NSG 6320 AGNP BOARD EXAM QUESTIONS Sexually Transmitted Diseases Prescribing | Download To Score A

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AGNP BOARD EXAM QUESTIONS Prescription (82 Questions) Question: Which of the following is NOT recommended as an alternative treatment for bacterial vaginosis? Intramuscular ceftriaxone (Rocephin)... Correct Clindamycin (Cleocin) vaginal cream Metronidazole (Flagyl) vaginal cream Tinidazole (Tindamax) orally Explanation: Intramuscular ceftriaxone (Rocephin) is not indicated in the treatment of bacterial vaginosis. Metronidazole (Flagyl) vaginal cream may be used if metronidazole oral is ineffective or not well tolerated. Alternative regimens include several tinidazole regimens or clindamycin (oral or intravaginal). Question: The recommended empiric treatment of pelvic inflammatory disease is: penicillin G benzathine (Bicillin) intramuscularly plus ceftriaxone (Rocephin) intramuscularly. azithromycin (Zithromax) orally plus ceftriaxone (Rocephin) intramuscularly. ceftriaxone (Rocephin) intramuscularly plus doxycycline (Vibramycin). Correct metronidazole (Flagyl) plus ofloxacin (Floxin). Explanation: The recommended empiric treatment for mild to moderate symptoms of pelvic inflammatory disease (PID) is ceftriaxone (Rocephin) 250 mg intramuscularly plus doxycycline (Vibramycin) 100 mg twice daily x 14 days with or without metronidazole (Flagyl) 500 mg PO twice daily x 14 days. All regimens used to treat PID should also be effective against Neisseria gonorrhoeae and Chlamydia trachomatis because negative endocervical screening for these organisms does not rule out upper-reproductive tract infection. Question: For the treatment of chlamydia, azithromycin (Zithromax) should be given: as one-time dose. Correct daily for 3 days. daily for 5 days. daily for 7 days. Explanation: For the treatment of chlamydia, azithromycin (Zithromax) should be given as a single dose, 1 gram orally. Azithromycin (Zithromax) is classified as a macrolide. It is active against most isolates of Chlamydia trachomatis, Neisseria gonorrhoeae, and Streptococcus pneumoniae. Question: Clindamycin (Cleocin) to treat bacterial vaginosis should NOT be used in combination with: atorvastatin. prednisone. estradiol. Correct ibuprofen. Explanation: Clindamycin (Cleocin) may decrease hormonal contraceptive efficacy and should not be coadministered with estradiol. The other choices are not known to cause drug-drug interactions when administered with clindamycin. Question: When treating latent syphilis, treatment outcomes do NOT include the prevention of: asymptomatic progression of the disease. neurosyphilis. sexual transmission. Correct transfer to a fetus in pregnancy. Explanation: Because latent syphilis is not transmitted sexually, the objective of treating patients in this stage of disease is to prevent complications (neurosyphilis and progression of disease) and transmission from a pregnant woman to her fetus. Question: The most commonly reported side effects of azithromycin (Zithromax) for treatment of chlamydia are: alopecia and headache. blurred vision and tinnitus. diarrhea and nausea. Correct dry mouth and tachycardia. Explanation: The most common treatment-related side effects of azithromycin (Zithromax) are related to the gastrointestinal system with diarrhea/loose stools, nausea, and abdominal pain. Most of the adverse reactions leading to discontinuation were related to the gastrointestinal tract. Potentially serious adverse reactions of angioedema and cholestatic jaundice have been reported. Question: The most common reason for persistent gonococcal infections is: inappropriate prescribing of the correct treatment regimen. treatment failure due to high resistance rates. failure of the patient to abstain from unprotected sexual intercourse. Correct lack of test-of-cure and follow-up after treatment. Explanation: A high prevalence of Neisseria gonorrhoeae infection has been observed among men and women previously treated for gonorrhea. Rather than signaling treatment failure, most of these infections result from reinfection caused by failure of sex partners to receive treatment or the initiation of sexual activity with a new infected partner. This indicates a need for improved patient education and treatment of sex partners. If the patient’s last potential sexual exposure was >60 days before onset of symptoms or diagnosis, the most recent sex partner should be treated. To avoid reinfection, sex partners should be instructed to abstain from unprotected sexual intercourse for 7 days after they and their sexual partner(s) have completed treatment and after resolution of symptoms. Question: The recommended treatment for chlamydia infection when azithromycin (Zithromax) or doxycycline (Doryx) is contraindicated is: clindamycin (Cleocin). erythromycin (Ery-Tab). Correct metronidazole (Flagyl). tetracycline (Sumycin). Explanation: First-line therapies for the treatment of chlamydia infection include azithromycin (Zithromax) or doxycycline (Doryx). Alternative therapies include levofloxacin (Levaquin), erythromycin base, erythromycin ethylsuccinate, or ofloxacin (Floxin). Question: An alternative intramuscular medication for ceftriaxone (Rocephin) in the treatment of pelvic inflammatory disease is: cefoxitin. Correct penicillin G benzathine (Bicillin). gentamicin. streptomycin. Explanation: Cefoxitin, a second-generation cephalosporin, has better anaerobic coverage than ceftriaxone (Rocephin), and in combination with probenecid and doxycycline is effective in achieving short-term clinical response in women with pelvic inflammatory disease. Ceftriaxone has better coverage against Neisseria gonorrhoeae. The addition of metronidazole (Flagyl) will also effectively treat bacterial vaginosis, which is frequently associated with PID. Question: The generic name for Flagyl is: fluconazole. methazolamide. metronidazole. Correct tinidazole. Explanation: The generic name for Flagyl is metronidazole. Flagyl is classified as a nitroimidazole. In addition to the treatment of bacterial vaginosis, it is used in the treatment of parasite infections, Clostridium difficile, and Helicobacter pylori. The brand name for fluconazole is Diflucan (an antifungal); methazolamide is Neptazane (a diuretic); tinidazole is Tindamax (an antiparasitic, antibacterial). Question: Tinidazole (Tindamax), used in the treatment of trichomoniasis, is classified as an: antiprotozoal and antiviral. antifungal and antiparasitic. antifungal and antibacterial. antiparasitic and antibacterial. Correct Explanation: Tinidazole (Tindamax) is a synthetic antiparasitic and antibacterial agent indicated for the treatment of trichomoniasis caused by Trichomonas vaginalis. Tindamax is metabolized by the CYP450 3A4 substrates and is excreted primarily unchanged in the urine. The half-life of Tindamax is 12-14 hours. Question: When treating trichomoniasis, tinidazole (Tindamax) compared to metronidazole (Flagyl): is more cost effective. reaches