7.4 Introduction to Sexually Transmitted Infections and Drugs to Treat Them
4 min read•june 18, 2024
are a major public health concern. These infections, caused by bacteria, viruses, or parasites, spread through sexual contact and can lead to serious health complications if left untreated.
Understanding STIs is crucial for nurses. From recognizing symptoms to administering treatments, nurses play a vital role in patient care. This knowledge helps prevent transmission, promote early detection, and ensure effective management of STIs.
Overview of Sexually Transmitted Infections (STIs)
Mechanisms of common STIs
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- Bacterial STIs invade and multiply within host cells causing inflammation and tissue damage (, , )
- Transmitted through sexual contact or from mother to child during childbirth
- Viral STIs invade host cells and hijack cellular machinery for replication leading to cell damage and (, , )
- Transmitted through sexual contact, blood, or from mother to child during pregnancy or childbirth
- Parasitic STIs attach to and feed on host cells causing inflammation and irritation ()
- Transmitted through sexual contact
Key symptoms of prevalent STIs
- Chlamydia often asymptomatic but can cause abnormal vaginal or penile discharge, burning during urination, and pelvic pain in women
- Gonorrhea frequently asymptomatic but may present with thick, cloudy, or bloody discharge from the penis or vagina, pain or burning during urination, and pelvic pain in women
- Syphilis progresses through stages:
- Primary: Painless sore () at the site of infection
- Secondary: Skin rash, fever, swollen lymph nodes
- Latent and tertiary: Damage to internal organs, neurological problems
- HPV causes genital warts and abnormal cell changes on the cervix (precancerous or cancerous)
- HSV presents with painful, fluid-filled blisters or sores on or around the genitals, rectum, or mouth and flu-like symptoms (fever, body aches, swollen lymph nodes)
- HIV initially causes flu-like symptoms within a few weeks of infection followed by a prolonged asymptomatic period and eventually weakens the immune system leading to opportunistic infections and cancers
- characterized by foul-smelling vaginal discharge, genital itching or irritation, and pain during urination or sexual intercourse
- Some individuals may be , capable of transmitting STIs without showing symptoms
Diagnostic approaches for STIs
- Physical examination inspects genital area for sores, warts, or discharge and palpates lymph nodes for swelling
- Laboratory tests include:
- Bacterial culture for Chlamydia and Gonorrhea
- Nucleic Acid Amplification Tests (NAATs) for bacterial and viral STIs
- Blood tests for Syphilis and HIV
- Pap smear for HPV
- Screening involves routine testing for high-risk individuals and prenatal screening for pregnant women
Prevention strategies for STIs
- Education promotes and encourages open communication between partners
- Barrier methods include consistent and correct use of condoms and dental dams for oral-genital or oral-anal contact
- Vaccination prevents cervical cancer and genital warts (HPV vaccine) and sexual transmission of Hepatitis B
- Regular testing allows for early detection and treatment of STIs
- Monogamy or abstinence reduces the number of sexual partners or abstains from sexual activity altogether
- programs in schools and communities play a crucial role in prevention
Public Health Measures
- helps identify and notify potentially infected individuals
- programs promote responsible use of to prevent resistance
- Comprehensive sexual health education in schools and communities
- Promotion of safe sex practices through public health campaigns
- Immune response research to develop new vaccines and treatments
Main drug classes for STIs
- Antibiotics treat bacterial STIs (Chlamydia, Gonorrhea, Syphilis) and include , , , and
- manage viral STIs (HIV, HSV) and include , , and Antiretroviral therapy (ART) for HIV
- treat parasitic STIs (Trichomoniasis) and include
Benefits vs risks of STI treatments
- Antibiotics effectively treat bacterial STIs, prevent complications and transmission but may cause allergic reactions, gastrointestinal side effects, and contribute to antibiotic resistance
- Antivirals reduce severity and frequency of HSV outbreaks and prevent HIV progression but can cause side effects (nausea, headache, dizziness) and interact with other drugs
- Antiparasitics effectively treat Trichomoniasis and prevent transmission but may cause gastrointestinal side effects and interact with alcohol (Metronidazole)
Nursing considerations for STI medications
- Assess for allergies and contraindications before administering medication
- Educate patients on proper dosing, duration, and potential side effects
- Monitor for adverse reactions and effectiveness of treatment
- Encourage adherence to the prescribed treatment regimen
- Maintain patient confidentiality and provide a non-judgmental environment
- Emphasize the importance of partner notification and treatment
Patient education for STI therapies
- Provide clear, written instructions on how to take the prescribed medication
- Discuss the importance of completing the full course of treatment, even if symptoms improve
- Advise on common side effects and when to seek medical attention
- Encourage the use of barrier methods during treatment to prevent transmission
- Stress the importance of follow-up testing to ensure the effectiveness of treatment
- Offer resources for emotional support and counseling services
- Educate on preventive measures to reduce the risk of future STIs
- Emphasize the importance of regular screening and early detection of STIs
Key Terms to Review (54)
Acyclovir: Acyclovir is an antiviral medication used to treat and prevent infections caused by certain types of viruses, particularly the herpes simplex virus (HSV) and varicella-zoster virus (VZV). It is a key drug in the management of viral infections, with applications across various medical contexts including bacterial, viral/COVID-19, and fungal infections, as well as sexually transmitted infections and dermatologic conditions.
