NR566 Exam Study Guide - Midterm Exam
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NR566 – Advanced Pharmacology for Care of the Family
Exam Study Guide – Midterm Exam
Exam Format: Non-Cumulative exam
Question Type: Multiple Choice
Number of Questions: 100
Time Allotted: 120 minutes (1.2 minutes per question)
Testing Timeframe: The midterm exam will be available starting on Wednesday wee
at 12:01 am MT until Saturday week #4 at 11:59 pm MT.
1. Exam Coverage
Content Areas:
• Week 1: Pharmacotherapy for Fungal and Viral Infections
• Week 2: Pharmacotherapy for Bacterial Infections
• Week 3: Pharmacotherapy for Gender Related Health
• Week 4: Pharmacotherapy for Urinary Conditions
2. Key Concepts to Study
Week 1
Chapter 81
Amphotericin
• Pharmacokinetics of Amphotericin B- for systemic mycoses. Severely toxic. Onl
use for infection that are progressive and potentially fatal. Poorly absorbed from the GI
tract so must be administered IV. Doesn’t penetrate to CSF
• Amphotericin B: Minimizing Nephrotoxicity- only use in setting of potentially life-
threatening infections. If >4G dose then permanent renal damage is likely. Infuse 1L o
saline on the days amphotericin is given and avoid other nephrotoxic drugs. Monitor
kidney function q3-4 days and I&O’s
Treatment Choice for Systemic Mycoses- two groups: opportunistic and non-
opportunistic. May require prolonged treatment= increase risks of toxicity.
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Opportunistic mycoses (candidiasis, aspergillosis, cryptoccosis, and mucormycosis)
caused by organisms that do not typically cause infection in healthy individuals
Non opportunistic (sporotrichosis, blastomycosis, histoplasmosis and
coccidioidomycosis)- can affect anyone (healthy and immunocompromised)
Itraconazole
• Itraconazole Drug Interactions -inhibits CYP3A4 and increases CYP3A3 substrates
Itraconazole is a CYP3A4 substrate, so it may become subtherapeutic when given with
CYP3A4 inducer.
CAUTION: if given with cyclosporine and warfarin- watch prothrombin time
If given with sulfonylureas- watch blood glucose
Drugs that raise pH (H2 antagonist, PPI’s)- decreases absorption of itraconazole
• Azole Use in Older Adults use in caution in patients with liver and renal impairme
Risk hypoglycemia in patients taking sulfonylureas
Capsofungin
• Therapeutic Uses of Caspofungin IV therapy for invasive aspergillosis in patients
unresponsive to or intolerant of traditional agents. For systemic Candida infection and
empiric treatment of neutropenic fever r/t fungal infection
• Adverse Effects of Caspofungin- infusion reaction occur in 30% of patients. Fever,
chills, tachycardia, hypotension, phlebitis
Griseofluvin
• Griseofulvin Indications- for superficial dermatophytic infections of the skin and
nails that doesn’t respond to topical therapy. For Tinea barbae (beard), Tinea capitis
(scalp), tinea corporis (body), tinea cruris (groin) and onychomycosis (nail infection.
NOT useful against candida or systemic mycoses
Terbinafine
• Oral Terbinafine Indications treat systemic onychomycosis- fungal infection of
toenails and fingernails caused by tinea unguium. Off label use for garden hose disease
(sporotrichosis)
• Tinea Pedis Treatment- Topical terbinafine, ciclopirox- wear absorbent cotton
socks, change shoes often, dry feet after bathing
, lOMoARcPSD|70468202
NR566 – Advanced Pharmacology for Care of the Family
Exam Study Guide – Midterm Exam
Exam Format: Non-Cumulative exam
Question Type: Multiple Choice
Number of Questions: 100
Time Allotted: 120 minutes (1.2 minutes per question)
Testing Timeframe: The midterm exam will be available starting on Wednesday wee
at 12:01 am MT until Saturday week #4 at 11:59 pm MT.
1. Exam Coverage
Content Areas:
• Week 1: Pharmacotherapy for Fungal and Viral Infections
• Week 2: Pharmacotherapy for Bacterial Infections
• Week 3: Pharmacotherapy for Gender Related Health
• Week 4: Pharmacotherapy for Urinary Conditions
2. Key Concepts to Study
Week 1
Chapter 81
Amphotericin
• Pharmacokinetics of Amphotericin B- for systemic mycoses. Severely toxic. Onl
use for infection that are progressive and potentially fatal. Poorly absorbed from the GI
tract so must be administered IV. Doesn’t penetrate to CSF
• Amphotericin B: Minimizing Nephrotoxicity- only use in setting of potentially life-
threatening infections. If >4G dose then permanent renal damage is likely. Infuse 1L o
saline on the days amphotericin is given and avoid other nephrotoxic drugs. Monitor
kidney function q3-4 days and I&O’s
Treatment Choice for Systemic Mycoses- two groups: opportunistic and non-
opportunistic. May require prolonged treatment= increase risks of toxicity.
, lOMoARcPSD|70468202
Opportunistic mycoses (candidiasis, aspergillosis, cryptoccosis, and mucormycosis)
caused by organisms that do not typically cause infection in healthy individuals
Non opportunistic (sporotrichosis, blastomycosis, histoplasmosis and
coccidioidomycosis)- can affect anyone (healthy and immunocompromised)
Itraconazole
• Itraconazole Drug Interactions -inhibits CYP3A4 and increases CYP3A3 substrates
Itraconazole is a CYP3A4 substrate, so it may become subtherapeutic when given with
CYP3A4 inducer.
CAUTION: if given with cyclosporine and warfarin- watch prothrombin time
If given with sulfonylureas- watch blood glucose
Drugs that raise pH (H2 antagonist, PPI’s)- decreases absorption of itraconazole
• Azole Use in Older Adults use in caution in patients with liver and renal impairme
Risk hypoglycemia in patients taking sulfonylureas
Capsofungin
• Therapeutic Uses of Caspofungin IV therapy for invasive aspergillosis in patients
unresponsive to or intolerant of traditional agents. For systemic Candida infection and
empiric treatment of neutropenic fever r/t fungal infection
• Adverse Effects of Caspofungin- infusion reaction occur in 30% of patients. Fever,
chills, tachycardia, hypotension, phlebitis
Griseofluvin
• Griseofulvin Indications- for superficial dermatophytic infections of the skin and
nails that doesn’t respond to topical therapy. For Tinea barbae (beard), Tinea capitis
(scalp), tinea corporis (body), tinea cruris (groin) and onychomycosis (nail infection.
NOT useful against candida or systemic mycoses
Terbinafine
• Oral Terbinafine Indications treat systemic onychomycosis- fungal infection of
toenails and fingernails caused by tinea unguium. Off label use for garden hose disease
(sporotrichosis)
• Tinea Pedis Treatment- Topical terbinafine, ciclopirox- wear absorbent cotton
socks, change shoes often, dry feet after bathing