higher drug concentrations in the urinary tract. Correct has a shorter-half life. has more gastrointestinal side effects. Explanation: Tinidazole (Tindamax) is generally more expensive than metronidazole (Flagyl). Tinidazole reaches higher drug concentrations in serum and the genitourinary tract, has a longer half-life (12.5 hours versus 7.3 hours), and has fewer gastrointestinal side effects than metronidazole. Question: Treatment of gonococcal urethritis in a child who weighs less than 45 kg is: azithromycin (Zithromax). ceftriaxone (Rocephin). Correct doxycycline (Vibramycin). erythromycin (Ery-Tab). Explanation: The recommended treatment for gonococcal urethritis in a child weighing less than 45 kg is ceftriaxone (Rocephin). Azithromycin (Zithromax) can be added if the child weighs more than 45 kg. Doxycycline (Vibramycin) and erythromycin (Ery-Tab) are not efficacious for the monotherapy treatment of gonococcal infections. Question: Topical regimens for treatment of herpes simplex are: safer and less expensive than oral treatment. less efficacious than oral treatment. Correct only recommended for herpes labialis. not effective for reducing pain or viral shedding. Explanation: Topical treatment of genital herpes offers minimal clinical benefit and its use is discouraged. The use of topical therapy for herpes labialis (cold sores) is not recommended. Oral therapy is preferred for treatment of recurrent herpes simplex labialis over topical antiviral creams. Antiviral creams have a small but statistically significant effect on the duration of cold sores. Pain and viral shedding may be significantly decreased with the use of penciclovir cream. Question: The recommended treatment of neonatal chlamydia infection is: amoxicillin (Amoxil). cefotaxime (Claforan). erythromycin base (PCE). Correct metronidazole (Flagyl). Explanation: The recommended treatment for neonatal chlamydia infection is erythromycin base (PCE) or ethylsuccinate (EryPed). Azithromycin (Zithromax) is an alternative recommendation. Topical antibiotic therapy alone is inadequate for treatment of ophthalmia neonatorum caused by chlamydia and is unnecessary when systemic treatment is administered. Question: To prevent gonococcal ophthalmia neonatorum in the neonate, the recommended treatment is: bacitracin ophthalmic. ciprofloxacin (Ciloxan) ophthalmic. erythromycin (Ilotycin) ophthalmic ointment. Correct gentamicin (Garamycin) ophthalmic ointment. Explanation: To prevent gonococcal ophthalmia neonatorum, erythromycin (Ilotycin) ophthalmic ointment should be instilled into both eyes of all newborn infants; this procedure is required by law in most states. Ocular prophylaxis is warranted because it can prevent sight-threatening gonococcal ophthalmia, has an excellent safety record, is easy to administer, and is inexpensive. The recommended prophylactic regimen prevents gonococcal ophthalmia. Erythromycin is the only antibiotic ointment recommended for use in neonates. Question: Sinecatechins 15% (Veregen) ointment for treatment of condyloma acuminata: is safe for use in children 6-12 years of age. must be applied three times daily and washed off within an hour to prevent irritation. should be washed off prior to sexual intercourse or application of a tampon. Correct must be applied by the provider to prevent contact with normal skin. Explanation: Sinecatechins (Veregen) ointment is a topical ointment indicated for the self-treatment of external genital and perianal warts (Condylomata acuminata) in immunocompetent patients 18 years and older. It is also known as Polyphenon E, and is a standardized extract of green tea, which has immunostimulatory, antiproliferative and antitumor properties. Treatment is to be applied three times per day to all external genital and perianal warts. It is not necessary to wash off the ointment from the treated area prior to the next application. Sexual contact should be avoided while the ointment is on the skin, or the ointment should be washed off prior to these activities or application of tampons. Question: The most commonly reported side effect in the short- and long-term administration of acyclovir for genital herpes is: anhedonia. nausea. Correct malaise. paresthesia. Explanation: The most commonly reported side effect in the short- and long-term administration of acyclovir (Zovirax) for suppression of genital herpes is nausea. Headache and diarrhea are also frequently reported. Acyclovir (Zovirax) is indicated in the acute and chronic suppression of genital herpes, acute treatment of herpes zoster, and treatment of chicken pox in children 2 years and older. Question: In the treatment of syphilis caused by Treponema pallidum, the preparation, dose and length of treatment are most likely to be determined by: diagnostic confirmation and ability to follow-up. disease stage and clinical manifestations. Correct cost of medication and ability to follow-up. disease stage and diagnostic confirmation. Explanation: Treponema pallidum is a spirochete bacterium with subspecies that cause treponemal diseases such as syphilis. Selection of the appropriate penicillin preparation is important, because Treponema pallidum can reside in sequestered sites (e.g., the CNS and aqueous humor) that are poorly accessed by some forms of penicillin. The preparation used (i.e., benzathine, aqueous procaine, or aqueous crystalline), dosage, and length of treatment depend on the stage and clinical manifestations of the disease. Question: Valacyclovir, used in the suppression of genital herpes, is: a prodrug of acyclovir. Correct an oral form of penciclovir. not well tolerated. less bioavailable than acyclovir. Explanation: Valacyclovir (Valtrex) is a prodrug of acyclovir (Zovirax). It has greater bioavailability, resulting in less frequent dosing. Famciclovir (Famvir) is the oral form of penciclovir (Denavir) topical. These drugs are well tolerated, effective and safe. Question: Metronidazole (Flagyl) is used to eradicate infections with: Escherichia coli. Haemophilus influenzae. Pseudomonas aeruginosa. Trichomonas vaginalis. Correct Explanation: Metronidazole (Flagyl) possesses direct trichomonacidal and amebicidal activity against Trichomonas vaginalis and Entamoeba histolytica. Flagyl is classified as a nitroimidazole. Metronidazole is active in vitro against most obligate anaerobes but does not appear to possess any clinically relevant activity against facultative anaerobes (Escherichia coli, Haemophilus influenzae, Pseudomonas aeruginosa) or obligate aerobes (Clostridium). Question: Ceftriaxone (Rocephin) is classified as a: first-generation cephalosporin. second-generation cephalosporin. third-generation cephalosporin. Correct fifth-generation cephalosporin. Explanation: Ceftriaxone (Rocephin) is a third-generation cephalosporin. Most first-generation cephalosporins begin with "ceph" and newer first-generation and all the later cephalosporins begin with "cef". Rocephin is available in intramuscular or intravenous forms. It