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
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 Azithromycin, 1 g PO once or
(Among Adolescents and Adults)
Doxycycline, 100 mg PO 2 times/day × 7 days
Uncomplicated gonococcal urethritis Ceftriaxone, 250 mg IM once, plus azithromycin, 1 g
PO once
Bacterial Vaginosis Metronidazole, 500 mg PO 2 times/day × 7 days or
Metronidazole gel (0.75%), 1 full applicator (5 g)
intravaginally once/day × 5 days or
Clindamycin cream (2%), 1 full applicator (5 g)
intravaginally at bedtime × 7 days
Herpes Simplex Virus Acyclovir, 400 mg PO 3 times/day × 7–10 days (or
(First Clinical Episode) longer) or
Acyclovir, 200 mg PO 5 times/day × 7–10 days (or
longer) or
Famciclovir, 250 mg PO 3 times/day × 7–10 days (or
longer) or
Valacyclovir, 1 g PO 2 times/day × 7–10 days (or
longer)
Doxycycline (100 mg PO 2 times/day × 14 days), plus
Pelvic Inflammatory Disease (PID) either cefoxitin (2 g IM once, boosted with probenecid
(IM or Oral Regimens) 1 g PO once) or ceftriaxone (250 mg IM once), with or
without metronidazole (500 mg PO 2 times/day × 14
days)
Syphilis Benzathine penicillin G, 2.4 million units IM once
(Primary and Secondary)
Doxazosin
o Side Effects orthostatic hypotension, reflex tachycardia, and nasal congestion
Dutasteride
o Patient teaching and response to delayed onset of therapeutic effect
extremely long half-life (about 5 weeks); therefore it takes months to clear the
, NR566 Final Study Guide
drug after dosing has stopped. Although many capsules can be opened and
sprinkled on food, this is not the case with dutasteride. The capsule contents can
be irritating to the oropharyngeal mucosa; therefore the capsule must be
swallowed whole with a full glass of water.
Terazosin
o How to know it’s working relaxes smooth muscle in the bladder neck (trigone
and sphincter), prostate capsule, and prostatic urethra, thereby decreasing
dynamic obstruction of the urethra. Symptomatic improvement and increased
urinary flow develop rapidly.
Various routes of administration of estrogen therapy and when each would be
used
Intravaginal: are used only for local effects, primarily treatment of vulval and vaginal
atrophy associated with menopause.
Parenteral: Although estrogens are formulated for intravenous (IV) and intramuscular
(IM) administration, use of these routes is rare. IV administration is generally limited to
acute, emergency control of heavy uterine bleeding.
Transdermal: specific to certain body regions.
Compared to oral dose- 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.
Oral: Owing to convenience, the oral route is used more than any other.
When is it safe and not safe to prescribe progesterone (AKA: progestin)
Progestins are contraindicated in the presence of undiagnosed abnormal vaginal
bleeding. Relative contraindications include active thrombophlebitis or a history of
thromboembolic disorders, active liver disease, and carcinoma of the breast.
o Side effects of progestin-only oral contraceptives progestins greatly
decrease production of cervical mucus and cause involution of the endometrial
layer. Effects on the endometrium lead to spotting, breakthrough bleeding, and
irregular menses. Progestins, in combination with estrogen, increase the risk for
breast cancer in postmenopausal women.
Benefits of prescribing medroxyprogesterone acetate (Depo-Provera)
Testosterone therapy
o Patient teaching in general and consider teaching specific to different
routes To minimize the risk for accidental skin-to-skin transfer, advise users of
testosterone gel or testosterone topical solution to (1) wash their hands after
every application, (2) cover the application site with clothing after the gel has
dried, and (3) wash the application site before anticipated contact with another
person.
o When is androgen therapy appropriate vs. not needed related to puberty? If
delayed puberty is the result of true hypogonadism, long-term replacement
therapy is indicated (see later section titled Androgen Preparations for Male
Hypogonadism).
o Common side effects Secondary exposure to testosterone gel on
uncovered skin and to testosterone gel on unwashed clothing has resulted in
virilization in children.
