NR566 Advanced
Pharmacology Midterm Exam
Study Guide – Practice
Questions with Answers.
Updated 2025/2026
What are the two categories of systemic mycoses? - Ans✔✔-Opportunistic
infections (primarily in debilitated or immunocompromised hosts) and non-
opportunistic infections (in any host).
What are the classes of systemic antifungal drugs? - Ans✔✔-Polyene antibiotics
(Amphotericin B), Azoles (Itraconazole), Echinocandins (Caspofungin),
Pyrimidine analogs (Flucytosine).
What is the drug of choice for most systemic mycoses? - Ans✔✔-Amphotericin
B.
What alternative antifungal can be used for some infections if amphotericin B is
not suitable? - Ans✔✔-Itraconazole.
What should be used if patients are unresponsive to amphotericin B or
itraconazole? - Ans✔✔-IV caspofungin.
,What is a key pharmacokinetic characteristic of Amphotericin B? - Ans✔✔-
After leaving the vascular system, it undergoes extensive binding to sterol-
containing membranes.
How is Amphotericin B eliminated from the body? - Ans✔✔-Little is known
about its elimination; renal excretion of unchanged amphotericin is minimal.
What is the recommended action for patients with preexisting renal
impairment receiving Amphotericin B? - Ans✔✔-Consider reducing the dose or
frequency.
What is a strategy to minimize nephrotoxicity when administering
Amphotericin B? - Ans✔✔-Infusing 1L of saline on the days amphotericin is
given.
Which drugs should be avoided to reduce nephrotoxicity when using
Amphotericin B? - Ans✔✔-Aminoglycosides, cyclosporine, NSAIDs.
What is a significant risk for older adults using azoles? - Ans✔✔-The risk for
achlorhydria, which makes the absorption of some antifungal agents
unpredictable.
What is the effect of azoles on CYP450 enzymes? - Ans✔✔-They inhibit
CYP450, increasing the levels of many drugs such as warfarin and phenytoin.
,What are the important drug interactions associated with Itraconazole? -
Ans✔✔-Increases levels of cisapride, pimozide, dofetilide, and quinidine,
leading to fatal ventricular dysrhythmias.
What should be monitored when using Itraconazole with warfarin? - Ans✔✔-
Monitor PT (Prothrombin Time).
How should antacids, H2RA, or PPI be administered in relation to Itraconazole?
- Ans✔✔-They should be given at least 1 hour before or 2 hours after
Itraconazole to avoid reducing its absorption.
What is the therapeutic use of Caspofungin? - Ans✔✔-IV therapy for invasive
aspergillosis in patients unresponsive to or intolerant of amphotericin B or
itraconazole, and systemic Candida infections.
What is a notable characteristic of the adverse effects of Caspofungin? -
Ans✔✔-Generally well tolerated.
What is the elimination time for Amphotericin B after discontinuation of
treatment? - Ans✔✔-Complete elimination takes over a year.
What should be monitored in patients receiving Amphotericin B? - Ans✔✔-
Kidney function tests every 3-4 days and I&O (intake and output).
What is the risk associated with a total dose of Amphotericin B greater than
4g? - Ans✔✔-Residual impairment of kidney function is likely.
, What is the primary mechanism of action for Caspofungin? - Ans✔✔-Disrupts
the fungal cell wall.
What types of infections can Caspofungin treat? - Ans✔✔-Candidemia,
Candida-related esophagitis, peritonitis, pleural space infections, and intra-
abdominal abscesses.
What are the most common adverse effects of Caspofungin? - Ans✔✔-Fever
and phlebitis at the injection site.
What less common adverse effects can occur with Caspofungin? - Ans✔✔-
Headache, rash, nausea/vomiting.
What effects of Caspofungin are mediated by histamine release? - Ans✔✔-
Rash, facial flushing, pruritus, sense of warmth.
What is the primary indication for Griseofulvin? - Ans✔✔-Oral treatment of
dermatophytic infections of the skin, hair, and nails.
How long does it typically take for skin infections to respond to Griseofulvin
treatment? - Ans✔✔-3-8 weeks; infections of palms may require 2-3 months,
toenails a year or more.
Is Griseofulvin effective against Candida species or systemic mycoses? -
Ans✔✔-No, it is not active against Candida species or systemic mycoses.
What is the primary use of oral terbinafine? - Ans✔✔-Treatment of ringworm
and onychomycosis (nails).
