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
