Slide Sifilis
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TREATMENT AND DRUGS MECHANISM OF ACTION
SECONDARY SYPHILLISM. ZHAFRAN DARWIS (C111 11 146)
MAGHFIRAH MAHMUDDIN (C111 11 310)NURFADILLAH (c111 10 310)
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What is SyphillisA disease caused by the
spirochete Treponema pallidum subspecies pallidum
that is usually sexually transmitted.
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Syphiliis StagesSyphilis passes through four distinct clinical phases:1. Primary stage, characterized by a chancre.2. Secondary stage, characterized typically by skin
eruption(s) with or without lymphadenopathy and organ disease.
3. A latent period of varied duration, characterized by the absence of signs or symptoms of disease, with only reactive serologic tests as evidence of infection.
4. Tertiary stage, with cutaneous, neurologic, or cardiovascular manifestations.
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Secondary syphillis Secondary syphilis is the stage when
generalized manifestations occur on the skin and mucous membranes. Serological tests are always positive in immunocompetent persons. Rashes in secondary syphilis have three common features:
1 they do not itch2 they are coppery red3 the lesions are symmetrically distributed
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Treatment of Syphillis
CDC recommendation
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Follow up syphillisFollow-up for clinical and serological
assessment should be done at 3, 6 and 12 months after the completion of treatment in early syphilis.
Non-treponemal antibody test titres correlate with disease activity and will usually become negative with time after successful treatment. In some patients
Treatment failure is suggested by a fourfold increase in titres
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titer for each person diagnosed with syphilis must be obtained on the day-of-treatment
In persons treated for secondary syphilis, the tests usually become nonreactive 12–24 months after treatment.
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The Jarisch–Herxheimer reaction The Jarisch–Herxheimer reaction is a self-limited
clinical syndrome consisting of Feverheadache flare of mucocutaneous lesionstender lymphadenopathy, pharyngitis, malaise,
myalgias, and leukocytosis.It occurs within 12 hours of initiating therapy and
resolves within 24–36 hours. The pathogenesis of the Jarisch–Herxheimer
reaction is unknown, but is thought to result from cytokine release mediated by the release of lipoproteins from dying T. pallidum organisms
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Penicilin Penicillins are members of the β-lactam
family.All penicillins have a nucleus composed of a thiazolidine ring and β-lactam ring, which
is required for antibiotic activity
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Penicilinpoorly absorbed and unstable at low PhPenicillins are widely distributed in body
fluids and tissuesNatural penicillins can interact with amines
(such as procaine and benzathine) to form salts with relatively low solubility; administered intramuscularly, penicillin is released more slowly, prolonging drug delivery
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bind to specific penicillin binding proteins (PNBs)
inhibit cell-wall peptidoglycan synthesis
inactivate an inhibitor of autolytic enzymes
present on bacterial cell walls.
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TetracyclineTetracycline is incompletely absorbed
primarily in the stomach and small intestineDoxycycline is excreted in the feces and no
adjustments for renal or hepatic failure are necessary
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Tetracycline
Tetracyclines inhibit bacterial protein synthesis by binding to the 30s ribosomal subunit and blocking
transfer RNA binding to the mRNA-ribosome complex
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