Question 1

A patient with open-angle glaucoma has a history of chronic obstructive pulmonary disease. Which ophthalmic $\beta$blocker will the provider prescribe?

Accepted Answer

Betaxolol is a selective β1-adrenergic receptor blocker, which is preferred in patients with respiratory risks like COPD, as it has less likelihood of causing bronchoconstriction compared to non-selective β-blockers like Timolol, Levobunolol, and Metipranolol.

Question 2

Amoxicillin is prescribed for a 12-month-old child who developed a second middle ear infection since age 8 months. Three days later, the parent calls to report that the child continues to have a temperature of 39.5 $\degree$C and is unable to sleep well because of pain. What action will the provider take to provide effective care to this child?

Accepted Answer

Given the child's lack of response to amoxicillin alone, escalating the treatment to include amoxicillin/clavulanate is a common next step to address possible resistant bacteria causing the ear infection.

Question 3

A patient who was prescribed cromolyn ophthalmic drops for severe allergic conjunctivitis reports persistence of allergic symptoms after 2 days of treatment. What additional drug will the provider consider prescribing while waiting for cromolyn to reach maximal effectiveness?

Accepted Answer

H1-receptor antagonists can provide rapid relief of allergic symptoms and can be used in conjunction with cromolyn, which takes longer to achieve its full effect.

Question 4

A patient has been diagnosed with fungal otitis externa (otomycosis). What will the provider prescribe initially?

Accepted Answer

Acidifying ear drops are often prescribed initially for fungal otitis externa to create an environment that inhibits fungal growth.

Question 5

A 2-year-old child presents to the clinic with otalgia and fever. The left tympanic membrane (TM) is erythematous and bulging; the right TMs is perforated and draining. The child's parent states, "This is the fifth ear infection this year. What can we do?" What action will the provider take to address the child's ear problems?

Accepted Answer

Given the child's history of multiple ear infections and the current state of the tympanic membranes, prescribing amoxicillin/clavulanate to address the infection and referring the child to an otolaryngologist for further evaluation and potential intervention, such as tympanostomy tube placement, is the most appropriate action.

Question 6

A patient has severe acne that has been refractory to treatment with tetracycline, topical tretinoin, and benzoyl peroxide. The provider plans to begin treatment with isotretinoin. The provider will include which statement when teaching this patient about this drug?

Accepted Answer

D  Tetracycline must be discontinued before starting isotretinoin due to the risk of increased intracranial pressure. Isotretinoin is teratogenic, so two negative pregnancy tests are required before each monthly refill to prevent pregnancy.

Question 7

An adolescent patient with moderate acne has begun a regimen consisting of combination clindamycin/benzoyl peroxide and tretinoin. Which statement by the patient indicates understanding of this medication regimen?

Accepted Answer

Tretinoin (Retin-A) increases the skin's sensitivity to sunlight, making it crucial for patients to use sunscreen daily to protect their skin from sunburn and damage.

Question 8

A 60-year-old patient asks about using tretinoin to minimize wrinkles. What response will the provider give?

Accepted Answer

Tretinoin is effective for fine wrinkles and skin texture but not for coarse wrinkles or significant sun damage.

Question 9

An 18-month-old child with a 24-hour history of fever and otalgia is seen in the clinic. The child's parents tell the provider that the child was inconsolable during the night. The provider examines the child and notes a bulging, immobile, erythematous tympanic membrane. What action will the provider take to provide the child with effective care?

Accepted Answer

The child's symptoms of fever, otalgia, and a bulging, immobile, erythematous tympanic membrane are indicative of acute otitis media (AOM). In children under 2 years of age with bilateral or unilateral AOM and severe symptoms, immediate antibiotic therapy is recommended. Amoxicillin is the first-line treatment for AOM, dosed at 45 mg/kg/dose twice daily.

Question 10

A patient with glaucoma will begin using brimonidine for long-term reduction of increased ocular pressure. The medication education provided by the prescriber appears to have been effective when the patient makes which statement?

Accepted Answer

Brimonidine can be absorbed systemically and cause drowsiness. It is important to wait 15 minutes before inserting contact lenses to ensure proper absorption and avoid contamination.

Question 11

An adolescent has recently developed scattered comedones across the forehead and nose. Which medication does the provider recommend to the patient and parents?