is bactericidal and works by inhibiting cell wall mucopeptide synthesis. Question: First-line therapies for the treatment of chlamydia infection include: azithromycin (Zithromax) or doxycycline (Doryx). Correct azithromycin (Zithromax) or clindamycin (Cleocin). clindamycin (Cleocin) or metronidazole (Flagyl). clindamycin (Cleocin) or doxycycline (Doryx). Explanation: First-line therapies for the treatment of chlamydia infection include azithromycin (Zithromax) or doxycycline (Doryx). Alternative therapies include levofloxacin (Levaquin), erythromycin (Erythrocin) or ofloxacin (Floxin). Question: The mechanism of action of acyclovir (Zovirax), an antiviral used in the treatment of genital herpes, is to: block the viral attachment and prevent entry into the host cell. prevent the release of the virus's nucleic acid into the host cell. block nucleic acid synthesis to prevent replication of the virus. Correct block the neuraminidase enzyme to prevent viral release from the host cell. Explanation: Acyclovir (Zovirax) is an antiviral, polymerase inhibitor that works by blocking nucleic acid synthesis to prevent replication of the virus. This is accomplished in three ways: 1) competitive inhibition of viral DNA polymerase, 2) incorporation into and termination of the growing viral DNA chain, and 3) inactivation of the viral DNA polymerase. Question: Podofilox (Condylox) topical gel causes wart necrosis by: arresting cell division in mitosis. Correct chemical coagulation. photochemotherapy. thermal-induced cytolysis. Explanation: Podofilox (Condylox) is an antimitotic drug used in the treatment of condyloma acuminata that causes wart necrosis by arresting cell division in mitosis through binding subunits of microtubules. Local inflammation, burning, itching and pain are common side effects. Cryotherapy destroys warts by thermal-induced cytolysis. Photodynamic therapy with topical or intralesional aminolevulinic acid (a photosensitizing agent) is a specialized form of photochemotherapy. Question: Tinnitus and vertigo may indicate ototoxicity, a drug-drug interaction, in the patient who is taking gentamicin and: amlodipine (Norvasc). furosemide (Lasix). Correct metformin (Glucophage). phenytoin (Dilantin). Explanation: Symptoms of ototoxicity include partial or profound hearing loss, vertigo, and tinnitus. Loop diuretics such as furosemide (Lasix) may cause ototoxicity if administered concurrently with other ototoxins, such as aminoglycoside antibiotics (e.g. gentamicin). Lasix may also cause ototoxicity when administered: rapidly through IV; to patients with severe renal impairment; in excessive doses; and in the presence of hypoproteinemia. Question: The recommended treatment for syphilis in a patient with HIV is: a single, one-time dose of penicillin G benzathine (Bicillin). Correct penicillin G benzathine (Bicillin) given as 3 doses over 2 weeks. penicillin G benzathine-procaine (Bicillin C-R) given as 3 intramuscular doses over 2 weeks. single, one-time dose of benzathine penicillin-G (Bicillin) and sulfamethoxazole/trimethoprim (Bactrim DS) x 14 days. Explanation: The first-line treatment of primary and secondary syphilis in patients with HIV infection is a single dose of intramuscular penicillin G benzathine (Bicillin). People with HIV infection should be assessed clinically and serologically for treatment failure at 3, 6, 9, 12 and 24 months after therapy. Question: Gentamicin, used as an alternative treatment for gonorrhea,: is an aminoglycoside. Correct is safe to administer during pregnancy. covers gram-positive and gram-negative organisms. is not likely to be nephrotoxic. Explanation: Gentamicin, an aminoglycoside, may be used in the treatment of gonorrhea when the patient is allergic to cephalosporins. Aminoglycosides are bactericidal antibiotics used primarily in the treatment of gram-negative infections. Because of their potential nephrotoxicity, aminoglycosides should be reserved as a last resort, for use in resistant or life-threatening infections. Aminoglycosides should be avoided during pregnancy. Question: The addition of oral probenecid to parenteral penicillin: inhibits cell wall synthesis. binds to beta-lactamase, hindering enzymatic activity. prolongs serum penicillin levels. Correct reduces the risk of penicillin hypersensitivity. Explanation: Concurrent administration of penicillin and probenecid increases and prolongs serum penicillin levels by decreasing the apparent volume of distribution and slowing the rate of excretion by competitively inhibiting renal tubular secretion of penicillin. Question: Two serious adverse reactions that may occur with the administration of metronidazole (Flagyl) include: esophageal ulcer and pericarditis. myalgia and hyperesthesia. peripheral neuropathy and seizures. Correct spontaneous tendinitis and tendon rupture. Explanation: Two serious adverse reactions that may occur with the administration of metronidazole (Flagyl) include peripheral neuropathy and seizures. Peripheral neuropathy has proven to be persistent in some patients. Flagyl should be stopped and symptoms immediately reported to the provider. Other CNS adverse reactions include headache, syncope, dizziness, vertigo, incoordination, ataxia, confusion, dysarthria and insomnia. Question: Patients receiving metronidazole (Flagyl) for the treatment of bacterial vaginosis should be advised: to avoid all alcohol consumption. Correct that partners should be treated. to avoid further sexual activity until asymptomatic. to stop the medication as soon as symptoms resolve. Explanation: Alcohol consumption should be avoided during treatment and at least 24 hours after discontinuation of metronidazole (Flagyl). If patients receiving metronidazole drink alcoholic beverages, they may experience abdominal distress, nausea, vomiting, flushing, or headache. Routine treatment of sex partners is not recommended. Women should be advised to refrain from sexual activity or to ensure that their partners use condoms consistently and correctly during the treatment regimen. Metronidazole should be taken for the full prescribed length of time. Symptoms may improve before the infection is completely cleared, however, not completing the dose increases the risk of bacterial resistance. Question: The recommended treatment for Trichomonas vaginalis is: single dose of azithromycin 2 g orally. doxycycline 100 mg orally twice daily x 14 days. erythromycin base 1000 mg orally twice daily x 10 days. metronidazole 2 g orally in a single dose. Correct Explanation: The recommended treatment of Trichomonas vaginalis is metronidazole 2 g orally in a single dose. Question: Which of the following statements is NOT true about the treatment of herpes simplex virus (HSV)? Acyclovir is recommended in the treatment of oral HSV disease in children 2-11 years of age. Duration of therapy should not extend beyond 7 days, despite unresolved lesions. Correct Therapy is most effective when started within 48 to 72 hours of onset. Treatment