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WorksheetsChapter 24 Pharm Final Review
Total questions: 99
Worksheet time: 50mins
What is candidiasis?
A fungal infection caused by Candida fungi
A bacterial infection of the skin
A viral infection affecting the lungs
A parasitic infection of the intestines
Which of the following best describes dermatophytes?
Fungal parasites that grow in or on the skin
Bacteria that infect the bloodstream
Viruses that cause respiratory infections
Parasites that live in the digestive tract
What are molds?
Multicellular fungi that form fuzzy colonies
Unicellular fungi of the genus Saccharomyces
Single-celled organisms that cause disease
Bacteria that thrive in moist environments
What is the role of glucan in fungal cells?
It is part of the thick cell wall
It is a component of the cell membrane
It is a type of protein found in the cytoplasm
It is a sugar used for energy storage
Which type of fungal infection is common in immunocompromised patients?
Opportunistic infections
Superficial infections
Systemic infections
Endemic infections
What is a challenge in drug therapy for fungal infections?
Fungal cells are similar to human cells, leading to high toxicity risk.
Fungal cells are resistant to all drugs.
Fungal infections are always mild and do not require treatment.
Fungal cells are identical to bacterial cells.
Which drug class binds ergosterol, causing membrane leakage or lysis?
Polyenes
Azoles
Echinocandins
Miscellaneous
What is the route of administration for Amphotericin B deoxycholate in systemic infections?
Intravenous
Oral
Topical
Inhalation
What is the initial serum half-life of Amphotericin B deoxycholate?
Approximately 24 hours
Approximately 48 hours
Approximately 72 hours
Approximately 12 hours
Which drug class blocks ergosterol synthesis, leading to defective membrane and cell death?
Azoles
Polyenes
Echinocandins
Miscellaneous
What is the primary action of Amphotericin B?
Binds to fungal cell membrane sterols, altering permeability
Inhibits bacterial cell wall synthesis
Blocks viral replication
Enhances immune response
Which of the following is a preferred use of lipid formulations of Amphotericin B?
Patients with preexisting abnormal kidney function
Patients with normal kidney function
Patients with mild infections
Patients with bacterial infections
What is a key characteristic of lipid formulations of Amphotericin B compared to the deoxycholate form?
They cause less damage to normal tissues
They are less expensive
They are interchangeable
They have a shorter duration of action
For which condition is Amphotericin B NOT recommended according to the black box warning?
Noninvasive disease
Progressive infections
Potentially fatal infections
Fungal infections
What is a necessary precaution when administering amphotericin B to children?
Monitor for respiratory arrest
Monitor electrolytes due to magnesium wasting
Monitor for cardiac arrest
Monitor for leukopenia
Why are lipid formulations of amphotericin B preferred for older adults?
They are more effective
They are less nephrotoxic
They are cheaper
They are easier to administer
What is a known contraindication for the use of amphotericin B?
Respiratory arrest
Cardiac arrest
Known allergy to amphotericin B
Hypokalemia
What should be monitored weekly to reduce nephrotoxicity when using amphotericin B?
Blood pressure
Serum creatinine and BUN
Heart rate
Blood glucose levels
Which adverse effect is associated with amphotericin B?
Hyperglycemia
Hyperkalemia
Hypertension
Hyperlipidemia
Which of the following is true about the interactions of amphotericin B?
Many herbs can increase its effects.
No known herb interactions are reported.
It has no drug interactions.
It should not be used with any other medication.
What is the recommended time frame for infusing amphotericin B after reconstitution?
Within 2 hours
Within 4 hours
Within 8 hours
Within 12 hours
Why should a separate IV line be used when administering amphotericin B?
To prevent mixing with other medications
To ensure faster delivery
To avoid using dextrose
To reduce the risk of phlebitis
What should be monitored to assess the therapeutic effects of amphotericin B?
Blood pressure levels
Symptom improvement and infection control
Heart rate
Respiratory rate
Which adverse effect should be monitored during IV administration of amphotericin B?
Hypertension
Phlebitis
Hyperglycemia
Tachycardia
Which of the following practices is recommended to prevent reinfection or spreading of infections?
Avoid cleaning the bathroom regularly
Use topical amphotericin without caution
Practice good hygiene
Keep home filled with potted plants
What is a potential side effect of using topical amphotericin?
Increased appetite
Staining of clothes
Improved vision
Enhanced energy levels
Which type of drugs can increase the risk of kidney damage when used with nephrotoxic antibiotics?
Antineoplastic agents
Cardiac glycosides
Corticosteroids
Antihistamines
What is a common adverse effect of oral nystatin?
Headache
Nausea
Rash
Dizziness
How is nystatin typically used for treating candidiasis?
Systemically for all types of infections
Only topically for oral, intestinal, and vaginal candidiasis
As an injection for rapid effect
Inhaled for respiratory infections
What is the primary method of administration for Fluconazole?
Oral or intravenous (IV)
Topical application
Inhalation
Subcutaneous injection
Which enzyme does Fluconazole interact with?
Cytochrome P450 (CYP)
Amylase
Lactase
Lipase
What is a potential use of Fluconazole in AIDS patients?
