Deck 42: Antifungal and Antiviral Drugs

Question 1

Using the available treatment options,select the primary treatment for respiratory syncytial virus-induced severe lower respiratory infections in hospitalized children.

A) Tipranavir (Aptivus)
B) Ribavirin (Virazole)
C) Amantadine (Symmetrel)
D) None of these are correct.

Answer 1

Ribavirin (Virazole)

Question 2

Use the adverse-effects profile of acyclovir (Zovirax) to select the true statement related to its use.

A) Patients taking acyclovir may develop hypotension and congestive heart failure.
B) Patients taking acyclovir may develop unusual adverse effects such as blurred vision or tinnitus.
C) Patients taking acyclovir may develop thrombocytopenia.
D) Patients taking acyclovir may develop leucopenia.

Answer 2

Patients taking acyclovir may develop unusual adverse effects such as blurred vision or tinnitus.

Question 3

Match the viral infection referred to as cytomegalovirus or CMV to the cells in the body that the virus occupies.

A) Eyes and liver
B) Skin and lungs
C) Pharynx and eyes
D) Nasal cavity and pharynx

Answer 3

Pharynx and eyes

Question 4

Explain the effects of the azole drugs on the action of warfarin (Coumadin).

A) The azole drugs completely inhibit the action of warfarin and should therefore not be taken at the same time.
B) The azole drugs prolong the anticoagulant action of warfarin.
C) The azole drugs speed the anticoagulant action of warfarin.
D) None of these are correct.

Question 5

Using the available treatment options,select the primary treatment for Tinea pedis.

A) Terbenafine (Lamisil)
B) Fluconazole (Diflucan)
C) Griseofulvin (Grifulvin V)
D) Ketoconazole (Nizoral)

Question 6

Describe the patient group most commonly diagnosed with esophageal candidiasis.

A) Esophageal candidiasis is most commonly diagnosed in patients with HIV.
B) Esophageal candidiasis is most commonly diagnosed in patients who are receiving treatment with antibiotics.
C) Esophageal candidiasis is most commonly diagnosed in patients using inhaled corticosteroids or those receiving chemotherapy.
D) All of these are correct.

Question 7

Identify the primary adverse effect of oral ketoconazole (Nizoral).

A) Ketoconazole, when used orally, has been associated with ototoxicity.
B) Ketoconazole, when used orally, has been associated with renal toxicity.
C) Ketoconazole, when used orally, has been associated with hepatic toxicity.
D) None of these are correct.

Question 8

Use critical thinking to determine the answer you would give a patient when she asks you if she can take nelfinavir (Viracept) while taking oral contraceptives.

A) Nelfinavir counteracts oral contraceptive action by decreasing the levels of estrogen.
B) Use alternate or additional contraceptives to avoid failure and pregnancy.
C) All of these are correct.

Question 9

Using the available treatment options,select the prophylactic treatment to reduce the severity of influenza A virus in susceptible groups.

A) Tipranavir (Aptivus)
B) Ribavirin (Virazole)
C) Amantadine (Symmetrel)
D) None of these are correct.

Question 10

Describe flucytosine's (Ancobon's) site of action within the cell.

A) Cell wall and nucleus
B) Nucleus and cell body
C) Cell body and cell wall
D) None of these are correct.

Question 11

Match the condition known as Reye's syndrome with the correct cause.

A) Reye's syndrome is a potentially fatal illness characterized by vomiting, an enlarged liver, convulsions, and coma, in children and adolescents; it is linked to the use of antiviral agents in the management of influenza, usually type B, or chickenpox.
B) Reye's syndrome is a potentially fatal illness characterized by vomiting, an enlarged liver, convulsions, and coma, in children and adolescents; it is linked to the use of salicylates in the management of influenza, usually type B, or chickenpox.
C) Reye's syndrome is a potentially fatal illness characterized by vomiting, an enlarged liver, convulsions, and coma, in children and adolescents; it is linked to the use of acetaminophen in the management of influenza, usually type B, or chickenpox.
D) None of these are correct.

Question 12

Match the antiviral agent didanosine (Videx) with the correct mechanism of action.

A) Didanosine inhibits HIV protease.
B) Didanosine inhibits viral fusion.
C) Didanosine inhibits viral DNA replication by interfering with viral reverse transcriptase.
D) None of these are correct.

Question 13

Match pneumonia and the common cold to the type of virus that causes them.

A) Coronavirus
B) Norovirus
C) Rotaviruses
D) Rhinoviruses

Question 14

Explain what is meant by the statement "Griseofulvin is contraindicated in patients with acute intermittent porphyria."

A) Porphyria is a disease associated with insufficient liver production of delta aminolevulonic acid needed to metabolize the drug in the liver and characterized by intermittent hypertension, abdominal cramps, and psychosis which can be impacted by the fact that griseofulvin is extensively metabolized in the liver.
B) Porphyria is a disease associated with interference of the normal kidney function and characterized by intermittent hypertension and abdominal cramps, which can be impacted by the fact that griseofulvin is excreted mostly unchanged in the urine.
C) Porphyria is a disease associated with excessive liver production of delta aminolevulonic acid and characterized by intermittent hypertension, abdominal cramps, and psychosis which can be impacted by the fact that griseofulvin is extensively metabolized in the liver.
D) None of these are correct.

