Question

Write prescription for following conditions and an alternative medications for patients who may have allergies to Penicillin.

1. 54 yr old female with Chlamydia.

2. 40 yr old female on Copper T- IUD and with acute PID that is managed on outpatient setting.

3. 65 yr old female with vaginal Candidiasis.

4. 60 yr old male with Acute Prostatitis.

5. 62 yr old male with acute Gout on Left great toe.

Answer 1

Answer q 1

Sexually transmitted disease can be transmitted by bacteria ,viruses , protozoa , fungi ,and ecto parasite. Chlamydia is a sexually transmitted disease caused by the bacterium chlamydia trachomatis.The incubation priod for this disease can last for 7 -21 days .In female it is manifest as cervisitis ,urethritis ,pelvic inflammatory disease , and for men it leads to urethritis ,epididymitis ,prostatitis ,procitisor reactive arthritis. The treatment includes

Doxycycline 100mg BD(twice a day) for 7 days

or

Azithromycin 1gm day 1

500mg day 2

500mg day 3

( OR)

Erythro mycin 500mg twice a day for 10 -14 days

Answer q 2

Pelvic inflammatory disease is a ascending pelvic infection that involves the upper genital tract. chlamydia trachomatis ,gonococci ,staphylococci ,streptococci and the other pus producing organisms are commonly caused pelvic inflammatory disease.The risk factor is the untrated bacterial infection .

Most of the client with pelvic inflammatory disease are treated as outpatient ,receiving antibiotics appropriate to the specific organism causing the infection , They are caution to avoid sexual activity ,douching and other activities that might enhance the infectious process .

-Doxycycline 100mg orally bd for 14 days

metronidazole 500mg twice a day for 14 days

Answer q 3

vaginal candidiasis is a fungal infection caused by candida. This fungus can live inside the body especially mouth , throat ,gut , and on the skin . thrush can cause intense itching and cheesy drainage. The aim of the treatment includes eliminate or control predisposing factors such as antibiotics, malnutrition ,diabetes ,immunosupression ,pregnency ,or use birth control pills .

Treatment

-use topical anti fungal powders and cream such as boric acid ,nystatin or flucyosine applied in to the area

-Flucazole as a single oral dose

Answer q4

Prostitis is a common and often perplexing problem it is an inflammation of the prostate gland . Gram negative bacteria such as Escherichia coli ,klebsiella and Enterobacter are the usual cause of acute and chronic prostate infection .

treatment

The client with acute prostitis may be so ill that they need hospitalization and iv antibiotic administration .

Quinolones is the drug of choice

levofloxacin 750mg QD(once a day)

or an alternate antibiotics is sulfamethoxazole-trimethoprim

The patient should have at lteast 4 weeks of antibiotic therapy to eradicate the infection completely and to prevent chronic prostitis.

Answer q 4

Gout is a metabolic bone disorder in which purine metabolism is altered and the by product ,uric acid accumulate.

The diagnosis of gout is confirmed by the presence of persistent hyperuricemia >7.0mg/dl along with the clinical manifestation. The management of acute attack includes the use of colchicine and NSAIDs(non steroid anti inflammatory drugs ) to reduce pain and inflammation.

The initial dose of colchicine is 0.6 mg to 1.0mg followed by 0.5mg/hr

non steroid anti inflammatory drugs such as

-Naproxen sodium  

-Indomethacin

corticosteroids medications such as prednisone

Medication to lower the uric acid includes allopurinol