of the first episode of genital herpes reduces the risk of neurologic complications. Explanation: Dosages and duration of therapy differ depending on the drug and the immune status of the host. CDC guidelines recommend 7-10 days of therapy, however, duration should be extended until all lesions are resolved, particularly if the patient is immunocompromised. Resistance to these drugs is rare in immunocompetent people. Acyclovir (Zovirax) is indicated in the treatment of genital/mucocutaneous HSV in immunocompetent children 2-11 years of age. Therapy is most effective when started within 48-72 hours of onset. The risk of neurologic complications is reduced with treatment of the first episode. Question: When administered concurrently with penicillin, which medication diminishes the bactericidal effect? Aspirin Buspirone (BuSpar) Clindamycin (Cleocin) Tetracycline (Sumycin) Correct Explanation: Tetracycline, a bacteriostatic antibiotic, may antagonize the bactericidal effect of penicillin and concurrent use of these drugs should be avoided. Question: A woman is being treated for pelvic inflammatory disease (PID). Her male partners should be evaluated and presumptively treated with: penicillin G benzathine (Bicillin) intramuscularly plus ceftriaxone (Rocephin) intramuscularly. metronidazole (Flagyl) plus ciprofloxacin (Cipro). azithromycin (Zithromax) plus ceftriaxone (Rocephin) intramuscularly. Correct azithromycin (Zithromax) plus doxycycline (Vibramycin). Explanation: Men who have had sexual contact with a woman with pelvic inflammatory disease (PID) during the 60 days preceding her onset of symptoms should be evaluated, tested, and presumptively treated. The treatment regimen should cover chlamydia and gonorrhea, regardless of the etiology of PID or pathogens isolated from the woman. The recommended treatment for gonorrhea and chlamydia is azithromycin (Zithromax) 1 g orally plus ceftriaxone (Rocephin) 250 mg intramuscularly given together. Question: In the presence of ceftriaxone (Rocephin) allergy, the alternative medication to combine with azithromycin for the treatment of uncomplicated gonococcal infection is: clarithromycin (Biaxin). doxycycline (Vibramycin). erythromycin (Erythrocin). intramuscular gentamicin. Correct Explanation: Intramuscular gentamicin may be used in combination with azithromycin (Zithromax) in the presence of a cephalosporin allergy. Clarithromycin (Biaxin) and erythromycin (Ery- Tab) are also macrolides and would not be paired with another macrolide. Because of the prevalence of tetracycline resistance, the use of azithromycin as the second antimicrobial is preferred. Question: Ofloxacin (Floxin), for the treatment of chlamydia, is classified as a: cephalosporin. fluoroquinolone. Correct penicillin. tetracycline. Explanation: Ofloxacin (Floxin) is classified as a fluoroquinolone. It is indicated in the treatment of bacterial infections, including chlamydial infections, non-gonococcal urethritis, prostatitis, and complicated and uncomplicated urinary tract infections. Question: Metronidazole (Flagyl) should not be administered in conjunction with: disulfiram (Antabuse). Correct lamotrigine (Lamictal). olanzapine (Zyprexa). prednisolone (Prelone). Explanation: Psychotic reactions have been reported in alcoholic patients who are concurrently using metronidazole (Flagyl) and disulfiram (Antabuse). Metronidazole should not be given to patients who have taken disulfiram within the last 2 weeks. Question: Azithromycin (Zithromax), a macrolide antibiotic, is NOT effective against: Chlamydia trachomatis. Neisseria gonorrhoeae. methicillin-resistant Staphylococci. Correct Streptococcus pneumoniae. Explanation: Azithromycin (Zithromax), a macrolide antibiotic, is active against most isolates of Chlamydia trachomatis, Neisseria gonorrhoeae, and Streptococcus pneumoniae. Most strains of Enterococcus faecalis and methicillin-resistant staphylococci are resistant to azithromycin. Question: A test-of-cure to assure resolution of gonococcal infection is NOT needed: in a 33-year-old man with uncomplicated rectal gonorrhea treated with first-line medications. Correct a 24-year-old pregnant woman treated with first-line medications. a 28-year-old woman with pharyngeal gonorrhea with a macrolide allergy. an 18-year-old man treated one month ago and who now has urethritis. Explanation: A test-of-cure is not needed for patients who receive a diagnosis of uncomplicated urogenital or rectal gonorrhea who are treated with any of the first-line medication regimens. Any person with pharyngeal gonorrhea who is treated with an alternative regimen should return 14 days after treatment for a test-of-cure. In the case of a macrolide allergy, a secondary treatment regimen is recommended. Test-of-cure is recommended in pregnant women within 7-14 days after treatment and again 3 months after treatment (or in the last month of pregnancy). Men or women who have persistent urethritis, cervicitis or proctitis should be tested for recurrent infection or antimicrobial susceptibility due to resistance of the organisms. Question: Metronidazole (Flagyl), used in the treatment of bacterial vaginosis, is NOT appropriate for use in: older adults. nursing mothers. Correct tetracycline-hypersensitive patients. patients with renal disease. Explanation: Metronidazole (Flagyl) is secreted in human milk in concentrations similar to those found in plasma. Because of the potential for tumorigenicity, nursing should be discontinued or an alternative therapy considered. Decreased renal function does not alter the single-dose pharmacokinetics of metronidazole. However, plasma clearance of metronidazole is decreased in patients with decreased liver function. In older adults, monitoring of serum levels may be necessary to adjust the metronidazole dosage accordingly, but it is not contraindicated. The risks versus the benefits should be considered in pregnancy because metronidazole crosses the placental barrier and its effects on the human fetal organogenesis are not known. Question: Imiquimod (Aldara) 5% cream, for the treatment of genital warts,: must be applied by the provider to prevent contact with normal skin. produces a T-cell mediated, cytotoxic immune response. Correct is associated with high rates of recurrence. is a standardized extract of green tea. Explanation: Imiquimod is a topical immune modulator that induces the production of the cytokines interferon alfa, interleukin-6 (IL-6), IL-8 and tumor necrosis factor alpha, leading to a T- cell-mediated, cytotoxic immune response for the treatment of condyloma acuminata. Recurrence rates are relatively low when compared with other treatments, such as podofilox (Condylox). Side effects include localized pruritus erythema, erosion, burning and pain. Should severe local skin reaction occur, the cream should be removed by washing the treatment area with mild soap and water. Sinecatechins (Veregen) ointment, also known as Polyphenon E, is a standardized extract of green