Anthracyclines/Antitumor Antibiotics: Anthracyclines are a class of antitumor antibiotics used in cancer therapy. They work by intercalating DNA, inhibiting topoisomerase II, and generating free radicals to kill cancer cells.
Antibiotic drug resistance: Antibiotic drug resistance occurs when bacteria develop the ability to defeat the drugs designed to kill them. This makes infections harder to treat and increases the risk of disease spread, severe illness, and death.
Antibiotic Stewardship: Antibiotic stewardship refers to the coordinated efforts to promote the responsible and appropriate use of antibiotics in healthcare settings. It aims to optimize clinical outcomes, minimize the development of antibiotic-resistant bacteria, and ensure the availability of effective antibiotics for future generations.
Antibiotics: Antibiotics are a class of drugs that are used to treat bacterial infections by either killing or inhibiting the growth of harmful bacteria in the body. They work by targeting specific structures or processes within bacterial cells, disrupting their ability to survive and replicate. Antibiotics play a crucial role in the management of various bacterial infections and are an essential component in the nursing process, drug administration, and the treatment of infections caused by bacteria, viruses, and fungi.
Antiparasitics: Antiparasitics are a class of medications used to treat infections caused by parasitic organisms, such as protozoa, helminths, and ectoparasites. These drugs target and eliminate the parasites that can cause sexually transmitted infections (STIs) and other parasitic diseases.
Antivirals: Antivirals are a class of medications that are specifically designed to target and inhibit the replication of viruses within the host's cells, thereby reducing the severity and duration of viral infections. These drugs play a crucial role in the management and treatment of various viral diseases, including COVID-19, influenza, HIV, and hepatitis, among others.
Asymptomatic Carriers: Asymptomatic carriers are individuals who are infected with a pathogen, such as a virus or bacteria, but do not exhibit any symptoms of the disease. They can unknowingly transmit the infection to others, posing a significant public health challenge, particularly in the context of sexually transmitted infections (STIs).
Azithromycin: Azithromycin is a macrolide antibiotic that is effective against a wide range of bacterial infections. It is also known to have antiviral and antifungal properties, making it a versatile drug with applications in various medical contexts.
Bacterial vaginosis: Bacterial vaginosis (BV) is a condition characterized by an imbalance in the vaginal bacterial flora, leading to overgrowth of certain bacteria. It is not classified as a sexually transmitted infection but can increase susceptibility to other infections.
Bicillin L-A: Bicillin L-A is a long-acting injectable antibiotic that contains penicillin G benzathine. It is commonly used to treat bacterial infections, including sexually transmitted infections like syphilis.
Ceftriaxone: Ceftriaxone is a third-generation cephalosporin antibiotic used to treat a wide range of bacterial infections. It is also known to have antiviral and anti-COVID-19 properties, and can be used to treat certain fungal infections. Ceftriaxone is a versatile medication that can be employed in the management of sexually transmitted infections as well as intracranial emergencies.
Cervicitis: Cervicitis is an inflammation of the cervix, the lower, narrow part of the uterus that connects to the vagina. It is often caused by sexually transmitted infections (STIs) and can lead to various complications if left untreated.
Chancre: A chancre is a painless, firm, round sore that appears at the site of a sexually transmitted infection, typically syphilis. It is the primary stage of syphilis and an important diagnostic indicator for this sexually transmitted disease.
Chlamydia: Chlamydia is a common sexually transmitted bacterial infection that can affect the genitals, rectum, and throat. It is caused by the bacterium Chlamydia trachomatis and is one of the most prevalent sexually transmitted infections (STIs) worldwide, often referred to as a silent epidemic due to its asymptomatic nature in many cases.
Cleocin: Cleocin, also known as clindamycin, is an antibiotic used to treat various bacterial infections. It inhibits bacterial protein synthesis by binding to the 50S ribosomal subunit.