Pharmacology Midterm Exam
Study Guide – Practice
Questions with Answers.
Updated 2025/2026
What are the two categories of systemic mycoses? - Ans✔✔-Opportunistic
infections (primarily in debilitated or immunocompromised hosts) and non-
opportunistic infections (in any host).
What are the classes of systemic antifungal drugs? - Ans✔✔-Polyene antibiotics
(Amphotericin B), Azoles (Itraconazole), Echinocandins (Caspofungin),
Pyrimidine analogs (Flucytosine).
What is the drug of choice for most systemic mycoses? - Ans✔✔-Amphotericin
B.
What alternative antifungal can be used for some infections if amphotericin B is
not suitable? - Ans✔✔-Itraconazole.
What should be used if patients are unresponsive to amphotericin B or
itraconazole? - Ans✔✔-IV caspofungin.
,What is a key pharmacokinetic characteristic of Amphotericin B? - Ans✔✔-
After leaving the vascular system, it undergoes extensive binding to sterol-
containing membranes.
How is Amphotericin B eliminated from the body? - Ans✔✔-Little is known
about its elimination; renal excretion of unchanged amphotericin is minimal.
What is the recommended action for patients with preexisting renal
impairment receiving Amphotericin B? - Ans✔✔-Consider reducing the dose or
frequency.
What is a strategy to minimize nephrotoxicity when administering
Amphotericin B? - Ans✔✔-Infusing 1L of saline on the days amphotericin is
given.
Which drugs should be avoided to reduce nephrotoxicity when using
Amphotericin B? - Ans✔✔-Aminoglycosides, cyclosporine, NSAIDs.
What is a significant risk for older adults using azoles? - Ans✔✔-The risk for
achlorhydria, which makes the absorption of some antifungal agents
unpredictable.
What is the effect of azoles on CYP450 enzymes? - Ans✔✔-They inhibit
CYP450, increasing the levels of many drugs such as warfarin and phenytoin.
,What are the important drug interactions associated with Itraconazole? -
Ans✔✔-Increases levels of cisapride, pimozide, dofetilide, and quinidine,
leading to fatal ventricular dysrhythmias.
What should be monitored when using Itraconazole with warfarin? - Ans✔✔-
Monitor PT (Prothrombin Time).
How should antacids, H2RA, or PPI be administered in relation to Itraconazole?
- Ans✔✔-They should be given at least 1 hour before or 2 hours after
Itraconazole to avoid reducing its absorption.
What is the therapeutic use of Caspofungin? - Ans✔✔-IV therapy for invasive
aspergillosis in patients unresponsive to or intolerant of amphotericin B or
itraconazole, and systemic Candida infections.
What is a notable characteristic of the adverse effects of Caspofungin? -
Ans✔✔-Generally well tolerated.
What is the elimination time for Amphotericin B after discontinuation of
treatment? - Ans✔✔-Complete elimination takes over a year.
What should be monitored in patients receiving Amphotericin B? - Ans✔✔-
Kidney function tests every 3-4 days and I&O (intake and output).
What is the risk associated with a total dose of Amphotericin B greater than
4g? - Ans✔✔-Residual impairment of kidney function is likely.
, What is the primary mechanism of action for Caspofungin? - Ans✔✔-Disrupts
the fungal cell wall.
What types of infections can Caspofungin treat? - Ans✔✔-Candidemia,
Candida-related esophagitis, peritonitis, pleural space infections, and intra-
abdominal abscesses.
What are the most common adverse effects of Caspofungin? - Ans✔✔-Fever
and phlebitis at the injection site.
What less common adverse effects can occur with Caspofungin? - Ans✔✔-
Headache, rash, nausea/vomiting.
What effects of Caspofungin are mediated by histamine release? - Ans✔✔-
Rash, facial flushing, pruritus, sense of warmth.
What is the primary indication for Griseofulvin? - Ans✔✔-Oral treatment of
dermatophytic infections of the skin, hair, and nails.
How long does it typically take for skin infections to respond to Griseofulvin
treatment? - Ans✔✔-3-8 weeks; infections of palms may require 2-3 months,
toenails a year or more.
Is Griseofulvin effective against Candida species or systemic mycoses? -
Ans✔✔-No, it is not active against Candida species or systemic mycoses.
What is the primary use of oral terbinafine? - Ans✔✔-Treatment of ringworm
and onychomycosis (nails).