tea. Question: The brand name of ceftriaxone is: Cedax. Cefotan. Rocephin. Correct Suprax. Explanation: The brand name of ceftriaxone is Rocephin. Rocephin is a 3rd generation cephalosporin. The generic name of Cedax is ceftibuten; Cefotan is cefotetan; and Suprax is cefixime. Question: Imiquimod (Aldara) is indicated for the treatment of: acne. condyloma acuminata. Correct erysipelas. keloids. Explanation: Imiquimod (Aldara) is indicated for the treatment of actinic keratosis, perianal warts/condyloma acuminata, and superficial basal cell carcinoma. Question: To prevent an iatrogenic procaine reaction from the accidental intravenous administration of penicillin-G procaine, administer: bolus fluids. Benadryl. corticosteroid therapy. Correct epinephrine. Explanation: Iatrogenic procaine reaction (procaine psychosis, procaine mania, Hoigne’s syndrome) may occur if intramuscular procaine penicillin-G is mistakenly administered intravenously. Corticosteroid therapy should be administered as soon as the mistake is realized to prevent the development of a pseudo penicillin allergic response, including anaphylactic shock. Symptoms include arthralgia, myalgia and transient worsening of the lesions of early syphilis. It usually starts 3-12 hours after receiving penicillin treatment for syphilis. Question: The recommended first-line treatment for bacterial vaginosis caused by Gardnerella vaginalis is: azithromycin (Zithromax). ciprofloxacin (Cipro). doxycycline (Vibramycin). metronidazole (Flagyl). Correct Explanation: The first-line recommended treatment for bacterial vaginosis caused by Gardnerella vaginalis is metronidazole (Flagyl). A disulfiram-like reaction may occur if alcohol is consumed while taking metronidazole and for 24 hours after completion. Patients should be advised to avoid alcohol consumption. Clindamycin cream is an alternative first-line treatment for bacterial vaginosis. Question: A side effect of gentamicin for the treatment of gonorrhea is: oral candidiasis. ototoxicity. Correct otomycosis. pharyngitis. Explanation: Aminoglycosides, such as gentamicin, are a significant potential source for iatrogenic hearing loss and balance dysfunction, particularly in the presence of tympanic membrane perforation. Ototoxicity is the most important concern with aminoglycoside agents, including neomycin, tobramycin, and gentamicin. Question: Patients using imiquimod (Aldara) 5% cream as a self-treatment option for condyloma acuminata should be advised: that the goal of treatment is to eradicate the virus. to avoid sexual contact for at least 1 hour after application. to expect scarring from the healing process. to avoid the use of sunlamps while using the cream. Correct Explanation: Patients using imiquimod (Aldara) 5% cream as a self-treatment option for condyloma acuminata should be advised to avoid exposure to sunlight (including sunlamps) during use because of concern for heightened sunburn susceptibility. The goal of treatment for patients with condyloma acuminata is to destroy or remove visible lesions. Although treatment may reduce human papillomavirus (HPV) infectivity, it is unlikely to eradicate it. Nonscarring healing is considered one of the advantages of this treatment. Sexual (genital, anal, oral) contact should be avoided while imiquimod cream is on the skin. Typically the cream is applied three times weekly, left in place for 6-10 hours and then washed off. Question: When prescribing oral clindamycin (Cleocin) for the treatment of bacterial vaginosis, caution should be used for the patient with: psoriasis. ulcerative colitis. Correct diabetes. hypothyroidism. Explanation: Patients who take clindamycin (Cleocin) for a prolonged time should be monitored for gastrointestinal, hematologic, and hepatic symptoms. Patients with a history of gastrointestinal disease, particularly colitis, should be monitored carefully for changes in bowel habits. Patients should be cautioned to immediately report the onset of watery, bloody diarrhea as this may be a sign of Clostridium difficile development and not just an exacerbation of the colitis. Question: In the treatment of syphilis, symptoms of Jarisch-Herxheimer reaction may occur after the initiation of penicillin-G benzathine (Bicillin) and include: anasarca, hypotension and diarrhea. fever, chills, headache and myalgia. Correct severe abdominal pain, vomiting and diarrhea. lethargy, bradycardia and rash. Explanation: Jarisch-Herxheimer reaction is an acute febrile reaction frequently accompanied by headache, myalgia, fever, hypotension, tachycardia, exacerbation of skin lesions and other symptoms that can occur within the first 24 hours after the initiation of any therapy for syphilis. It is a reaction to endotoxin-like products released by the death of harmful microorganisms within the body during antibiotic treatment. The antibiotics are so successful at killing large numbers of bacterial cells that the contents of these ruptured cells provoke irritation and must be cleared. Patients should be informed about this possible adverse reaction and consider taking antipyretics to lessen the symptoms. The Jarisch-Herxheimer reaction might induce early labor or cause fetal distress in pregnant women, but this should not prevent or delay therapy. It is not typically life threatening. Question: Acyclovir (Zovirax), an antiviral,: cures genital herpes. is only indicated for acute outbreaks of herpes. is not effective against varicella. requires a dosage adjustment in renally impaired patients. Correct Explanation: Acyclovir (Zovirax) is indicated in the acute and chronic suppression of genital herpes, acute treatment of herpes zoster and treatment of chicken pox in children 2 years and older. Patients should be informed that acyclovir is not a cure for genital herpes. The half-life and total body clearance of acyclovir are dependent on renal function. A dosage adjustment is recommended for patients with reduced renal function. Question: Which medication is indicated for the treatment of trichomoniasis? Intramuscular ceftriaxone (Rocephin) Clindamycin (Cleocin) vaginal cream Metronidazole (Flagyl) vaginal cream Metronidazole (Flagyl) oral Correct Explanation: Oral metronidazole (Flagyl) is indicated for the treatment of trichomoniasis. Metronidazole gel (MetroGel Vaginal) does not reach therapeutic levels in the urethra and perivaginal glands. Because it is less efficacious than oral metronidazole, it is not recommended for the treatment of trichomoniasis. Tinidazole is the only other medication recommended for the treatment of trichomoniasis. Question: Patients applying imiquimod (Aldara) for the treatment of genital condyloma acuminata should be advised to: avoid vaginal use. Correct avoid rubbing the cream into the affected area. apply thick layers of the cream to affected areas. reapply the cream if it rubs off on underwear. Explanation: Imiquimod cream should not be applied in or near the mouth, eyes, nose or inner layers of vaginal tissue. A thin layer of Imiquimod cream should be applied only to the affected area. Do not use more cream than is needed to cover the affected area. The cream should be rubbed into the skin. Question: Partner therapy for a patient diagnosed with primary, secondary or early latent syphilis should be completed presumptively for all partners in the past: 30 days if serologic testing is positive. 