Which azole antifungal requires an acidic environment for absorption?

Ketoconazole

DS has just received a prescription for baloxavir marboxil (Xofluza). He has been feeling incredibly weak from the flu for the past 24 hours. DS has asthma and has been wheezing since he became ill. How many days will the patient need to take this medication?

1 day

Baloxavir marboxil (Xofluza) is a one-time dose for influenza that is given within 48 hours of symptom onset.

Which of the following medications require patient counseling for risk of photosensitivity?

Vfend

Which dosing instructions for the use of OTC docosanol are correct?

Apply five times daily at the first sign of an outbreak

Which of the following is a boxed warning for ketoconazole?

Severe hepatotoxicity

GP is receiving amphotericin B deoxycholate for the treatment of mucormycosis. Which of the following side effects are most likely to occur with treatment?

Hypomagnesemia, hypokalemia, rigors

LR had a gastric bypass procedure 2 months ago and experienced complications. Since the procedure, she has required parenteral nutrition through a central line. She recently developed a Candida glabrata bloodstream infection and is being treated with micafungin. Which of the statements are correct regarding the use of micafungin in this patient? (Select ALL that apply)

It inhibits the synthesis of the fungal cell wall

It does not require renal dose adjustments

It can cause a histamine-mediated reaction

A patient is being discharged home from the hospital. The patient was getting fluconazole 400 mg IV daily for the treatment of his fungal infection. The physician would like to continue with oral fluconazole therapy. What is the equivalent oral dose?

400 mg

The fluconazole IV to oral ratio is 1:1.

History of Present Illness: IH is a 45-year-old female who was admitted to the hospital 3 days ago with persistent fever, decreased appetite and shortness of breath. Prior to admission, her symptoms had progressively worsened over a 2-3 week period, despite a 5-day course of Levaquin that had been prescribed for presumed pneumonia.

Allergies: NKDA

Past Medical History
Hypertension
Hyperlipidemia
Migraines
Rheumatoid arthritisAdmission Chest X-ray: nodular densities in the right upper and middle lobes, bilateral pleural effusions, concerning for bacterial, viral or fungal infection given history - consider additional diagnostic evaluationDiagnostic Test Results:
CT chest with contrast: pleural thickening, and centrilobular nodules
Pleural fluid culture: Aspergillus niger

Choose the most appropriate treatment for this patient based on the pleural fluid culture.

Vfend

A healthy 23-year-old woman presents to her OBGYN office complaining of a vaginal yeast infection. The patient prefers an oral treatment option. Which of the following is the most appropriate oral treatment of her yeast infection?

One time dose of fluconazole

An 85-year-old man is hospitalized with a fungal infection. He has CKD stage 3 and chronic pain (on methadone). Micafungin 100 mg intravenous is given. During the infusion, the man develops a drop in blood pressure, pruritis and flushing. What is the most likely cause of this reaction?

Micafungin is causing a histamine-release reaction

LT is a 37-year-old female who presented to the ED on 10/2 with fever, fatigue and generalized aches. She receives chronic parenteral nutrition due to a non-healing enterocutaneous fistula. Blood cultures x2 were drawn, and she was admitted to the hospital. Her past medical history is significant for Crohn's disease. She is noted to have a Hickman central catheter at the right chest for TPN administration. The site is red and warm.

Tests:10/2 Blood cultures x2 reveal C. glabrata.

Question:Which medication is preferred to treat LT's bloodstream infection?

Caspofungin

Which of the following is the mechanism of action of Diflucan?

It decreases ergosterol synthesis and cell membrane formation

History of Present Illness: TP is a 52-year-old African American female who was admitted to the hospital 5 days ago for resection of an abdominal mass.

Allergies: Accupril (cough), cefepime (anaphylaxis)

Past Medical History:
Hypertension
Kidney transplant (cadaveric donor) 6 years agoPain: 6/10 around the abdominal incisionGeneral: patient in mild distress, has had a decreased appetite and decreased PO intake in the past 48 hoursAbdominal: decreased bowel sounds, erythema and swelling around the surgical incision site

Assessment/Plan: possible complicated skin and soft tissue infection. CT abdomen to evaluate for abscess, paralytic bowel and/or other abdominal complications.

