NR 566 ADVANCED PHARMACOLOGY
CARE OF THE FAMILY MIDTERM EXAM
REVIEW| QUESTIONS AND VERIFIED
ANSWERS
Antifungals
Antifungals in immunocompromised
Answer: Fluconazole, Ketoconazole, Posaconazole.
Explanation: Azoles are effective and orally available.
Systemic fungal infections
Answer: Amphotericin B & azoles.
Explanation: Amphotericin B for severe cases; azoles for maintenance.
Amphotericin B
Answer: Broad‑spectrum, highly toxic, IV only, 6–8 weeks.
Explanation: Reserved for life‑threatening infections.
Azoles
Answer: Broad‑spectrum, CYP450 inhibition, PO/IV, hepatotoxicity risk.
Explanation: Monitor liver enzymes and pregnancy status.
Ketoconazole + Omeprazole
Answer: Ketoconazole reduces omeprazole effect.
Explanation: Acidic environment needed for absorption.
,Parasitic Infections
Enterobius vermicularis
Answer: Pinworm, common in children.
Explanation: Causes nocturnal perianal itching.
Viral Infections
HIV patient with HSV resistant to acyclovir
Answer: IV foscarnet every 8 hours for 2–3 weeks.
Explanation: Effective against acyclovir‑resistant HSV.
Antibiotics
Empiric therapy before culture
Answer: Broad spectrum.
Explanation: Covers multiple pathogens until culture results.
Additional Pharmacology Topics
Tetracyclines
Answer: Avoid in children <8 and pregnancy.
Explanation: Causes teeth discoloration and bone effects.
Macrolides
Answer: Azithromycin, clarithromycin, erythromycin.
Explanation: Used for respiratory infections, pertussis, chlamydia.
Aminoglycosides
Answer: Gentamicin, tobramycin, amikacin.
Explanation: Nephrotoxicity and ototoxicity risk.
Fluoroquinolones
, Answer: Ciprofloxacin, levofloxacin.
Explanation: Black box: tendon rupture, neuropathy.
Sulfonamides
Answer: Trimethoprim‑sulfamethoxazole.
Explanation: Risk of Stevens‑Johnson syndrome, crystalluria.
Penicillin allergy
Answer: Cross‑reactivity with cephalosporins.
Explanation: Use caution in allergic patients.
Cephalosporins
Answer: 1st–5th generations, increasing gram‑negative coverage.
Explanation: Later generations cover resistant organisms.
Carbapenems
Answer: Imipenem, meropenem.
Explanation: Broadest spectrum, reserved for resistant infections.
Vancomycin
Answer: Used for MRSA, C. difficile.
Explanation: Monitor trough levels, nephrotoxicity risk.
Antivirals
Oseltamivir
Answer: Influenza A & B.
Explanation: Best within 48 hours of symptom onset.
Ribavirin
CARE OF THE FAMILY MIDTERM EXAM
REVIEW| QUESTIONS AND VERIFIED
ANSWERS
Antifungals
Antifungals in immunocompromised
Answer: Fluconazole, Ketoconazole, Posaconazole.
Explanation: Azoles are effective and orally available.
Systemic fungal infections
Answer: Amphotericin B & azoles.
Explanation: Amphotericin B for severe cases; azoles for maintenance.
Amphotericin B
Answer: Broad‑spectrum, highly toxic, IV only, 6–8 weeks.
Explanation: Reserved for life‑threatening infections.
Azoles
Answer: Broad‑spectrum, CYP450 inhibition, PO/IV, hepatotoxicity risk.
Explanation: Monitor liver enzymes and pregnancy status.
Ketoconazole + Omeprazole
Answer: Ketoconazole reduces omeprazole effect.
Explanation: Acidic environment needed for absorption.
,Parasitic Infections
Enterobius vermicularis
Answer: Pinworm, common in children.
Explanation: Causes nocturnal perianal itching.
Viral Infections
HIV patient with HSV resistant to acyclovir
Answer: IV foscarnet every 8 hours for 2–3 weeks.
Explanation: Effective against acyclovir‑resistant HSV.
Antibiotics
Empiric therapy before culture
Answer: Broad spectrum.
Explanation: Covers multiple pathogens until culture results.
Additional Pharmacology Topics
Tetracyclines
Answer: Avoid in children <8 and pregnancy.
Explanation: Causes teeth discoloration and bone effects.
Macrolides
Answer: Azithromycin, clarithromycin, erythromycin.
Explanation: Used for respiratory infections, pertussis, chlamydia.
Aminoglycosides
Answer: Gentamicin, tobramycin, amikacin.
Explanation: Nephrotoxicity and ototoxicity risk.
Fluoroquinolones
, Answer: Ciprofloxacin, levofloxacin.
Explanation: Black box: tendon rupture, neuropathy.
Sulfonamides
Answer: Trimethoprim‑sulfamethoxazole.
Explanation: Risk of Stevens‑Johnson syndrome, crystalluria.
Penicillin allergy
Answer: Cross‑reactivity with cephalosporins.
Explanation: Use caution in allergic patients.
Cephalosporins
Answer: 1st–5th generations, increasing gram‑negative coverage.
Explanation: Later generations cover resistant organisms.
Carbapenems
Answer: Imipenem, meropenem.
Explanation: Broadest spectrum, reserved for resistant infections.
Vancomycin
Answer: Used for MRSA, C. difficile.
Explanation: Monitor trough levels, nephrotoxicity risk.
Antivirals
Oseltamivir
Answer: Influenza A & B.
Explanation: Best within 48 hours of symptom onset.
Ribavirin
