STI Pharmacotherapy Dr. Dowling Flashcards
EXAM 2 (36 cards)
What are the common strains of the HPV virus?
Genital wart strain
-> most regress spontaneously within 1-2 years
Cervical neoplasia strain
->also non-cervical malignanceis (throat cancer)
Which disease that is caused by HPV can be self-treated?
Genital warts
-Cryotherapy
-topical wart removal
-surgery
-> destruction of lesions
What is the only available HPV vaccine?
9-valent HPV vaccine
Gardasil 9
How does Herpes simplex (HSV) present in a patient?
-often asymptomatic
-painful lesions
When do lesions start to develop in HSV-infected patients?
develop over 7-10 days and last 2-4 weeks
Which cells are involved in the long-term persistance (latency) of HSV?
Ganglia (neurons in the brain)
HPV vaccine schedule
CDC guideline
-can start at 9
-routine vaccines at 11-12y -> through 26 if not previously vaccinated
-administer to age 27-48y if not previously vaccinated and at risk for HPV (shared clinical decision-making)
How many doses should patients from the age of 9-14 receive?
2-dose series
at 0 and 6-12 months
How many doses of the HPV vaccine should patients from the age of 15 and older receive?
3 dose series
at 0
1-2 months and
6 months
Which type of Genital warts (HPV) may be treated by the patient?
External anogenital warts (anus, genitals)
-> with self-applied topical treatments or through in-office procedures
-Imiquimod 5%
-Podofilox 0.5%
-Sine catechins (Veregen) 15%
What are the treatment options for the first clinical episode of Genital herpes?
Acyclovir
Valacyclovir
Famciclovir
duration: 7-10 days
What are the treatment approaches for :recurring: Genital herpes?
Episodic Tx:
start within 6-12 hours of prodrome and no more than 24h after the lesion appears
-> patient should have the drug ready, and get a refill after using it to have it ready again
Suppressive Tx: indefinite, patients are taking it until instructed to stop
Which patient population benefits from the suppressive Tx?
-patients with frequent recurrences and severe episodes
-reevaluate after 1 year and see if they have any outbreaks and how severe they are
-consider transfer to Episodic Tx if no recurrence
What is the drug treatment duration for recurrent infection of Genital Herpes?
different schedules
up to 5 days!
How are initial Trichomoniasis infections treated in men and women?
men: single dose of Metronidazole
women: 7 days BID of Metronidazole
if persistent/recurrent: 7 days Metro
When should patients with a Trichomoniasis, Chlamydia or Gonorrhea infection get retested?
after 3 months
What factor determines treatment in Genital Herpes?
First clinical episode
or recurrent infection
episodic Tx
suppressive Tx
What factor determines treatment for a Trichomoniasis infection?
Male or female
and
Initial treatment or persistent/recurrent infection (truly treatment failure, most of the time recurrent infections are reinfection from the partner)
What is the recommended treatment for Chlamydia?
Doxycycline 100 mg BID for 7 days
What is the time of symptom onset for Gonorrhea?
2-10 days
What determines the treatment of a Gonorrhea infection?
the patient’s weight
<150 kg or >150 kg
What are the treatment options to treat Gonorrhea?
<150 kg: Ceftriaxone 500 mg single dose
OR Gentamicin 240 mg + Azithromycin 2g
> 150 kg: Ceftriaxone 1g IM single dose
OR Cefixime 800 mg single dose
Which drug should be added to the Gonorrhea treatment regimen?
if chlamydia infection has not been ruled out:
Doxycycline 100 mg BID for 7days
Which other STI often presents with Syphilis?
HIV
test for HIV when infected with Syphilis and vice versa
