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NR566 WEEK 2 EXAM QUESTIONS AND ANSWERS
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NR566 WEEK 2 EXAM QUESTIONS AND ANSWERS
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NR566 WEEK 2 EXAM QUESTIONS ANDANSWERS
Amphotericin B - Answer--polyene macrolide
-broad spectrum antifungal
*HIGHLY TOXIC*
-only given for infections that are progressive and potentially fatal
- given IV only
Amphotericin B Black Box Warning - Answer-should only be used in the setting of a
potentially life-threatening infection
Amphotericin B side effects - Answer--infusion reactions (fever, chills,rigors, nausea,
headache)
-neprhotoxic
-bone marrow suppression
Drug interactions with Amphotericin B - Answer-increased risk for kidney damage when
used with other nephrotoxic drugs such as:
aminoglycosides
cyclsoporine
NSAIDs
Azoles for systemic mycoses - Answer-itraconazole
ketoconazole
fluconazole
voriconazole
posaconazole
isavuconazonium
Itraconazole (Sporanox) - Answer--alternative to amph b for systemic mycoses
- safer; oral dosing
- adverse effects cardiosupporession and liver injury
-causes transient decrease in EF
-administration with cola enhances absorption
Itraconazole Black Box Warning - Answer-negative inotropic actions; should not be
used for superficial fungal infections, patients with HF, hx of HF or other indications of
ventricular dysfunction
Drug interactios with Itraconazole - Answer--cyclosporine
-warfarin
-sulfonylurea-type oral hypoglycemics
-digoxin
, -quinidine
-give antacids 1 hour before or 2 hours after
Prescribing Considerations for Azoles - Answer--use with caution in patients with liver
disease
-avoid use with drugs metabolized by cyp3a4:
-warfarin
-cyclosporine
-digoxin
-quinidine
Lifespan considerations for Azoles - Answer-ketoconazole has high potential for
hepatotoxicity; do not use in breastfeeding women
Treatment for tines pedis (athlete's foot) - Answer-Topical ketaconazole (antifungal)
Terbinafine
Treatment for tinea corporis (ringworm) - Answer-Topical anti-fungal medication
Terbinafine
Treatment for tinea cruris (jock itch) - Answer-topical and oral antifungals
Terbinafine
may require systemic anti fungal (clotrimazole); topical or systemic glucocorticoids
Treatment for tinea capitis ("ringworm of the scalp" - Answer-oral griseofulvin for 6-8
weeks
OR
oral terbinafine for 2-4 weeks
**topical tx will not work
Treatment for oral candidiasis - Answer-nystatin, clotrimazole, and miconazole
OR
oral fluconazole or ketoconazole for immunocompromised
Treatment for Aspergillosis - Answer-Voriconazole is tx of choice
Amphotericin B
itraconazole
micafungin
Drug interaction with Voriconazole and Phenobarbital - Answer-SHOULD NOT BE
COMBINED DUE TO CYP450
Phenobarbital is a CYP450 inhibitor which can reduce levels of drugs like voriconazole
Diagnostics and Monitoring for antihelmintics - Answer--goal is to eradicate parasitic
worm -infection
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