NR566 Final Study Guide
Be familiar with the interactive activities throughout course modules. You could see
variations of those same questions on your exams.
Week 5
Chapters 50-53 and STD-82
Complete the following table to study/prepare for the treatment of STIs/STDs according to
National STD curriculum completed in Week 5 of the course.
STI/STD First line drug, dose, route, frequency
Chlamydia Doxycycline (oral) 100 mg BID x 7 days Or
(Among Adolescents and Adults) Azithromycin 1 g PO single dose
Uncomplicated gonococcal urethritis Book: Ceftriaxone 250 mg IM once + Azithromycin 1g
PO once
Website: 500 mg IM once (<150kg) 1 g (>150kg)
Bacterial Vaginosis Metronidazole 500mg PO BID x 7 days
Herpes Simplex Virus Acyclovir 400 mg PO three times a day for 7-10 days
(First Clinical Episode) Famciclovir 250 mg same as above
Valacyclovir 1 g PO BID for 7-10 days
Single dose Ceftriaxone 250mg IM
Pelvic Inflammatory Disease (PID) +
(IM or Oral Regimens) Doxycycline 100 mg PO BID x 14 days
+ Or -
Metronidazole 500 mg PO BID x 14 days
Syphilis Single dose Benzathine Penicillin G 2.4 million units
(Primary and Secondary) IM
What is the treatment for someone who cannot take first-line treatment for chlamydia?
o They may take erythromycin,levofloxacin,orofloxacin.
Treatment of Chlamydia for pregnant women?
o Azithromycin 1 g PO once
Treatment for newborns with chlamydia ophthalmia?
o Erythromycin base
Doxazosin (Non-selective alpha-1 blocker, treatment of BPH)
o Side Effects
Hypotension, fainting, dizziness, somnolence, and nasal congestion
Dutasteride (5-Alpha-Reductase inhibitors, treatment for BPH)
o Patient teaching and response to delayed onset of therapeutic effect
Reduces ejaculate volume and libido in some men and causes a decline
in Prostate Specific Antigen in all men
Cannot donate blood while taking this medication for at least 6 months
(long half life)
, NR566 Final Study Guide
Teratogenic, absorbed through skin (pregnant women should not even
touch it)
Terazosin (Nonselective alpha-1 adrenergic blockers, treatment of BPH)
o How to know it’s working
Will not shrink prostate size, but there should be symptomatic
improvement and increased urinary flow develop rapidly (Blockade of α1
receptors relaxes smooth muscle in the bladder neck (trigone and
sphincter), prostate capsule, and prostatic urethra, thereby decreasing
dynamic obstruction of the urethra
Estrogen Therapy Uses:
o Contraceptives
o Menopause
o Female Hypogonadism
o Acne
o Cancer palliation
o Gender-affirmation therapy for transgender women
Various routes of administration of estrogen therapy and when each would be used
o Routes
PO
Most common/convenient
Transdermal (4 benefits) (Emulsion, spray, gel, Patches)
The total dose of estrogen is greatly reduced (because the liver is
bypassed).
There is less nausea and vomiting
Blood levels of estrogen fluctuate less
There is a lower risk for DVT, pulmonary embolism, and stroke
Intravaginal
Treats Vulval/vaginal atrophy, some can lower systemic effects
(control of night sweats, hot flashes, etc.) in additional to local
effects (to of vulval/vaginal atrophy)
Parenteral (IV, IM)
Rarely used, only for acute emergency control of heavy uterine
bleeding
o Black box therapy: risk for endometrial cancer, DVT, Stroke, not for CV disease
or dementia patients
When is it safe and not safe to prescribe progesterone (AKA: progestin)
o Contraindicated in presence of undiagnosed abnormal vaginal bleeding. Relative
contraindication include active thrombophlebitis or a history of thromboembolic
disorder, active liver disease, and carcinoma of the breast.
o Side effects of progestin-only oral contraceptives
20% of patients experience breast tenderness headache, abdominal
discomfort, arthralgias (joint stiffness), and depression.
When used as contraceptive, it can lead to spotting, breakthrough
bleeding, irregular menses = irregular bleeding is main reason women
discontinue them
Benefits of prescribing medroxyprogesterone acetate (provera)
Be familiar with the interactive activities throughout course modules. You could see
variations of those same questions on your exams.