Long-term suppression of cryptococcal meningitis
Treatment of bacterial infections
Management of hypertension
Reduction of cholesterol levels
What should women planning pregnancy do if taking a dose of Fluconazole greater than 400 mg/day?
Use contraception
Increase the dose
Discontinue use
Take with food
What is the primary route of excretion for Fluconazole?
Urine
Feces
Sweat
Breath
What is the recommended action for adjusting fluconazole dosage in patients with creatinine clearance ≤ 50 mL/min?
Increase the dose by 50%
Reduce the dose by 50%
Maintain the same dose
Discontinue the medication
Which of the following is a common side effect of fluconazole?
Elevated liver enzymes
Nausea
Hepatic necrosis
Alopecia
According to the FDA Alert (2016), what is the risk associated with fluconazole use during pregnancy?
Increased risk of birth defects
Increased risk of miscarriage
No risk associated
Increased risk of alopecia
Why should fluconazole be used cautiously in patients with liver disease?
It may cause alopecia
It may cause hepatotoxicity
It is not effective in these patients
It is poorly absorbed
What is the contraindication for fluconazole use mentioned in the document?
Pregnancy
Liver disease
Hypersensitivity
Renal impairment
Which enzyme do azoles primarily inhibit, increasing the effects/toxicity of many drugs?
CYP2C9
CYP3A4
CYP1A2
CYP2D6
What is the maximum IV infusion rate for fluconazole?
100 mg/hour
150 mg/hour
200 mg/hour
250 mg/hour
Which of the following is a therapeutic effect of azoles in treating systemic infections?
Increased fever
Decreased fever
Increased diarrhea
Increased rash
What should be monitored every 1–2 months to check for hepatotoxicity when using azoles?
Blood pressure
Hepatic enzymes (AST, ALT)
Heart rate
Blood glucose levels
What is a key patient teaching point when administering azoles?
Avoid all physical activity
Practice good hand hygiene
Increase sugar intake
Avoid all dairy products
Which of the following should be avoided to prevent mold production?
Fresh flowers
Air conditioning
Frequent meals
Scheduled tests
What should be done daily to maintain cleanliness in the bathroom?
Use air fresheners
Clean with bleach
Use non-slip mats
Open windows
What is a side effect of Itraconazole that requires monitoring?
Increased appetite
GI upset
Improved vision
Weight loss
Which drug is associated with a BLACK BOX WARNING for heart failure risks?
Ketoconazole
Posaconazole
Voriconazole
Itraconazole
Which of the following drugs is metabolized by CYP3A4 and eliminated in feces?
Posaconazole
Voriconazole
Isavuconazole
Caspofungin
What is a common side effect of Voriconazole?
Nausea
Transient visual disturbances
Headache
Abdominal pain
Which drug is unique in shortening the QTc interval?
Posaconazole
Voriconazole
Isavuconazole
Caspofungin
What is the prototype drug for Echinocandins?
Posaconazole
Voriconazole
Isavuconazole
Caspofungin
How is Caspofungin primarily excreted from the body?
Through sweat
Through urine and feces
Through saliva
Through tears
What is the primary action of Caspofungin?
Inhibits fungal DNA synthesis
Inhibits the synthesis of the fungal cell wall
Inhibits fungal protein synthesis
Inhibits fungal RNA synthesis
For which condition is Caspofungin NOT used?
Invasive aspergillosis
Candida infections
Febrile neutropenia
Bacterial pneumonia
At what age is Caspofungin approved for use in children?
Older than 1 month
Older than 3 months
Older than 6 months
Older than 12 months
What is a potential adverse effect of caspofungin?
Increased appetite
Fever
Weight gain
Improved vision
Which of the following is a contraindication for administering caspofungin?
Diabetes
Hypertension
Hypersensitivity
Asthma
What should be monitored when caspofungin is given with tacrolimus?
Blood pressure
Heart rate
Serum blood levels
Respiratory rate
How should caspofungin be administered?
Orally with food
Intravenously, incompatible with dextrose
Intramuscularly with saline
Subcutaneously with water
What is recommended for caspofungin dosage in patients with hepatic insufficiency?
Increase the dose
No change in dose
Dose reduction
Double the dose
What symptoms are expected to decrease with the treatment mentioned in the document?
Increased appetite and energy
Decreased fungal growth and reduced symptoms such as malaise, fever, and GI complaints
Improved vision and hearing
Enhanced muscle strength and endurance
At what dosage should patients be monitored for nausea, vomiting, and infusion site phlebitis?
10 mg daily
25 mg daily
50 mg daily
100 mg daily
Which adverse effects should be monitored at a dosage of 50-70 mg?
Increased appetite and weight gain
Fever, headache, lab abnormalities
Improved sleep and relaxation
Enhanced cognitive function
What should patients be instructed about regarding histamine reactions?
They are harmless and require no action
They should be ignored unless severe
They should be aware of the possibility and report any cardiac symptoms immediately
They should only report them during follow-up visits
Which drug increases serum effects when administered with caspofungin?
