Pharm: STD – Flashcards
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Chancroid sns:sx and pathogen
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Painful genital ulcer and tender suppurative inguinal adenopathy H. ducreyi
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3 tx used for Chancroid
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Azithromycin (Zithromax) 1 gram by mouth Once OR Ceftriaxone (Rocephin) 250mg IM Once OR Ciprofloxacin orally x 3 days
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what drug must be avoided in pregnancy
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Cipro & erthromycin
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What is the DOC for the TX of chlamydia?
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Single 1 gram dose of Azithromycin (Zithromax)
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What are four drugs that can be used for the Tx of chlamydia?
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Azithromycin (Zithromax) Or Doxycyline (Vibramycin) x 7 days Or Levofloxacin (Levaquin) for 7 days Erythromycin
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Erythromycin SE
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(GI side effects)
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What drugs are used for the tx of chlamydia in the infant population?
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Oral Erythromycin
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What harmful SE can oral erythromycin cause in infants under 6 weeks old?
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hypertrophic pyloric stenosis
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Besides erythromycin, what drug can also be used for the treatment of chlamydia in infants?
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azithromycin
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What two pathogens are the MCC of urethritis?
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chlamydia and gonnorhea
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What can be given t tx non-gonnococal urethritis?
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Azithromycin (Zithromax) Or Doxycyline (Vibramycin) x 7 days Or Levofloxacin (Levaquin) for 7 days
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What drugs are Mycoplasma genitalium resistant to?
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doxycycline and azithromycin.
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What can be used to tx urethritis caused by resistant Mycoplasma genitalium?
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Moxifloxacillin x 14days
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pathogens of PID
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C trachomatitis N gonorrhea M genitalium M hominis anaerobic bacteria
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What txs are used for PID?
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broad spectrum, Parenteral Treatment x 24 hours oral tx for 14days Cefotetan (Cefotan) IV OR Cefoxitin (Mefoxin) IV PLUS Doxycylycine IV or PO
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Alternative therapy for the tx of PID
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Clindamycin (Cleocin) IV PLUS Gentamicin IV (ototoxicity)
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What are the drugs used to tx sexually transmitted epididymitis?
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Ceftriaxone IV plus doxycycline
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How would you tx a patient with epidydimitis caused by a gram - bacillis
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Very well Ceftriaxone plus Levofloxacin
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What is the TOC for proctitis
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Single IM Ceftriaxone plus 7 days of oral doxycycline
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Name some drugs N. Gonorrhea is resistant to
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Resistance to PCN, Sulfa Drugs, TCNs, Fluroquinolones
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How to tx a patient with a gonorheal infx
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IM Ceftriaxone and single dose Azithromycin OR 7 days of doxycycyline
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how to tx a preggers patient with gonorheal infx?
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Ceftriaxone IM and Azithromycin
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What medication is apply to newborns to prevent gonococcal conjunctivitis?
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Erythromycin 0.5% opthalmic ointment
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How do you tx an initial infx with HSV
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Acyclovir (zovirax) 400 mg orally 3 times/day for 7 to 10 days Famcyclovir (Famvir) Valacyclovir (Valtrex) Good Bioavailability
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When should tx be started for HSV outbreaks?
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within 24 hours of lesion onset
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What therapy should be given for a patient with 6 or more outbreaks of HSV in a year?
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suppressive therapy Acyclovir (Zovirax) 400 mg orally twice daily Famciclovir (Famvir) 250mg orally twice a day Valacyclovir 500mg or 1gm Once a day
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Valcyclovir MOA
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Inhibits replication of herpes viral DNA by inhibition of viral DNA polymerase
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valcyclovir SE
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rash, abdominal pain, nausea, vomiting, headache
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What must be monitored with beginning valcyclovir tx
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renal func.
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How does the suppressive therapy change in a patient with HSV and a Crcl >30ml/min
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it doesnt
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How does the suppressive therapy change in a patient with HSV and a Crcl less than 30ml/min?
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meds are given once a day if <9 outbreaks in a year can give supressive therapy every 48 hours
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If a patient with HSV infection experiencing hepatitis, pneumnitis, or disseminated infection, what is the medication therapy?
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IV Acyclovir 5 to 10 mg per kg IV every 8 hour for 7 days followed by oral therapy Remember to adjust dosing in Renal Dysfunction
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Tx for bacterial vaginosis?
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Metronidazole x 7 days Vaginal Metronidazole Clindamycin Tinidazole is an alternative
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TOC for Trichomoniasis (yellow, green disharge)
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Metronidazole or tinidazole
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A woman comes in c/o milky white discharge. You suspect vaginal candidiasis. Tx?
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OTC/Rx vaginal antifungals and oral fluconazole
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Tx for bacterial vaginosis
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Oral Metronidazole for 7 days OR vaginal metronidazole clindamycin Oral tinidazole is an alternative
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What medications can be used to tx bacterial vaginosis in a pregnant woman?
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Metronidazole or Clindamycin
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What tx can be used to suppress the rate of recurrence of bacterial vaginosis?
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Metronidazole gel
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What is the TOC for primary, secondary, and latent syphilus infx lasting up to one year?
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Parenteral Penicillin G: D Benzathine PCN G, Single IM Injection
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What is the DOC for primary, secondary, and latent syphilus infx during pregnancy
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Benzathine PCN G, Single IM Injection
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What is the DOC for primary, secondary, and latent syphilis infx for penicillin allergic patients?
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Benzathine PCN G, Single IM Injection - desensitization must be attempted
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Tx for late latent syphilis (more than 1 year) or tertiary syphilis
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PCN G, benzathine IM Weekly x 3 doses
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What is the preventative vaccine used for the tx of HPV?
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gardasil
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what age group should gardasil be given to
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9-26
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pharm tx for genital warts caused by HPV
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Imiqimod 3.75% cream, Aldara cream, Podofilox solution
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Alternative tx for genital warts caused by HPV
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Trichloroacetic acid and Cryotherapy
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What is the MOA of topical Podofilox (Condylox)?
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Mitotoxic agent inhibiting cell mitosis; tissue erosion Use minimum amount of topical form on wart only External/perianal