60 days if serologic testing is positive. 90 days, even if serologic testing is negative. Correct year, even if serologic testing is negative. Explanation: People who have had sexual contact with a patient who receives a diagnosis of primary, secondary, or early latent syphilis within 90 days preceding the diagnosis should be treated presumptively for early syphilis, even if serologic test results are negative. Question: The brand name for penicillin G benzathine is: Bicillin C-R. Bicillin L-A. Correct Cuprimine. Pfizerpen. Explanation: The brand name for penicillin G benzathine is Bicillin L-A. The generic name for Bicillin C-R is benzathine-procaine penicillin. Bicillin C-R has been inadvertently confused with benzathine penicillin product (Bicillin L-A). Bicillin C-R is not indicated in the treatment of syphilis and may lead to an adverse reaction if administered intravenously. The generic name for Cuprimine is penicillamine; it is classified as a disease-modifying antirheumatic drug. The generic name for Pfizerpen is penicillin G potassium. Question: The goal of daily suppressive therapy in the treatment of genital herpes is to: prevent recurrence and reduce the risk of transmission. decrease the number of, and shorten the duration, of outbreaks. decrease the number of outbreaks and reduce the risk of transmission. Correct shorten the duration of the outbreak and reduce the risk of transmission. Explanation: The goal of daily suppressive therapy in the treatment of genital herpes is to decrease the number of outbreaks and/or reduce the risk of genital herpes transmission. The goal of episodic treatment is to shorten the duration of the outbreak. Acyclovir (Zovirax) is indicated in the acute and chronic suppression of genital herpes, acute treatment of herpes zoster, and treatment of chicken pox in children 2 years and older. Question: The first-line treatment for late latent, tertiary and gummatous syphilis (without neurosyphilis) is: single, one-time dose of penicillin G benzathine (Bicillin) penicillin G benzathine (Bicillin L-A) given as 3 intramuscular doses over 2 weeks. Correct penicillin G benzathine-procaine (Bicillin C-R) given as 3 intramuscular doses over 2 weeks. single, one-time dose of penicillin G procaine plus ceftriaxone (Rocephin) intramuscularly. Explanation: The first-line treatment for late latent, tertiary and gummatous syphilis (without neurosyphilis) is intramuscular penicillin G benzathine (Bicillin) given as 3 doses over 2 weeks (days 0, 7, and 14). Limited clinical studies suggest that ceftriaxone (Rocephin) 1-2 g daily either IM or IV for 10-14 days is effective for treating primary and secondary syphilis, but the optimal dose and duration of ceftriaxone therapy has yet to be defined. Reports indicate that practitioners have inadvertently prescribed combination benzathine-procaine penicillin (Bicillin C-R) instead of the standard benzathine penicillin product (Bicillin L-A). Bicillin C-R is not indicated in the treatment of syphilis. Question: The treatment of choice, in combination with ceftriaxone (Rocephin), for uncomplicated gonococcal infection in the patient allergic to azithromycin (Zithromax) is: clarithromycin (Biaxin). doxycycline (Vibramycin). Correct erythromycin (Erythrocin). gemifloxacin (Factive). Explanation: Because of the prevalence of tetracycline resistance, the use of azithromycin (Zithromax) as the second antimicrobial is preferred. However, in the case of azithromycin allergy, doxycycline (Vibramycin, 100 mg orally twice a day for 7 days) can be used as an alternative second antimicrobial in combination with ceftriaxone (Rocephin) or cefixime (Suprax). Clarithromycin (Biaxin) and erythromycin (Ery-Tab) are macrolides and would not be indicated in a patient with a known allergy to azithromycin. Gemifloxacin (Factive) may be used in combination with azithromycin in the presence of a cephalosporin allergy. Question: The brand name of azithromycin, a macrolide, is: Erythrocin. Moxatag. Zithromax. Correct Zovirax. Explanation: The brand name of azithromycin is Zithromax. Zithromax is a macrolide indicated for the treatment of chlamydial and gonococcal infections. The generic name of Erythrocin is erythromycin; Moxatag is amoxicillin; and Zovirax is acyclovir. Question: Women who are treated with triple therapy for pelvic inflammatory disease should be considered for intravenous therapy if no response is seen within: 3 days. Correct 7 days. 10 days. 14 days. Explanation: Triple therapy comprised of intramuscular ceftriaxone (Rocephin), plus oral doxycycline (Vibramycin), plus oral metronidazole (Flagyl) can be considered for women with mild to moderately severe acute pelvic inflammatory disease. Women who do not respond to the triple therapy regimen within 72 hours should be reevaluated to confirm the diagnosis and should receive intravenous therapy. Question: The alternative first-line treatment for primary, secondary and early latent syphilis (without neurosyphilis) in the presence of IgE-mediated penicillin allergy is: amphotericin B (Abelcet). azithromycin (Zithromax). doxycycline (Vibramycin). Correct sulfamethoxazole/trimethoprim (Bactrim DS). Explanation: Several therapies might be effective in nonpregnant, penicillin-allergic patients who have primary or secondary syphilis without neurosyphilis. Regimens of doxycycline (Vibramycin) 100 mg orally twice daily or tetracycline (Sumycin) 500 mg four times daily for 14 days have been used for many years. Compliance is likely to be better with doxycycline than tetracycline, because tetracycline can cause gastrointestinal side effects and requires more frequent dosing. Treponema pallidum has documented macrolide (i.e. azithromycin [Zithromax]) resistance and treatment failures in multiple geographical areas in the United States. Question: The recommended patient-delivered expedited partner therapy (EPT) for the treatment of Neisseria gonorrhoeae is: azithromycin (Zithromax) 1 gram orally plus doxycycline (Vibramycin) 100 mg twice daily x 7 days. azithromycin (Zithromax) 1 g orally plus cefixime (Suprax) 400 mg orally. Correct azithromycin (Zithromax) 1 gram orally plus ofloxacin (Floxin) 300 mg PO twice daily x 7 days. azithromycin (Zithromax) 1 gram orally plus metronidazole (Flagyl) 500 mg PO twice daily x 7 days. Explanation: Expedited partner therapy (EPT) for the treatment of Neisseria gonorrhoeae with cefixime (Suprax) 400 mg and azithromycin (Zithromax) 1 g can be delivered to the partner by the patient, a disease investigation specialist, or a collaborating pharmacy as permitted by law. EPT is appropriate for heterosexual men