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DRUGS USED FOR THE TREATMENT OF SYPHILIS & GONORRHEA

Learn about medications used for syphilis and gonorrhea treatment, including mechanism of action, adverse effects, contraindications, regimens, and alternative treatments for allergic patients. Understand stages of syphilis and recommended drug regimens.

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DRUGS USED FOR THE TREATMENT OF SYPHILIS & GONORRHEA

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  1. DRUGS USED FOR THE TREATMENT OF SYPHILIS & GONORRHEA

  2. Prof. Mohammad Alhumayyd

  3. OBJECTIVES • At the end of lecture , the students should understand: • The drugs used in the treatment of syphilis & gonorrhea. • The mechanism of action, adverse effects of each drug

  4. OBJECTIVES ( continue) • The contraindications of drugs used • The recommended regimens used for treatment of syphilis & gonorrhaea • The alternative treatments in allergic patients

  5. SYPHILIS What is Syphilis? • Sexually transmitted disease caused by bacterium TreponemaPallidum

  6. Stages Of Syphilis • A primary stage ( a single sore ( a chancre ) )

  7. Secondary Stage • Skin rash & mucous membranes lesions

  8. Latent stage 70% may have NO SYMPTOMS

  9. Drugs used in the treatment of Syphilis • Penicillins*** Penicillin G BenzathinP. ; Procaine P. • Tetracyclines Doxycycline • Macrolides Clarithromycin • Cephalosporins Ceftriaxone

  10. PENICILLINS • Mechanism of action • Inhibit the synthesis of bacterial cell wall . These drugs are bactericidal

  11. Preparations of penicillins used for the treatment of syphilis • Penicillin G, i.v(Short duration of action) • Procaine P,i.m(Long acting(24-48hrs) • BenzathineP,i.m(Long acting(every 3-4 weeks) All are: Acid unstable Penicillinasesensitive

  12. Adverse effects of penicillins • Hypersensitivity • Convulsions with high doses or in renal failure • Super infections

  13. Drugs used in Allergic Patients To Penicillins • Tetracyclines such as: Doxycycline • Macrolidessuch as: Clarithromycin • Cephalosprins such as : Ceftriaxone cefixime

  14. TETRACYCLINES e.g, Doxycycline • Well absorbed orally • Long-acting

  15. Mechanism of action • Inhibit bacterial protein synthesis by reversibly binding to 30 S bacterial ribosomal subunits .

  16. Side effects 1. nausea, vomiting ,diarrhea & epigastric pain(give with food) 2. Hepatic toxicity ( prolonged therapy with high dose ) 3. Brown discolouration of teeth – children 4. Deformity or growth inhibition of bones – children 5. Vertigo 6. Superinfections.

  17. Contraindications • Pregnancy • Breast feeding • Children(below 10 yrs)

  18. MACROLIDES e.g., clarithromycin Mechanism of action • Inhibits bacterial protein synthesis by binding to bacterial 50S ribosomal subunits

  19. Side Effects Nausea, vomiting, abdominal pain & diarrhea. Allergic reactions- urticaria, mild skin rashes Irregular heart beats(recent)

  20. Cephalosporins Mechanism of action Inhibits bacterial cell wall synthesis Bactericidal β-lactam antibiotics 3rd Generation cephalosporins e.g. Ceftriaxone cefixime

  21. Adverse effects • Allergic manifestations • Thrombophilibitis • Superinfection • Diarrhea

  22. GONORRHEA Caused by Neisseria gonorrhea, a pus producing bacteria Up to 1 MILLION people affected each year Teenagers (15-19) have the highest rate if infection

  23. Drugs used in the treatment of Gonorrhea • 3rd generation Cephalosporins*** Ceftriaxone,I.M, Cefixime,P.O • Fluoroquinolones Ciprofloxacin • Spectinomycin

  24. :Recommended regimens ( 1st line treatment) Uncomplicated gonorrheal infections 3rd generation cephalosporins 500mg ceftriaxone,IM or 400 mg of cefixime,po Typically given with a single dose of azithromycin(1gm,po) or doxycycline(100mg,b.i.d,po) for 7 days.

  25. FLUOROQUINOLONES Single oral dose of : Ciprofloxacin(500 mg) Ofloxacin(400 mg)

  26. MECHANISM OF ACTION of fluoroquinolones • All are bactericidal • Inhibit DNA synthesis by inhibiting DNA gyrase enzyme

  27. Side effects Nausea , vomiting & diarrhoea Headache& dizziness May damage growing cartilage &cause arthropathy. Phototoxicity – avoid excessive sunlight

  28. CONTRAINDICATIONS • Pregnancy • Nursing mothers • Children under 18 years

  29. Alternative treatment in pts cannot tolerate or be treated with 1st line treatment Spectinomycin • 2g ,IM

  30. Mechanism of action • Inhibits protein synthesis by binding to 30 S ribosomal subunits

  31. Adverse Effects 2. Fever Nausea • Pain at the site of injection Nephrotoxicity (not common)

  32. CONTINUE Complicated gonorrheal infections Spread through blood stream • EYE • Joints • Heart valves • Brain

  33. Harmful effects of gonorrhea Newborn eye infections, may lead to blindness

  34. Treatment of Complicated infections • With conjunctivitis in new born Silver nitrate Germicidal effects are due to precipitation of bacterial proteins by liberated silver ions

  35. Silver nitrate ( continue) • Put into conjunctival sac once immediately after birth (no later than 1 h after birth )

  36. ERYTHROMYCIN • 0.5% ointement for teatment & prevention of corneal & conjunctival infections. • Put into conjunctival sac immediately after birth (no later than 1 hr after delivery )

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