Clindamycin: Clindamycin is an antibiotic used to treat various bacterial infections by inhibiting protein synthesis. It is commonly prescribed for skin, respiratory, and pelvic infections.
Combination Therapy: Combination therapy refers to the use of two or more medications or treatments simultaneously to manage a health condition. This approach is commonly employed in the treatment of various diseases, including sexually transmitted infections and nicotine use disorder, to enhance efficacy, reduce side effects, and prevent the development of drug resistance.
Contact Tracing: Contact tracing is the process of identifying, assessing, and managing people who have been exposed to a contagious disease in order to prevent further transmission. It is a critical public health strategy for controlling the spread of infectious diseases, particularly in the context of sexually transmitted infections (STIs).
Doxycycline: Doxycycline is a broad-spectrum tetracycline antibiotic used to treat a variety of bacterial infections, as well as certain viral and fungal infections. It is commonly employed in the context of antibiotics, antiviral/anti-COVID-19 drugs, and antifungal medications, and also plays a role in the treatment of sexually transmitted infections and acne.
Drug Resistance: Drug resistance refers to the ability of a pathogen, such as a virus, bacteria, parasite, or cancer cell, to withstand the effects of a drug or medication that is designed to kill or inhibit its growth. This phenomenon can significantly impact the effectiveness of various treatments, including those for HIV/AIDS, sexually transmitted infections, parasitic infections, and cancer.
Flagyl: Flagyl, also known as metronidazole, is an antibiotic and antiprotozoal medication used to treat various infections including sexually transmitted infections (STIs) and parasitic infections. It is commonly administered orally or intravenously.
Gonorrhea: Gonorrhea is a highly contagious sexually transmitted infection (STI) caused by the bacterium Neisseria gonorrhoeae. It primarily affects the mucous membranes of the reproductive tract, urethra, and other areas, and can lead to serious complications if left untreated.
Health equity: Health equity is the fair and just opportunity for everyone to attain their highest level of health. It involves removing obstacles such as poverty, discrimination, and lack of access to good jobs and quality education.
Herpes simplex virus (HSV): Herpes simplex virus (HSV) is a viral infection that causes herpes, which can appear in various parts of the body, most commonly on the genitals or mouth. It exists primarily in two forms: HSV-1 and HSV-2.
HIV: HIV, or Human Immunodeficiency Virus, is a virus that attacks the body's immune system, specifically the CD4+ T cells, which are crucial for fighting off infections. If left untreated, HIV can progress to the advanced stage of the disease, known as Acquired Immunodeficiency Syndrome (AIDS), which can be life-threatening.
HIV transmission: HIV transmission is the spread of the Human Immunodeficiency Virus (HIV) from one person to another. It occurs through specific activities that allow contact with infected bodily fluids such as blood, semen, vaginal fluids, and breast milk.
HPV: HPV, or Human Papillomavirus, is a highly prevalent viral infection that is primarily transmitted through sexual contact. It is a significant public health concern, as certain strains of HPV can lead to the development of various types of cancer, including cervical, anal, and oropharyngeal cancers.
HSV: HSV, or Herpes Simplex Virus, is a highly contagious viral infection that primarily affects the skin and mucous membranes. It is a significant topic within the context of sexually transmitted infections (STIs) and the drugs used to treat them.
Human papillomavirus: Human papillomavirus (HPV) is a group of viruses linked to various cancers and genital warts. It is commonly transmitted through sexual contact.
Immune Response: The immune response is the body's defense mechanism against foreign substances, pathogens, and other threats. It involves the activation and coordination of various immune cells, proteins, and processes to recognize, neutralize, and eliminate threats to maintain health and homeostasis.
Infertility: Infertility is the inability to become pregnant after one year of regular, unprotected sexual intercourse. It can be caused by a variety of factors affecting the male or female reproductive system and can have significant implications in the context of sexually transmitted infections and their treatment.
Metronidazole: Metronidazole is a nitroimidazole antibiotic and antiparasitic medication used to treat a variety of infections, including sexually transmitted infections, parasitic infections, and alcohol use disorder. It works by disrupting the DNA of anaerobic bacteria and protozoa, leading to their death or inhibition of growth.
Nucleic Acid Amplification Test: A nucleic acid amplification test (NAAT) is a laboratory technique that detects and amplifies specific genetic sequences of microorganisms, such as viruses or bacteria, to identify the presence of an infection. This test is commonly used in the diagnosis and monitoring of sexually transmitted infections (STIs) like chlamydia, gonorrhea, and HIV.
Ocular antivirals: Ocular antivirals are medications used to treat viral infections of the eye, such as herpes simplex virus and adenovirus. They can be administered in various forms, including eye drops, ointments, and systemic medications.