Question 15

Identify the primary reason why griseofulvin is an effective treatment option for dermatophytic infections.

A) Griseofulvin changes the cell-wall synthesis of the fungus.
B) Griseofulvin binds to the keratin protein that the dermatophyte needs for survival.
C) Griseofulvin incorporates itself into the fungal DNA
D) All of these are correct.

Question 16

Explain what is meant by the statement "Flucytosine is an antimetabolite of 5-fluorouracil."

A) An antimetabolite is a drug that is different in chemical structure to the natural chemicals in a normal biochemical reaction that inhibits the normal division of the cells from occurring.
B) An antimetabolite is a drug that is very similar to natural chemicals in a normal biochemical reaction in cells but different enough to interfere with the normal division and functions of cells.
C) An antimetabolite is a drug that is different in chemical structure to the natural chemicals in a normal biochemical reaction that inhibits the normal function of the cells from occurring.
D) None of these are correct.

Question 17

Identify the principal area where a fungus is encountered that requires drug intervention.

A) Systemic infection
B) Dermatophytic infection
C) Candida albacans infection
D) All of these are correct.

Question 18

Identify the condition in which there is an abnormal decrease in the number of circulating platelets.

A) Neutropenia
B) Thrombocytopenia
C) Leukopenia
D) None of these are correct.

Question 19

Using the drug interactions and adverse-effects profile of the antifungal agents,give a patient auxiliary instructions for the use of these agents while on treatment for athlete's foot.

A) The cleansed feet should be covered with clean, natural-fiber fabric that allows air and moisture to move away from the skin-preferably white or light-colored cotton socks.
B) Do not wear sneakers or loafers without socks.
C) Change socks more than once a day.
D) All of these are correct.

Question 20

Identify the drug classification of the agents useful in the treatment of systemic mycotic infections and candidiasis.

A) Bacteriocidal
B) Fungistatic
C) Fungicidal
D) Bacteriostatic

Question 21

Differentiate between Herpes simplex type 1 and Herpes zoster,and select the true statement related to their similarities or differences.

A) Herpes zoster is responsible for producing innocuous, though unpleasant, skin lesions known as fever blisters or cold sores. Herpes simplex type 1 causes inflammation of nerve roots, resulting in a severe, painful, blistering rash.
B) Like Herpes simplex, the Herpes zoster virus persists for years in the anterior horn cells before it is reactivated.
C) The reactivation of the Herpes simplex and Herpes zoster viruses is referred to as antigenic shifting.
D) None of these are correct.

Question 22

Differentiate between the available treatments for the influenza virus,and select the false statement related to their mechanism of action or dosing schedule.

A) Amantadine (Symmetrel) is taken as a single 200-mg daily dose or 100 mg BID for at least 10 days, and Rimantadine (Flumadine) is taken as 100 mg BID for 7 days.
B) Amantadine (Symmetrel) works by inhibiting the release of viral DNA into the host cell. Rimantadine (Flumadine) inhibits early viral replication by uncoating the virus.
C) Rimantadine (Flumadine) works by inhibiting the release of viral DNA into the host cell. Amantadine (Symmetrel) inhibits early viral replication by uncoating the virus.
D) None of these are false.

Question 23

Select the statement that best explains the reason why it has not been possible to develop a vaccine for HIV.

A) In many cases, as with human immunodeficiency virus (HIV), it has not been possible to develop a vaccine. HIV rapidly replicates and undergoes mutations so frequently that even small changes in its proteins make the virus unrecognizable to host immune cells.
B) The identification of the metabolic process and subtypes of the human immunodeficiency virus are not yet fully understood, so there has not been enough time to create a vaccine that would protect against all of the subtypes of HIV.
C) The macrophages, dendritic cells, and T and B cells interact with the protein components of HIV, and therefore no vaccine can be developed until a solution to the interaction between the cells of the body and the protein components is found.
D) None of these are correct.

Question 24

Select the true statement about the properties of fluconazole (Diflucan) that makes it a good choice in the treatment of cryptococcal and coccidioidal meningitis.

A) Fluconazole is a water-soluble drug absorbed almost completely after an oral dose. It has high penetration into CSF and has been especially useful in treating cryptococcal and coccidioidal meningitis.
B) Fluconazole has very few adverse effects and, as a result, can be taken for 3 to 4 months to ensure penetration of the CSF.
C) Fluconazole is a water-soluble drug absorbed almost completely after an oral dose. It has high penetration into CSF and has no effect on the central nervous system.
D) All of these are correct.

Question 25

Select the statement containing the method by which the activity of a virus may be interrupted.

A) Viral activity could be interrupted by inhibiting the initial attachment of the virus to the human host cells.
B) Viral activity could be interrupted by inhibiting the injection of viral contents into the host cell or inhibiting the enzymes that transcribe or synthesize viral proteins.
C) Viral activity could be interrupted by inhibiting the virus from shedding into the circulation.
D) All of these are correct.