Week 5
Chapters 50-53 and STD-82
Complete the following table to study/prepare for the treatment of STIs/STDs according to
National STD curriculum completed in Week 5 of the course.
STI/STD First line drug, dose, route, frequency
Chlamydia Doxycycline (oral) 100 mg BID x 7 days Or
(Among Adolescents and Adults) Azithromycin 1 g PO single dose
Uncomplicated gonococcal urethritis Book: Ceftriaxone 250 mg IM once + Azithromycin 1g
PO once
Website: 500 mg IM once (<150kg) 1 g (>150kg)
Bacterial Vaginosis Metronidazole 500mg PO BID x 7 days
Herpes Simplex Virus Acyclovir 400 mg PO three times a day for 7-10 days
(First Clinical Episode) Famciclovir 250 mg same as above
Valacyclovir 1 g PO BID for 7-10 days
Single dose Ceftriaxone 250mg IM
Pelvic Inflammatory Disease (PID) +
(IM or Oral Regimens) Doxycycline 100 mg PO BID x 14 days
+ Or -
Metronidazole 500 mg PO BID x 14 days
Syphilis Single dose Benzathine Penicillin G 2.4 million units
(Primary and Secondary) IM
What is the treatment for someone who cannot take first-line treatment for chlamydia?
o They may take erythromycin,levofloxacin,orofloxacin.
Treatment of Chlamydia for pregnant women?
o Azithromycin 1 g PO once
Treatment for newborns with chlamydia ophthalmia?
o Erythromycin base
Doxazosin (Non-selective alpha-1 blocker, treatment of BPH)
o Side Effects
Hypotension, fainting, dizziness, somnolence, and nasal congestion
Dutasteride (5-Alpha-Reductase inhibitors, treatment for BPH)
o Patient teaching and response to delayed onset of therapeutic effect
Reduces ejaculate volume and libido in some men and causes a decline
in Prostate Specific Antigen in all men
Cannot donate blood while taking this medication for at least 6 months
(long half life)
, NR566 Final Study Guide
Teratogenic, absorbed through skin (pregnant women should not even
touch it)
Terazosin (Nonselective alpha-1 adrenergic blockers, treatment of BPH)
o How to know it’s working
Will not shrink prostate size, but there should be symptomatic
improvement and increased urinary flow develop rapidly (Blockade of α1
receptors relaxes smooth muscle in the bladder neck (trigone and
sphincter), prostate capsule, and prostatic urethra, thereby decreasing
dynamic obstruction of the urethra
Estrogen Therapy Uses:
o Contraceptives
o Menopause
o Female Hypogonadism
o Acne
o Cancer palliation
o Gender-affirmation therapy for transgender women
Various routes of administration of estrogen therapy and when each would be used
o Routes
PO
Most common/convenient
Transdermal (4 benefits) (Emulsion, spray, gel, Patches)
The total dose of estrogen is greatly reduced (because the liver is
bypassed).
There is less nausea and vomiting
Blood levels of estrogen fluctuate less
There is a lower risk for DVT, pulmonary embolism, and stroke
Intravaginal
Treats Vulval/vaginal atrophy, some can lower systemic effects
(control of night sweats, hot flashes, etc.) in additional to local
effects (to of vulval/vaginal atrophy)
Parenteral (IV, IM)
Rarely used, only for acute emergency control of heavy uterine
bleeding
o Black box therapy: risk for endometrial cancer, DVT, Stroke, not for CV disease
or dementia patients
When is it safe and not safe to prescribe progesterone (AKA: progestin)
o Contraindicated in presence of undiagnosed abnormal vaginal bleeding. Relative
contraindication include active thrombophlebitis or a history of thromboembolic
disorder, active liver disease, and carcinoma of the breast.
o Side effects of progestin-only oral contraceptives
20% of patients experience breast tenderness headache, abdominal
discomfort, arthralgias (joint stiffness), and depression.
When used as contraceptive, it can lead to spotting, breakthrough
bleeding, irregular menses = irregular bleeding is main reason women
discontinue them
Benefits of prescribing medroxyprogesterone acetate (provera)