Accepted Answer

The answer of An adolescent has recently developed scattered comedones...

Question 12

To provide effective protection against the full range of ultraviolet (UV) radiation, an organic sunscreen must contain which agent?

Accepted Answer

Avobenzone is known for its ability to absorb the full spectrum of UVA rays, providing comprehensive protection against UV radiation when included in sunscreen formulations.

Question 13

A 6-year-old child presents with crying due to ear pain. Tympanic membranes are erythematous, bulging, and immobile, but intact. In addition to antibiotic therapy, what will the provider recommend for pain management?

Accepted Answer

Lidocaine ear drops can be used for pain management in cases of acute otitis media where the tympanic membrane is intact, providing local analgesia without the systemic side effects associated with oral medications.

Question 14

A patient will begin initial treatment for severe acne. Which regimen will the provider order?

Accepted Answer

For severe acne, a combination of oral antibiotics (such as doxycycline) and topical retinoids (such as tretinoin) is a common and effective treatment regimen. This approach targets acne-causing bacteria and promotes skin cell turnover to prevent clogged pores.

Question 15

An adolescent with acne who uses benzoyl peroxide lotion twice daily reports experiencing drying and burning of the skin. What action will the prescriber take?

Accepted Answer

Reducing the frequency of benzoyl peroxide application to once a day can help minimize skin irritation such as drying and burning without stopping the acne treatment.

Question 16

A provider prescribes the keratolytic agent salicylic acid for a patient with extensive acne on the face, shoulders, trunk, and back. What drug information does the providers give to the patient?

Accepted Answer

The answer of A provider prescribes the keratolytic agent salicylic...

Question 17

A 14-year-old female patient has moderate acne that has not responded to topical drugs. Which treatment will the provider discuss with the patient and parents?

Accepted Answer

Doxycycline is an oral antibiotic commonly used for moderate acne that has not responded to topical treatments. It helps reduce inflammation and bacterial growth.

Question 18

A provider considers prescribing timolol for a patient with primary open-angle glaucoma. Which condition could be worsened if this drug is prescribed?

Accepted Answer

Timolol is a non-selective beta-blocker that can exacerbate respiratory conditions like asthma by causing bronchoconstriction.

Question 19

A patient who uses latanoprost ophthalmic drops tells the provider, "My eyes used to be greenish-brown, but now they're brown." What response will the provider give to address the patient's concern?

Accepted Answer

Latanoprost, a prostaglandin analogue used in the treatment of glaucoma, can cause increased pigmentation of the iris, leading to a permanent change in eye color, particularly in patients with mixed-color irises. This side effect is considered harmless, and patients should be reassured about its benign nature.

Question 20

A child with eczema has been treated unsuccessfully with a topical glucocorticoid for a year and now has skin atrophy and hypopigmentation. What change in therapy will the provider recommend to the parents?

Accepted Answer

Topical immunosuppressants, such as tacrolimus or pimecrolimus, are often recommended when there is a need to avoid the side effects of long-term topical glucocorticoid use, such as skin atrophy and hypopigmentation. These agents work by suppressing the immune response in the skin, thereby reducing inflammation and itching without the adverse effects associated with prolonged steroid use.

Quiz 20: Drugs for Eyes, Ears, and Skin

A patient with open-angle glaucoma has a history of chronic obstructive pulmonary disease. Which ophthalmic $\beta$ blocker will the provider prescribe?

A patient who was prescribed cromolyn ophthalmic drops for severe allergic conjunctivitis reports persistence of allergic symptoms after 2 days of treatment. What additional drug will the provider consider prescribing while waiting for cromolyn to reach maximal effectiveness?

A patient has been diagnosed with fungal otitis externa (otomycosis) . What will the provider prescribe initially?

A patient has severe acne that has been refractory to treatment with tetracycline, topical tretinoin, and benzoyl peroxide. The provider plans to begin treatment with isotretinoin. The provider will include which statement when teaching this patient about this drug?

An adolescent patient with moderate acne has begun a regimen consisting of combination clindamycin/benzoyl peroxide and tretinoin. Which statement by the patient indicates understanding of this medication regimen?

A 60-year-old patient asks about using tretinoin to minimize wrinkles. What response will the provider give?

