sexually transmitted infections

patho/pharm exam 2

what are sexually transmitted infections (STIs)?

infections transmitted primarily through sexual contact or direct mucosal contact, and sometimes from mother to infant during birth

what types of organisms cause STIs

bacteria

viruses

protozoa

fungi

parasites

what organism causes chlamydia?

chlamydia trachomatis, a bacterial STI

what symptoms does chlamydia cause?

often asymptomatic

disuria

discharge

what are common treatments for chlamydia?

azithromycin & doxycycline

what organism causes gonorrhea?

neisseria gonorrhoeae; a bacterial STI

symptoms of gonorrhea?

purulent discharge

pelvic pain

men → burning when peeing and puss from penis; women → asymptomatic

what is first line treatment for gonorrhea?

ceftriaxone (a cephalosporin)

what is pelvic inflammatory disease?

a syndrome involving infection and inflammation of the female reproductive organs, including fallopian tubes and pelvic structures

what organisms most commonly cause pelvic inflammatory disease?

nisseria gonorrhea and chalamydia trachomatis

treatment for pelvic inflammatory disease?

hospitalized → IV cefoxitin/cefotetan + doxycycline

outpatient → ceftriaxine/cefoxitin + doxycycline + possibly metronidazole

what is epididymitis?

inflammation of the epididymis causing testicular pain and fever

what medications treat epididymitis?

ceftriazone + doxycline

ofloxacin or levofloxacin

what organism causes syphilis?

treponema pallidum, a pacterial STI

what are the stages of syphilis?

primary → painless chancre (painless ulcer on genitals)

secondary → rash systemic symptoms 2 weeks after chancre heals

tertiary → organ damage 5-30 yrs after initial infection

first-line treatment for syphilis?

penicillin G

what organism causes trichomoniasis?

trichomonas vaginalis, a bacterial STI

treatment for trichomoniasis?

metronidazole

symptoms associated with trichomoniasis?

frothy green discharge

what organism causes vaginal candidiasis?

candid albicans fungus

symptoms of vaginal candidiasis?

itching

burning

disuria

thick white discharge

treatment for vaginal candidiasis?

clotmazole

miconazole

terconazole

antifungals

what does human palillomavirus (HPV) cause?

genital and anal warts

what vaccine protects against HPV?

Gardasil vaccine

what is the treatment for HPV?

remove lesions and vaccination

what is herpes caused by?

herpes simplex virus that causes painful, fluid-filled blisters or sores on the genital, anal, or oral areas, often accompanied by flu-like symptoms. PAINFUL VESICLES.

key characteristic of herpes (HSV) infections?

virus becomes latent and can reactivate after the initial infection

first line treatment for herpes (HSV)?

acyclovir

can herpes be transmitted without visible sores?

yes, viral shedding allows transmission even without symptoms

what is the mechanism of action of acyclovir?

inhibits viral DNA replication, preventing herpesvirus replication

major adverse effects of acyclovir?

IV → nephrotoxicity, neurotoxicity, phlebitis

oral → GI issues, vertigo

what is the drug valacyclovir?

an antiviral medication used to treat infections caused by the herpesvirus family. A prodrug of acyclovir (meaning it converts to acyclovir in the body).

what is the drug famciclovir?

a prodrug of acyclovir (meaning it converts to acyclovir in the body) used to treat herpes zoster or genital herpes infection.

what virus causes CMV infection?

cytomegalovirus, part of the herpesvirus family

which patients are most at risk for CMV disease?

immunocompromised pts (such as HIV or transplant pts)

what is ganciclovir used for?

treatment and prevention of CMV infections and treatment of herpes simplex virus (HSV)

major adverse effects of ganiclovir?

granulocytopenia

thrombocytopenia

reproductive toxicity

nausea, fever, rash, anemia

what is valganciclovir?

oral prodrug of ganciclovir (trurns into ganciclovir in the body) and used to treat CMV infections.

what is cidofovir?

IV medication used to treat CMV in patients with AIDS who have failed on ganciclovir and foscarnet

LAST RESORT MED

adverse effects for cidofovir?

nephrotoxicity

neutropenia

ocular disorders

what is foscarnet (foscavir) used for?

used for acyclovir-resistant herpes infections or CMV in immunocompromised pts

major adverse effects for foscarne (foscavir)?

nephrotoxicity

electrolyte imbalances

what is HIV (human immunodeficiency virus)?

retrovirus that attacks the immune system, specifically T-helper cells, leading to immune deficiency. If untreated can progress to AIDs.

symptoms associated with HIV?

flu-like symptoms

fever

fatigue

sore throat

rash

swollen lymph nodes

headache

treatment for HIV?

antiretroviral therapy (NRTIs, protease inhibitors, integrase inhibitors

what is HBV (hepatitis B virus)?

a DNA virus that infects the liver causing inflammation of the liver

symptoms of HBV?

fever

n/v

loss of appetite

abdominal pain

JAUNDICE

FATIGUE

dark urine

clay-colored urine