Gonorrhea vs Chlamydia - Essay Example

"Gonorrhea vs Chlamydia" is a decent example of a paper on infections.
A careful assessment of the symptoms reveals that Robert is infected with Neisseria gonorrhoeae and co-infected with Chlamydia trachomatis; thus, Robert is suffering from Gonorrhea and Chlamydia.

Question 1

Dual therapy is appropriate for this condition. The drug regimen of choice includes cephalosporins and macrolide antibiotics. The medication of choice is oral cephalosporin Cefixime 400 mg in a single oral dose and Azithromycin 1 g orally in a single dose. According to Pereira et al., (2013) the chosen medications are better than the other regimens as Robert is allergic to penicillin thus ceftriaxone administration is not appropriate as it may cause allergic reactions (p. 640-643). The pharmacodynamics action of Cefixime is the binding to specific penicillin-binding proteins inside the bacterial cell wall this blocks the third and final stage of bacterial cell wall synthesis. The pharmacodynamics action of azithromycin is the inhibition of bacterial protein synthesis by the binding action of the 50s ribosomal subunit of the bacterial 70s ribosome. This binding action inhibits peptidyl transferase activity as well as amino acid translocation during translation (Furuya et al., 2006).

Question 2

Instructional points I would use in the management of these symptoms include the following

• Instruct Robert to refer his sex partner for evaluation and treatment to prevent re-infection
• Instruct the patient to take the recommended medication
• The infected patient has to avoid sexual contact until the infection has cleared off, and that is approximately a week
• The most important instructional point I would emphasize is education on sexual risk reduction. I would insist on the usage of condoms with every sexual partner to prevent cases of reinfection and other infections i.e. HIV (Lopez et al., 2013).

Question 3

Potential side effects of Cefixime include nausea, abdominal pain, vomiting, rash, joint pain, diarrhea, itching, and dizziness. Potential side effects of Azithromycin include diarrhea, nausea, abdominal pain, loose stool, cramping, dyspepsia, flatulence, vomiting, agitation, constipation, fatigue, headache, increased cough, and insomnia. The potential side effect of nausea can be managed by encouraging the patient to take the medication with food. Adverse reactions i.e. headaches and dizziness go away with time (Bope et al., 2013).

Worst-case scenarios for both drugs include an allergic reaction. Instances of rashes, swelling of the tongue, and difficulty in breathing are expected as worse case scenarios symptoms. If these happen, then the patient must visit the nearest health facility immediately.

Question 4

Potential drug interactions of Azithromycin include the decrease of the effectiveness of the other drugs when combined i.e. live bacterial vaccines, hormonal birth controls. In addition, Azithromycin should not be taken together with aluminum or magnesium-based antacids as these antacids will bind Azithromycin and inhibit it from being absorbed from the intestine. Potential drug interactions of Cefixime include wrong mechanisms of action when combined with anticoagulants and carbamazepine (Bope et al., 2013).

Question 5

I prescribed a generic name for Cefixime. The brand name is Suprax. Yes, there is a generic version of this drug. I prescribed a generic name Azithromycin. The brand name is Zithromax. Yes, there is a generic version of this drug. I choose a generic version since it's affordable and easily assessable as compared to the brand version for both drugs. 

Question 6

Suprax is price $0.99 while Cefixime 400mg price is $2.97. Zithromax is $1.86, while Azithromycin is $0.43. The prescribed medications can be found at area stores.

Question 7

I would like to see the patient after a week as the medication is expected to work after one week. A test of cure has to be performed. This includes GC culture or a NAAT test. The diagnostic evaluation must also be done to see if the medicine has worked. They include a gram stain to check for urethral discharge, to see if Gonorrhea and Chlamydia infection has completely disappeared. Physical examination has to be done on the mouth, anus, and genitals. The urethra has to be checked for discharge. Moreover, the skin has to be checked for lesions and rashes (Bignell & Unemo, 2013).

Question 8

Should this option fail, alternative treatment includes cephalosporin administration following desensitization or a single oral dose of azithromycin 2 g with a test of cure after a week.

Question 9

Azithromycin and Cefixime both fall under pregnancy category B. These drugs may be taken with caution when the fetus is at risk only.