Shared Flashcard Set

Details

Infectious Disease EXAM 3 - STIs
Infectious Disease EXAM 3 - STIs
21
Pharmacology
Graduate
02/08/2011

Additional Pharmacology Flashcards

 


 

Cards

Term
age: 15-24 yo account for 1/2 of STIs
# of sexual partners
prostitution
illicit drug use
sexual preference
Definition
risk factors for STIs
Term
incubation period: 1-14 days
women are usually asymptomatic
urethral infection: dysuria and urinary frequency; purulent discharge
anorectal infection: severe rectal pain, pruritus, bleeding
pharyngeal infection: mild pharyngitis
abnormal vaginal discharge; uterine bleeding
complications: PID, disseminated gonorrhea
complications if untreated during pregnancy: ophthalmia neonatorum (ophthalmic infection leading to blindness)
Definition
clinical presentation of gonorrhea
Term

uncomplicated gonorrhea:

Ceftriaxone 125 mg IM x 1 dose

OR

Cefixime PO x 1 dose

PLUS

Azithromycin 1 g x 1 dose (for Chlamydia)

 

if allergic to beta lactams - Azithromycin 2 g (emerging resistance)

OR

Ciprofloxacin/Levofloxacin (quinolone resistant gonorrhea)

 

disseminated gonorrhea:

Ceftriaxone 1 g IM or IV q 24 hours until improvement begins, then switch to oral regimen x 7 days

 

pregnancy DOC = ceftriaxone or if allergic 2 g azithromycin

Definition
treatment of uncomplicated and disseminated gonorrhea and gonorrhea during pregnancy
Term
strong association between HIV and syphilis
diagnosis with RPR (rapid plasma reagent)
primary stage: 10-90 days, chancre sore, regional lymphadenopathy
secondary stage: 2-8 weeks, pruritic or non-pruritic rash (usually on hands), mucocutaneous lesions, flu-like symptoms
latent stage: 4-10 weeks after secondary stage, asymptomatic
tertiary stage: 10-30 years after secondary stage, cardiovascular syphilis, gumma lesions present, neurosyphilis (dementia, auditory hallucinations, deafness, blindness)
Definition
clinical presentation of syphilis
Term
primary, secondary, early latent:
PCN G 2.4 million units IM
follow up: RPR at 6 and 12 months

late latent and neurosyphilis:
PCN G 2.4 million units IM weekly x 3 weeks OR aqueous crystalline PCN G 18-24 million units IV infusion x 10-14 days
follow up: RPR at 6, 12, and 24 months, CSF examination q 6 months until clear
Definition
treatment of syphilis in the primary, secondary, and early latent phases
treatment of syphilis in the late latent and neurosyphilis stages
Term
Jarisch-Herxheimer Reaction
Definition
acute febrile reaction of unknown MOA (but may be due to release of toxins of the syphilis bacteria)
NOT an allergic reaction
flu-like symptoms: HA, myalgia, tachypnea, malaise
develops 2-24 hours post PCN dose
treatment: antipyretics, analgesics, and rest
Term
primary, secondary, early latent syphilis:
doxycycline 100 mg PO BID x 14 days
OR
tetracycline 500 mg PO QID x 14 days
OR
ceftriaxone 1 g IM x 14 days

latent or unknown duration syphilis:
doxycycline 100 mg PO BID x 28 days
OR
tetracycline 500 mg PO QID x 28 days
Definition
PCN allergic patients
treatment of primary, secondary, and early latent syphilis
treatment of latent or unknown duration syphilis
Term
transmission: sexual activity, mother to fetus (birth canal)
symptom onset 7-21 days
sites of infection: urethra, endocervical canal, rectum, oropharynx, eye
usually asymptomatic
urethral discharge (watery)
abnormal vaginal discharge
dysuria
mild pharyngitis
complications: PID, infertility, Reiter syndrom (rare, autoimmune response to infection that presents like arthritis)
Definition
clinical presentation of chlamydia
Term
uncomplicated infections:
azithromycin 1 g PO x 1 dose
OR
doxycycline 100 mg PO BID x 7 days
abstain from sexual intercourse x 7 days post treatment (applies to all STIs)