and women for whom health department partner-management strategies are impractical or unavailable and whose providers are concerned about partners’ access to prompt clinical evaluation and treatment. EPT should not be considered a routine partner management strategy in men having sex with men (MSM) with gonorrhea because of a high risk for coexisting infections (especially HIV infection) and because no data exist on efficacy in this population. Question: Preferred self-treatment of anogenital warts caused by human papillomavirus is: acyclovir (Zovirax) ointment. azithromycin (Zithromax) orally. gemifloxacin (Factive) orally. imiquimod (Aldara) cream. Correct Explanation: Treatment regimens for anogenital warts caused by human papillomavirus (HPV) are classified as either patient-applied or provider-administered modalities. Patient-applied modalities are preferred by some patients because they can be administered in the privacy of their home. Imiquimod (Aldara) cream, podofilox (Condylox) gel and sinecatechins (Veregen) ointment are recommended for the self-treatment options of external warts. Question: The recommended treatment for neurosyphilis in the outpatient setting is: a single, one-time dose of penicillin-G benzathine (Bicillin). procaine penicillin given daily x 7 doses. IV aqueous penicillin G. Correct single, one-time intramuscular dose of benzathine penicillin-G plus ceftriaxone. Explanation: First-line treatment of neurosyphilis is intravenous aqueous penicillin-G. Second-line treatment is intramuscular procaine penicillin plus oral probenecid. After the initial treatment regimen, penicillin-G benzathine intramuscularly once weekly for up to 3 weeks has been used to ensure the duration of treatment is comparable with that of late syphilis without neurosyphilis. The provider should stress the importance of compliance with the treatment regimen to the family. Question: The generic name of Valtrex is: acyclovir. famciclovir. penciclovir. valacyclovir. Correct Explanation: The generic name of Valtrex is valacyclovir. Valtrex is an antiviral indicated for the treatment of herpes, varicella and zoster. The brand name for acyclovir is Zovirax; penciclovir is Denavir. There are no brand monographs for famciclovir. Question: The brand name of acyclovir, used in the treatment of genital herpes, is: Famvir. Valtrex. Zithromax. Zovirax. Correct Explanation: The brand name of acyclovir is Zovirax. Acyclovir is an antiviral indicated in the acute and chronic suppression of genital herpes, acute treatment of herpes zoster, and treatment of chicken pox in children 2 years and older. The generic name of Famvir is famciclovir; Valtrex is valacyclovir; and Zithromax is azithromycin. Question: The goal of episodic treatment of genital herpes is to: prevent recurrence. decrease the number of outbreaks. reduce the risk of transmission. shorten the duration of the outbreak. Correct Explanation: The goal of episodic treatment is to shorten the duration and severity of an episode. The goal of daily suppressive therapy in the treatment of genital herpes is to decrease the number of outbreaks and/or reduce the risk of genital herpes transmission. Acyclovir (Zovirax) is indicated in the acute and chronic suppression of genital herpes, acute treatment of herpes zoster, and treatment of chicken pox in children 2 years and older. Question: The first-line treatment of primary, secondary and early latent syphilis (without neurosyphilis) is: penicillin G benzathine (Bicillin). Correct penicillin G potassium (Pfizerpen). penicillin G procaine. penicillin V potassium. Explanation: Penicillin G benzathine (Bicillin), administered parenterally, is first-line treatment of primary, secondary and early latent syphilis (without neurosyphilis). The preparation used (i.e., benzathine, aqueous procaine, or aqueous crystalline), dosage, and length of treatment depends on the stage and clinical manifestations of the disease. Penicillin G potassium (Pfizerpen) and penicillin G procaine can both be used in the treatment of neurosyphilis. Question: Patients who receive a prescription for oral clindamycin (Cleocin) should be instructed to: use an antidiarrheal medication if diarrhea occurs. take with a full glass of water. Correct stop the medication once the symptoms subside. double the dose if a dose is missed. Explanation: Oral clindamycin (Cleocin) should be administered with a full glass of water (to avoid esophageal irritation) and may be taken with or without food. If diarrhea occurs, the patient should be instructed to notify the nurse practitioner and avoid the use of antidiarrheal medications, since these may mask the symptoms of Clostridium difficile infection. Patients should be instructed to complete the entire course of the medication and to not double the dose if a dose is skipped. Question: In the treatment of pelvic inflammatory disease, the best medication to cover anaerobic organism activity is: azithromycin (Zithromax). doxycycline (Vibramycin). erythromycin (PCE). metronidazole (Flagyl). Correct Explanation: The recommended treatment for mild to moderate symptoms of pelvic inflammatory disease (PID) is ceftriaxone (Rocephin) 250 mg intramuscularly plus doxycycline (Vibramycin) 100 mg twice daily x 14 days with or without metronidazole (Flagyl) 500 mg PO twice daily x 14 days. Third-generation cephalosporins such as ceftriaxone are limited in the coverage of anaerobes. Metronidazole (Flagyl) is the best medication to add to the third-generation cephalosporin as it is the most effective in eradication of anaerobic organisms. Question: Confirmed gonococcal conjunctivitis in a child should be treated with: azithromycin (Zithromax) intravenously. ceftriaxone (Rocephin) intravenously. Correct erythromycin (Ilotycin) ophthalmic ointment. gentamicin (Garamycin) ophthalmic ointment. Explanation: Gonococcal ophthalmia is strongly suspected when intracellular gram-negative diplococci are identified on gram stain of conjunctival exudate. One dose of ceftriaxone (Rocephin IV or IM) is adequate therapy for gonococcal conjunctivitis. Ceftriaxone should be administered cautiously to hyperbilirubinemic infants, especially those born prematurely. No data exist on the use of dual therapy for the treatment of gonococcal ophthalmia. Topical antibiotic therapy alone is inadequate and unnecessary if systemic treatment is administered. Question: The recommended treatment for uncomplicated urethral gonorrhea is: azithromycin (Zithromax) 1 gram orally. ceftriaxone (Rocephin) 250 mg intramuscularly. azithromycin (Zithromax) 1 gram orally plus ceftriaxone (Rocephin) 250 mg intramuscularly. Correct azithromycin (Zithromax) 1 gram orally plus doxycycline (Doryx) 100 mg orally. Explanation: The recommended treatment for uncomplicated urethral gonorrhea is ceftriaxone (Rocephin) 250 mg IM plus azithromycin (Zithromax) 1 gram PO. Doses should be administered on the same day, simultaneously and directly observed if possible. Dual therapy is