTC
gel/cream -azole

29

fluconazole

Rx
PO -azole
CYP2C9 inhibitor

30

miconazole

OTC
gel/cream -azole