A patient with glaucoma will begin using brimonidine for long-term reduction of increased ocular pressure. The medication education provided by the prescriber appears to have been effective when the patient makes which statement?

An adolescent has recently developed scattered comedones across the forehead and nose. Which medication does the provider recommend to the patient and parents?

To provide effective protection against the full range of ultraviolet (UV) radiation, an organic sunscreen must contain which agent?

A 6-year-old child presents with crying due to ear pain. Tympanic membranes are erythematous, bulging, and immobile, but intact. In addition to antibiotic therapy, what will the provider recommend for pain management?

A patient will begin initial treatment for severe acne. Which regimen will the provider order?

An adolescent with acne who uses benzoyl peroxide lotion twice daily reports experiencing drying and burning of the skin. What action will the prescriber take?

A provider prescribes the keratolytic agent salicylic acid for a patient with extensive acne on the face, shoulders, trunk, and back. What drug information does the providers give to the patient?

A 14-year-old female patient has moderate acne that has not responded to topical drugs. Which treatment will the provider discuss with the patient and parents?

A provider considers prescribing timolol for a patient with primary open-angle glaucoma. Which condition could be worsened if this drug is prescribed?

A patient who uses latanoprost ophthalmic drops tells the provider, "My eyes used to be greenish-brown, but now they're brown." What response will the provider give to address the patient's concern?

A child with eczema has been treated unsuccessfully with a topical glucocorticoid for a year and now has skin atrophy and hypopigmentation. What change in therapy will the provider recommend to the parents?

Quiz 20: Drugs for Eyes, Ears, and Skin

A patient with open-angle glaucoma has a history of chronic obstructive pulmonary disease. Which ophthalmic β\betaβ blocker will the provider prescribe?

A patient who was prescribed cromolyn ophthalmic drops for severe allergic conjunctivitis reports persistence of allergic symptoms after 2 days of treatment. What additional drug will the provider consider prescribing while waiting for cromolyn to reach maximal effectiveness?

A patient has been diagnosed with fungal otitis externa (otomycosis) . What will the provider prescribe initially?

A patient has severe acne that has been refractory to treatment with tetracycline, topical tretinoin, and benzoyl peroxide. The provider plans to begin treatment with isotretinoin. The provider will include which statement when teaching this patient about this drug?

An adolescent patient with moderate acne has begun a regimen consisting of combination clindamycin/benzoyl peroxide and tretinoin. Which statement by the patient indicates understanding of this medication regimen?

A 60-year-old patient asks about using tretinoin to minimize wrinkles. What response will the provider give?

A patient with glaucoma will begin using brimonidine for long-term reduction of increased ocular pressure. The medication education provided by the prescriber appears to have been effective when the patient makes which statement?

An adolescent has recently developed scattered comedones across the forehead and nose. Which medication does the provider recommend to the patient and parents?

To provide effective protection against the full range of ultraviolet (UV) radiation, an organic sunscreen must contain which agent?

A 6-year-old child presents with crying due to ear pain. Tympanic membranes are erythematous, bulging, and immobile, but intact. In addition to antibiotic therapy, what will the provider recommend for pain management?

A patient will begin initial treatment for severe acne. Which regimen will the provider order?

An adolescent with acne who uses benzoyl peroxide lotion twice daily reports experiencing drying and burning of the skin. What action will the prescriber take?

A provider prescribes the keratolytic agent salicylic acid for a patient with extensive acne on the face, shoulders, trunk, and back. What drug information does the providers give to the patient?

A 14-year-old female patient has moderate acne that has not responded to topical drugs. Which treatment will the provider discuss with the patient and parents?

A provider considers prescribing timolol for a patient with primary open-angle glaucoma. Which condition could be worsened if this drug is prescribed?

A patient who uses latanoprost ophthalmic drops tells the provider, "My eyes used to be greenish-brown, but now they're brown." What response will the provider give to address the patient's concern?

A child with eczema has been treated unsuccessfully with a topical glucocorticoid for a year and now has skin atrophy and hypopigmentation. What change in therapy will the provider recommend to the parents?

A patient with open-angle glaucoma has a history of chronic obstructive pulmonary disease. Which ophthalmic $\beta$ blocker will the provider prescribe?