Anidulafungin
Micafungin
Cyclosporine
Rifampin
What is the function of Anidulafungin (Eraxis) as mentioned in the document?
It is a pain reliever
It is a semisynthetic antifungal that inhibits glucan synthase
It is a blood pressure medication
It is a sedative
What is a significant risk associated with the use of pyrimidine analogs if used in error?
Low blood pressure
High risk of patient harm
Increased appetite
Improved kidney function
Which organ systems are affected by the adverse effects of pyrimidine analogs?
Respiratory and digestive
Hematologic, kidney, and hepatic
Nervous and muscular
Skeletal and integumentary
What type of monitoring is required when using pyrimidine analogs?
Blood pressure and heart rate
Complete blood count and liver enzymes
Respiratory rate and oxygen levels
Blood sugar and cholesterol levels
What is the prototype drug for pyrimidine analogs?
Amphotericin B
Flucytosine
Penicillin
Ciprofloxacin
How is flucytosine primarily absorbed in the body?
Through the skin
Via the GI tract
Through inhalation
Via intravenous injection
What is the half-life of flucytosine in patients with normal kidney function?
10–15 hours
2–5 hours
20–25 hours
30–35 hours
For what purpose is flucytosine used in combination with amphotericin B?
To treat bacterial infections
For systemic fungal infections
To reduce inflammation
For viral infections
What is a necessary precaution when using the medication in children?
Use with acetaminophen
Use with ibuprofen
Use with amphotericin B or another antifungal
Use with aspirin
What is the medication metabolized to, which may cause adverse effects during pregnancy?
Paracetamol
Fluorouracil
Ibuprofen
Aspirin
What is the black box warning associated with this medication?
Use with extreme caution in liver impairment
Use with extreme caution in kidney impairment
Use with extreme caution in heart disease
Use with extreme caution in diabetes
What is the recommended dosage adjustment for patients with a creatinine clearance of 10–20 mL/min?
Dose every 6 hours
Dose every 12 hours
Dose every 24 hours
Dose every 48 hours
Which adverse effect is related to higher doses and occurs after 10 to 26 days of therapy?
Nausea
Bone Marrow Depression
Rash
Photosensitivity
What is the effect of food on the absorption of flucytosine?
Increases the extent of absorption
Decreases the rate of absorption
Increases the rate of absorption
Decreases the extent of absorption
Which medication is known to increase serum levels of flucytosine?
Fluconazole
Amphotericin B
Penicillin
Ciprofloxacin
What should be monitored to detect bone marrow depression when administering flucytosine?
Blood pressure
Heart rate
Leukocyte, differential, and platelet counts
Liver enzymes
What is the recommended oral dose of flucytosine for cryptococcal meningoencephalitis?
25 mg/kg every 4 hours
25 mg/kg every 6 hours
50 mg/kg every 6 hours
50 mg/kg every 4 hours
What should patients report when taking flucytosine?
Increased appetite
Unusual bleeding such as bleeding of the gums or mouth
Increased energy levels
Decreased thirst
What is the prototype drug for miscellaneous antifungal agents for superficial mycoses?
Fluconazole
Griseofulvin
Ketoconazole
Itraconazole
How is Griseofulvin absorbed in the body?
Through the skin
Through the GI tract
Through the lungs
Through the bloodstream
What is the serum half-life of Griseofulvin?
1 to 5 hours
5 to 10 hours
9 to 24 hours
24 to 48 hours
What action does Griseofulvin have on cell division?
Enhances cell division
Disrupts metaphase of cell division by binding to keratin
Inhibits DNA synthesis
Promotes cell growth
For which type of infections is Griseofulvin used?
Bacterial infections
Viral infections
Dermatophyte infections of the scalp and nails
Parasitic infections
What is a key consideration for males after Griseofulvin therapy?
Avoid alcohol for 6 months
Avoid fathering children for at least 6 months
Avoid driving for 6 months
Avoid exercise for 6 months
Which of the following is an adverse effect of the medication mentioned in the document?
Increased appetite
Dizziness
Weight gain
Improved vision
What is a contraindication for the use of the medication?
Hypertension
Liver disease
Diabetes
Asthma
How should the medication be administered to reduce gastric upset?
On an empty stomach
With meals
Before bedtime
With a glass of milk
What should be monitored as an adverse effect of the medication?
Increased energy
CNS depression
Enhanced memory
Weight loss
What is the recommended storage condition for the medication?
In the refrigerator
At 15°C to 30°C
In direct sunlight
Below 10°C
Which of the following should be monitored due to the risk of hepatotoxicity when using certain antifungal medications?
Blood pressure
Liver enzymes
Heart rate
Blood sugar levels
What should patients avoid to prevent adverse effects when taking certain antifungal medications?
High-fat foods
Sunlight or extreme artificial light
Alcohol
Dairy products
Which drug can increase the effects of griseofulvin and may cause breakthrough bleeding?
Rifampin
Estrogen
Ibuprofen
Aspirin
What is a common adverse effect of Terbinafine (Lamisil)?
Insomnia
Headache
Weight gain
Hypertension