Pelvic Inflammatory Disease: Pelvic inflammatory disease (PID) is a serious infection of the female reproductive organs, including the uterus, fallopian tubes, and ovaries. It is typically caused by sexually transmitted bacteria and can lead to long-term complications if left untreated.
Penicillin G: Penicillin G, also known as benzylpenicillin, is a beta-lactam antibiotic that is widely used to treat various bacterial infections, including those caused by sexually transmitted pathogens. It is a naturally occurring compound produced by the Penicillium fungus and is a cornerstone in the treatment of sexually transmitted infections (STIs).
Penicillin G benzathine: Penicillin G benzathine is a long-acting antibiotic administered via intramuscular injection. It is commonly used to treat bacterial infections, including sexually transmitted infections such as syphilis.
Prophylaxis: Prophylaxis refers to the measures taken to prevent the occurrence or development of a disease or condition. It is a proactive approach to healthcare aimed at reducing the risk of illness or infection.
Racial and ethnic minorities: Racial and ethnic minorities are groups of people who differ in race or ethnicity from the majority population. In healthcare, they often face disparities in access, treatment, and outcomes.
Rocephin: Rocephin is a brand name for ceftriaxone, a broad-spectrum cephalosporin antibiotic. It is used to treat various bacterial infections, including sexually transmitted infections like gonorrhea.
Safe Sex Practices: Safe sex practices refer to a set of behaviors and precautions taken during sexual activity to reduce the risk of contracting or transmitting sexually transmitted infections (STIs) and unintended pregnancy. These practices aim to promote sexual health and well-being by minimizing the potential negative consequences of sexual activity.
Sexual Health Education: Sexual health education refers to the comprehensive instruction and guidance provided to individuals, typically in educational settings, to promote responsible, healthy, and informed attitudes and behaviors related to sexuality, relationships, and overall well-being. It encompasses a wide range of topics, including sexually transmitted infections, contraception, and the social and emotional aspects of sexual development.
Sexually transmitted infections (STIs): Sexually Transmitted Infections (STIs) are infections primarily spread through sexual contact. They can be caused by bacteria, viruses, or parasites and require medical intervention for treatment.
Single-Dose Therapy: Single-dose therapy refers to the administration of a single, complete dose of a medication to treat a condition or infection. This approach is often utilized in the management of sexually transmitted infections (STIs) to provide immediate and effective treatment.
Syphilis: Syphilis is a sexually transmitted infection (STI) caused by the bacterium Treponema pallidum. It is a progressive disease that can have severe consequences if left untreated, affecting various organ systems and potentially leading to life-threatening complications. Understanding syphilis is crucial in the context of sexually transmitted infections and the drugs used to treat them.
Trichomoniasis: Trichomoniasis is a sexually transmitted infection caused by the protozoan parasite Trichomonas vaginalis. It primarily affects the urogenital tract, leading to symptoms such as itching, burning, and discharge.
Trichomoniasis: Trichomoniasis is a common sexually transmitted infection (STI) caused by a single-celled protozoan parasite called Trichomonas vaginalis. It primarily affects the urogenital tract and can lead to various symptoms and complications if left untreated.
Urethritis: Urethritis is an inflammation of the urethra, the tube that carries urine from the bladder out of the body. It is often caused by sexually transmitted infections (STIs) and can lead to various complications if left untreated.
Valacyclovir: Valacyclovir is an antiviral medication used to treat and prevent various viral infections, particularly those caused by the herpes simplex virus (HSV) and varicella-zoster virus (VZV). It is a prodrug that is converted to the active form, acyclovir, within the body, allowing for improved absorption and bioavailability compared to acyclovir alone.
VDRL: VDRL (Venereal Disease Research Laboratory) is a type of serological test used to detect the presence of antibodies against the syphilis-causing bacterium, Treponema pallidum, in a person's blood. It is a common screening tool for syphilis, a sexually transmitted infection (STI) that can have serious health consequences if left untreated.
Vertical Transmission: Vertical transmission refers to the transmission of a pathogen, such as a virus or bacteria, from a mother to her child during pregnancy, childbirth, or breastfeeding. This mode of transmission is particularly important in the context of infectious diseases that can be passed from an infected mother to her offspring.
Vibramycin: Vibramycin is a brand name for doxycycline, a tetracycline antibiotic used to treat various bacterial infections. It is effective against acne, respiratory tract infections, and sexually transmitted infections.
Zovirax: Zovirax is an antiviral medication used primarily to treat infections caused by herpes viruses, including genital herpes, cold sores, shingles, and chickenpox. It works by inhibiting the replication of viral DNA.