recommended due to high rates of antimicrobial resistance to fluoroquinolone, cephalosporin, tetracycline and penicillin. All cases of gonorrhea should be treated with two antimicrobials with different mechanisms of action. Use of azithromycin as the second antimicrobial is preferred to doxycycline because of the convenience and compliance advantages of single-dose therapy and the substantially higher prevalence of gonococcal resistance to tetracycline compared to azithromycin Question: A serious adverse reaction related to azithromycin (Zithromax) is: essential tremors. pancytopenia. renal failure. QT prolongation. Correct Explanation: Serious adverse reactions related to azithromycin (Zithromax) for the treatment of chlamydia include angioedema, cholestatic jaundice, hepatoxicity and QT prolongation. Question: Aqueous penicillin G, for the treatment of syphilis,: is a second-generation penicillin. may be used orally or intravenously. should not be administered to patients weighing less than 70 kilograms. is more active than penicillin V against gram-negative bacteria. Correct Explanation: Aqueous penicillin G is a first-generation penicillin. Penicillin G is used for the treatment of congenital syphilis in children weighing less than 70 pounds and is calculated at 50,000 units/kg/day for 10 days. Penicillin V is less active than penicillin G (benzylpenicillin) against gram-negative bacteria, but penicillin V is more acid-stable than penicillin G, so it can be given orally. Penicillin G is typically given parenterally. Question: Which of the following treatments for condyloma acuminata must be applied by a healthcare provider? Imiquimod 5% (Aldara) cream Podofilox 5% (Condylox) cream Sinecatechins 15% (Veregen) ointment Trichloroacetic acid 80% (Tri-Chlor) solution Correct Explanation: Provider-administered therapy for the treatment of condyloma acuminata is trichloroacetic acid (Tri-Chlor) solution. It is a caustic agent that destroys warts by chemical coagulation. This agent has significant cytodestructive potential and must be applied by a healthcare provider to prevent contact with normal skin and mucous membranes. It causes oxidative damage and destruction of genital warts. Question: Imiquimod (Aldara) 5% cream is NOT indicated for the treatment of: actinic keratoses (AK) on the face or scalp. condyloma acuminata in patients 12 years and older. external perianal warts, human papillomavirus-related. intravaginal warts, human papillomavirus-related. Correct Explanation: Imiquimod (Aldara) cream is not for oral, ophthalmic, or intravaginal use. Treatment of urethral, intravaginal, cervical, rectal or intra-anal viral disease is not recommended. Imiquimod cream is indicated for the treatment of external genital and perianal warts/condyloma acuminata in patients 12 years or older; clinically typical, nonhyperkeratotic, nonhypertrophic actinic keratoses (AK) on the face or scalp in immunocompetent adults; and biopsy-confirmed, primary superficial basal cell carcinoma in immunocompetent adults. Question: The most commonly reported side effects with the use of metronidazole (Flagyl) for the treatment of trichomoniasis are: hypotension and nausea. nausea and metallic taste. Correct photosensitivity and tooth discoloration. pruritus and urticaria. Explanation: The most commonly reported side effects with the use of metronidazole (Flagyl) is gastrointestinal tract symptoms, particularly nausea (reported by about 12% of patients). It is sometimes accompanied by headache, anorexia, and vomiting. Constipation has also been reported. A sharp, unpleasant metallic taste is not unusual while taking Flagyl. Question: Podofilox (Condylox) topical gel for the treatment of condyloma acuminata: must be applied by the provider to prevent contact with normal skin. may cause localized itching and pain. Correct is safe for use in pregnancy. is NOT recommended for treatment of urethral meatus warts. Explanation: Podofilox (Condylox) topical gel is a patient-applied form of therapy for condyloma acuminata. The patient should be advised that the gel may cause localized itching and pain. Compared with the liquid form, Condylox topical gel is easier for patients to apply and has the same efficacy. The liquid form would need to be provider-applied as it is difficult for a patient to apply without contact with normal skin or mucous membranes. Podofilox can be used for urethral meatus warts and anal warts. Cryotherapy and TCA are recommended for vaginal warts. Podofilox is avoided in pregnancy due to teratogenicity. Imiquimod (Aldara) and sinecatechins (Veregen) have not been studied in pregnant patients. Warts in pregnancy must be removed with destructive methods. Question: Tinidazole (Tindamax) is NOT indicated in the treatment of: bacterial vaginosis. giardiasis. trichomoniasis. vaginal candidiasis. Correct Explanation: Tinidazole (Tindamax) is NOT indicated in the treatment of vaginal candidiasis. The use of tinidazole may cause a Candida overgrowth. It is indicated in the treatment of bacterial vaginosis, giardiasis, trichomonas and intestinal amebiasis and amebic liver abscess caused by Entamoeba histolytic. Question: For the treatment of genital condyloma acuminata, imiquimod (Aldara) should be applied: daily and removed in 6 hours. twice daily, removing after 6-10 hours. three times weekly, removing after 8 hours. Correct weekly, removing after 8 hours. Explanation: Imiquimod (Aldara) for the treatment of genital condyloma acuminata should be applied three times weekly on alternating days. It should be applied before sleep and removed after 6-10 hours. Question: Azithromycin (Zithromax) is classified as a: cephalosporin. fluoroquinolone. macrolide. Correct tetracycline. Explanation: Azithromycin (Zithromax) is classified as a macrolide. It is active against most isolates of Chlamydia trachomatis, Neisseria gonorrhoeae, and Streptococcus pneumoniae. An example of a cephalosporin is cefixime (Suprax); fluoroquinolone is ciprofloxacin (Cipro); and tetracycline is doxycycline (Doryx). Question: Patients receiving tinidazole (Tindamax) for the treatment of trichomoniasis should be advised: to avoid prolonged ultraviolet exposure due to photosensitivity. that it is not necessary to treat partners. that they should be tested for cure within 3 months. Correct to stop the medication as soon as symptoms resolve. Explanation: All sexually active women should be advised that retesting for Trichomonas vaginalis is recommended within 3 months following initial treatment. Concurrent treatment of all sex partners is critical for symptomatic relief, microbiologic cure, and prevention of transmission and reinfections. Tinidazole should be taken for the full prescribed length of time. Symptoms may improve before the infection is completely cleared, however, not completing the dose increases the risk of bacterial resistance. Photosensitivity is not a side effect of tinidazole. [Show More]

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