Chlamydia in Pregnancy:
azithromycin 1 g PO x 1 dose
Definition
treatment of chlamydia
Term
upper genital tract infection in women resulting from the spread of bacteria that have colonized in the endocervical area
risk factors: young age, use of IUD
pelvic pain: lower abdominal tenderness, cervical motion tenderness
cervical discharge
fever
elevated erythrocyte sedimentation rate and C-reactive protein
lab verification of infection with gonorrhea or chlamydia
Definition
clinical presentation of pelvic inflammatory disease
Term
oral outpatient regimens:
ceftriaxone 250 mg IM x 1 dose PLUS doxycyline 100 mg BID x 14 days

parenteral inpatient regimen:
cefoxitin 2 g IV q 6 h PLUS doxycycline 100 mg IV q 12 h
Definition
treatment of pelvic inflammatory disease
Term
incubation period: 2-14 days
HSV1 = oropharyngeal disease
HSV2 = genital disease
transmission: from infected secretions onto mucosal surfaces
HSV cycle: primary mucocutaneous infection, infection of the ganglia, establishment of latency, reactivation (through physical/emotional stress), recurrent infection
asymptomatic (primary infection)
prodrome: mild burning, itching, tingling
multiple painful pustular or ulcerative lesions (usually heal in 2-4 weeks)
flu-like symptoms (fever, HA, malaise)

complications:
lesions at extragenital sites - eye, rectum, pharynx
CNS involvement - meningitis, encephalitis
neonatal exposure (in birth canal) - high morbidity (permanent neurological damage) and mortality (50%)
Definition
clinical presentation of herpes simplex virus
Term
goals: relieve symptoms, shorten duration of clinical course, prevent recurrences, decrease disease transmission

treatment is palliative, not curative

first clinical episode:
acyclovir 400 mg PO TID x 7-10 days
famciclovir 250 mg PO TID x 7-10 days
valacyclovir 1 g PO BID x 7-10 days

recurrent infections: chronic suppressive therapy (> 6 episodes/year)
acyclovir 400 mg PO BID
famiciclovir 250 mg PO BID
valacyclovir 500 mg or 1000 mg PO q day

episodic treatment:
acyclovir 400 mg PO TID x 5 d
acyclovir 800 mg PO BID x 5 d
acyclovir 800 mg PO TID x 2 d
famiciclovir 125 mg PO TID x 5 d
valacyclovir 500 mg PO BID x 5 d
valacyclovir 1 g PO q d x 5 d
Definition
treatment of genital herpes
Term
counsel regarding the disease and its transmission
abstain from sexual activity when lesions or prodromal symptoms are present
episodic recurrent treatment: begin your antiviral during prodromal phase or 1 day after lesion onset
topical acyclovir is INEFFECTIVE treatment for genital herpes
Definition
patient counseling on herpes infection
Term
females > males
incubation period: 3-28 days
transmission: sexual contact, contamination of inanimate objects
females: scant to copious, malodorous vaginal discharge and pruitus
males: often asymptomatic, urethral discharge (clear to mucopurulent)
complications: PID, premature labor, infertility (male and female), cervical neoplasia
Definition
clinical presentation of Trichomoniasis
Term
metronidazole 2 g PO x 1 dose
OR
metronidazole 500 mg PO x 7 d
OR
tinidazole 2 g PO x 1 dose
Definition
treatment of trichomoniasis
Term
may take with food to decrease GI upset
use 7 day course in those with severe GI complaints
treat sexual partners simultaneously
pregnancy Category B (better to wait until 2nd or 3rd trimester to treat)
ADRs: diarrhea, N/V, dry mouth, metallic taste, abdominal pain, HA, dizziness
AVOID ALCOHOL: during treatment and 3 days after treatment, disulfiram like reaction
Definition
patient education on metronidazole
Term
most common viral STI in the US
6 and 11 are associated with the development of genital warts
16 and 18 increases risk of cerival neoplasia
treatment: cryotherapy with liquid nitrogen or surgial removal of external warts
Definition
clinical presentation of human papillomavirus
Term
stimulates antibody production against 4 types of HPV
provides protection against cervical cancer from 16 and 18
provides protection against genital warts from 6 and 11
Definition
the HPV vaccine, gardasil protects against what strains of HPV?
Term
antibody protection against 16 and 18 (cervical cancer)
Definition
Cervarix provides protection against what strains of HPV?
Term
injection site reaction (pain and swelling)
HA, fever, fatigue
post marketing surveillance: fainting and VTE
VTE risk factors: OC, genetic predispostion to blood clots
CDC recommendations: benefits outweigh risks
Definition
gardasil tolerability and concerns
Supporting users have an ad free experience!