STD'S, VIRAL DISEASE.GONORRHOEA

1. Dr. B.Venkata Subbareddy Pharm.D
Asst.Professor
Sri Lakshmi Venkateswra Institute of Pharmaceutical Sciences,
Proddatur

2. INTRODUCTION
• The term gonorrhea was coined by a greek physician Galen
in 150 A.D.
• Distribution of the disease is world wide and the probability
of acquiring infection (by sexual contact with an infected
person) from a single exposure varies between men and
women.
• Probability of acquiring infection from single exposure for
men ranges from 20-30% whereas for women it ranges
from 50-90%, indicating that women are at higher risk
compared to men.
 CDC estimates that more than 700,000people in U.S are
effected.
 In 2004, 330,132 cases of gonorrhea were reported to the
CDC

3. Causative Oraganism
‘Neisseria Gonorrhoeae’.

5. Mode of Transmission
• In most of the cases,
gonorrhoea is transmitted
from person to person via
sexual intercourse.
(Vaginal, oral, anal)
• The disease is also transmitted
from mother to infant during
pregnancy.
(Materno - Foetal
Transmission)
• Similar to syphilis, human is
the only host for the causative
organism.

6. Staying
• The tends to infect warm, moist areas of the body,
including the:
• urethra (the tube that drains
urine from the urinary bladder)
• eyes
• throat
• vagina
• anus
• female reproductive tract
(the fallopian tubes, cervix, and uterus)

7. Discharge from the vagina (watery, creamy, or slightly green)
Pain or burning sensation while urinating
The need to urinate more frequently
Heavier periods or spotting
Sore throat
Pain upon engaging in sexual intercourse
Sharp pain in the lower abdomen
Fever

8. SYMPTOMS IN MEN
Men may not develop noticeable symptoms for
several weeks. Some men may never develop
symptoms.
Typically, the infection begins to show symptoms a
week after its transmission. The first noticeable
symptom in men is often a burning or painful sensation
during urination . As it progresses, other symptoms may
include:
greater frequency or urgency of urination
a pus-like discharge (or drip) from the penis
(white, yellow, beige, or greenish)
swelling or redness at the opening of the penis
Swelling or pain in the testicles
a persistent sore throat The infection will stay in the
body for a few weeks after the symptoms have been
treated. In rare instances, gonorrhea can continue to
cause damage to the body, specifically the urethra and
testicles. Pain may also spread to the rectum

10. Conted…,,,
Increased risk of HIV/AIDS. Having gonorrhea
makes you more susceptible to infection with human
immunodeficiency virus (HIV), the virus that leads to
AIDS. People who have both gonorrhea and HIV are
able to pass both diseases more readily to their
partners.
Complications in babies. Babies who contract
gonorrhea from their mothers during birth can
develop blindness, sores on the scalp and infections.

11. Infection that spreads to the joints and other areas of your
body
The bacterium that causes gonorrhea can spread through the bloodstream
and infect other parts of your body, including your joints. Fever, rash,
skin sores, joint pain, swelling and stiffness are possible results.

14. Infertility in women.
Untreated gonorrhea
can spread into the
uterus and fallopian
tubes, causing pelvic
inflammatory disease
(PID), which may
result in scarring of the
tubes, greater risk of
pregnancy
complications and
infertility. PID is a
serious infection that
requires immediate
treatment.

15. Infertility in men
Men with untreated
gonorrhea can experience
epididymitis —
inflammation of a small,
coiled tube in the rear
portion of the testicles
where the sperm ducts are
located (epididymis).
Epididymitis is treatable,
but if left untreated, it may
lead to infertility.

17. LABORATORY TESTS
• Urine test. This may help identify bacteria in your
urethra.
• Swab of affected area. A swab of your throat,
urethra, vagina or rectum may collect bacteria that
can be identified in a laboratory.
• Specimens.
• Smears.
• Culture.
• Nucleic acid Amplification tests.
• Serological Tests.

18. Acute
Gonorrhoea
(Uncomplicated)
Aqueous Penicillin G
Initial oral administration of 1gm
Probenecid, after ½ an hour 2
injections of 2.4 mega units of
Penicillin each at different sites.
Repeat if symptoms persist.
Ampicillin
+
Probenecid
Initially 1gm Probenecid given
orally fallowed by 2-3gm ampicillin
orally.
Azithromycin Administered orally in doses of
2gm.
Cotrimoxazole Two tablets b.i.d for 5days or 4
tablets b.i.d for 2 days
Cefixime Given orally in single doses of
400mg.
Cefotaxime I.M. injection of 500mg.
Cefpodoxime Oral single dose of 400mg.
Ceftriaxone Daily single dose of 125-250mg I.M.
Ciprofloxacin Single oral dose of 500mg.
Ofloxacin 400mg single oral dose.
CONDITION DRUG DOSAGE AND ROUTE

19. CONDITION DRUG DOSAGE AND ROUTE
Gonorrhoea
with
Pelvic
Inflammatory
Disease
Procaine Penicillin
+
Doxycycline
Daily dose of 2mega units of procaine
penicillin is given for 10days along with
doxycycline 100mg twice daily for 2
weeks.
Cefoxitin
+
Doxycycline
Cefoxitin of 2gm given I.V. every 2hrs
and initial doxycycline given 100mg I.V
every 12hrs for 2days followed by oral
doxycycline 100mg b.i.d for next 12days.
Ofloxacin
+
Clindamycin
Ofloxacin 400mg given orally twice daily
for 2 weeks and clindamycin 450mg given
orally 4 times a day for 2 weeks.
Gentamycin
+
Clindamycin
An initial loading dose of gentamycin
2mg/kg given I.V or I.M. Should be
followed by gentamycin in 1.5 mg/kg
given 8hrs for atleast 2days along with
I.V. administration of clindamycin 900mg
every 8hrs for atleast 2 days. After 2days,
administer 100mg doxycycline orally,
b.i.d for 12days.