A culture of an abdominal abscess drainage identifies the presence of bacteria and C. albicans. Which medication will treat the fungal infection and will have the lowest risk of drug interactions with TP's other medications?

Cancidas

Chief Complaint: “I feel weak and exhausted"
History of Present Illness: TN is 67-year-old Vietnamese female. She states that she is very weak, but cannot really elaborate on how her symptoms are different than normal. Her daily activities have declined over the past two months and she is sleeping most of the day. She describes a tingling sensation over the "rash on her back" for the last 48 hours.
Allergies: ibuprofen and morphine "make her vomit"

Based on the subjective and objective information presented, which diagnosis is most likely?

Herpes zoster

DE is a 61-year-old male who is experiencing a blistery rash that wraps around the right side of his torso. He reports that the rash is tingling with shooting pain. The appearance of the rash is consistent with herpes zoster. Which medication is appropriate to treat this condition?

Valtrex

Antiviral agents active against cytomegalovirus (CMV) include which of the following:

valganciclovir, foscarnet and cidofovir

A 32-year-old female who is receiving chemotherapy for acute leukemia is diagnosed with mucormycosis via tissue culture and will begin therapy with IV isavuconazonium. The nurse contacts the pharmacist asking what he needs to know, as he has never administered the drug before. Which of the following is an important point regarding this medication?

This medication requires a filter for administration

The pharmacist is on rounds with the internal medicine team. They are discussing a patient who has oral candidiasis due to a recent chemotherapy treatment. The infection is very painful for the patient and is considered moderate to severe. Which of the following is the best regimen to recommend for this patient?

Fluconazole 200 mg IV daily

A 32-year-old critically-ill patient with diabetes is admitted to the intensive care unit with respiratory compromise and acute kidney injury. She is diagnosed with pulmonary Aspergillosis. Which of the following antifungal agents would be most appropriate to initiate?

Vfend

A 59-year-old male is admitted to the hospital with a CrCl of 35 mL/min and a fungal infection. Which of the following antifungal medications would require a dose adjustment?

Fluconazole

Which of the following is a first-line treatment for dermatophytes that cause nail bed infections? (Select ALL that apply.)

Itraconazole, terbinafine

Which of the following is the most appropriate administration of nystatin for the treatment of oral candidiasis?

Swish the suspension in the mouth and swallow

What is a 79-year-old woman receiving intravenous acyclovir most at risk for?

Kidney damage

Choose the correct mechanism of action for oseltamivir:

Inhibits neuraminidase

SF was prescribed a Symbicort inhaler for her asthma. One month later, SF reports developing a white film on her tongue and throat. When asked, she stated that she isn't always able to rinse her mouth after each dose. Which of the following is the most appropriate treatment for SF?

Clotrimazole lozenges

Due to the risk of life-threatening arrhythmias, coadministration of dofetilide is contraindicated with which medication?

Itraconazole

Which of the following counseling points are correct for Vfend? (Select ALL that apply.)

It can cause visual changes; care is advised when driving and driving at night should be avoided

It can damage the liver and liver function tests may need to be monitored

It is associated with many drug interactions

RS is a 23-year-old male with poorly controlled asthma. He is currently presenting to the ED with a sudden onset of headache, dry cough and fever (temperature 101.9 degrees F). His symptoms started 24 hours ago. A rapid test reveals influenza B. Which antiviral agent would be most useful to initiate?

Oseltamivir

Which of the following is the most appropriate treatment for postherpetic neuralgia?

Lidoderm patch

Which of the following medications is contraindicated in a patient with heart failure?

Itraconazole

All of the following statements regarding amphotericin B are correct EXCEPT:

Lipid formulations have a greater risk for nephrotoxicity than conventional formulations