Question 26

Differentiate between hair/scalp infections and fingernail/toenail infections,and select the true statement related to their treatment with griseofulvin.

A) Griseofulvin is usually taken for 3 to 4 months for hair and scalp infections.
B) Griseofulvin is usually taken for 4 to 6 weeks for fingernail infections.
C) The duration of therapy coincides with the pattern of hair or nail growth to incorporate griseofulvin into the keratin.
D) Griseofulvin is usually taken for at least 6 months for hair and scalp infections.

Question 27

Select the statement that describes the major site where antiviral action is blocked by the protease inhibitors.

A) The protease inhibitors block the ability of the human immunodeficiency virus from attaching and entering the cell membrane.
B) The protease inhibitors block the uncoating process of the human immunodeficiency virus by binding to protease.
C) The protease inhibitors block the nucleic acid synthesis of the human
D) immunodeficiency virus.
E) The protease inhibitors inhibit the late protein synthesis and processing of the human immunodeficiency virus.

Question 28

Select the statement that describes the major site where antiviral action is blocked by NNRTIs.

A) NNRTIs block the ability of the human immunodeficiency virus to attach and enter the cell membrane.
B) NNRTIs block the uncoating process of the human immunodeficiency virus by binding to reverse transcriptase.
C) NNRTIs block the nucleic acid synthesis of the human immunodeficiency virus.
D) NNRTIs block the late protein synthesis and processing of the human immunodeficiency virus by binding the reverse transcriptase.

Question 29

Select the statement containing the correct mechanism of action of amphotericin B.

A)Amphotericin B binds to ergosterol within the cell wall,forming pores that leak electrolytes,especially potassium.
B)Amphotericin B inhibits glucan synthase,which makes an essential polysaccharide sugar (glucan) substance.
C)Amphotericin B causes essential nutrients and inorganic substances to leak out of the cell,causing cell destruction.
D)Amphotericin B inhibits the P450-dependent enzymes midway in the process of the fungal respiration chain.

Question 30

Select the statement containing the correct mechanism of action of the ophthalmic treatment for Herpes simplex keratitis,idoxuridine (Dendrid,Herplex).

A) Idoxuridine (Dendrid, Herplex) inhibits viral DNA synthesis by blocking incorporation of the protein thymidine.
B) Idoxuridine (Dendrid, Herplex) inhibits viral DNA synthesis by inhibiting viral replication.
C) Idoxuridine (Dendrid, Herplex) inhibits viral DNA synthesis by inhibiting viral DNA synthesis and the replacement of the protein guanosine.
D) None of these are correct.

Question 31

Select the statement that best explains the advantages of nystatin (Mycostatin,Nilstat) remaining unmetabolized in the intestinal tract and being excreted into the feces.

A) Nystatin exhibits little or no absorption following oral administration and, as a result, little adverse effects.
B) Nystatin remains unmetabolized in the intestine, which makes it a good choice in the treatment of intestinal candidiasis.
C) Nystatin remains unmetabolized in the intestine, which makes it a good choice for the treatment of pregnant women because the drug cannot affect developing fetal tissues.
D) All of these are correct.

Question 32

Select the statement that best explains the activity of the retrovirus HIV.

A) The viral DNA creates RNA replicas of itself that eventually leave the lymphocytes after coating themselves with a protein.
B) HIV reverses the normal host cell process and reproduces by transcribing itself into the DNA of the host cell.
C) The target cells for HIV are macrophages and helper T cells. After transcription has taken place, the viral DNA gains access to lymphocyte DNA, reproducing along with the cell and its offspring.
D) All of these are correct

Question 33

Explain why taking griseofulvin on an empty stomach versus with a meal can or cannot alter the absorption of the drug.

A) The presence of food does not alter the rate of absorption of griseofulvin because the drug is not affected by the presence of fat.
B) The presence of food increases the absorption of griseofulvin. This is directly related to the fat content of the meal, as griseofulvin is fat rather than water soluble.
C) The presence of food decreases the rate of the absorption of griseofulvin. This is directly related to the carbohydrate content of the meal, as griseofulvin binds to the carbohydrate molecule.
D) None of these are correct.

Question 34

Select the true statement related to HIV and the immune process.

A) HIV attacks the heart of the cell-mediated immune system (lymphocytes) so that the human host is progressively immunosuppressed and cannot fight disease.
B) Patients become susceptible to multiple infections such as candidiasis, pneumonia, tuberculosis, and toxoplasmosis.
C) Deterioration of cell-mediated immunity permits patients to develop secondary cancers, such as Kaposi's sarcoma, non-Hodgkin's lymphoma, or primary lymphoma of the brain.
D) All of these are correct.

Question 35

Differentiate between primary and secondary microorganism resistance,and select the true statement related to this issue of resistance.

A) Primary resistance occurs when the organism does not respond to the drug because it doesn't recognize the drug or it has a protective mechanism to destroy the drug on contact. Secondary resistance occurs when the organism initially responds to the drug but then stops responding or requires greater doses to kill the organism.
B) Primary resistance occurs when the organism initially responds to the drug but then stops responding or requires greater doses to kill the organism. Secondary resistance occurs when the organism does not respond to the drug because it doesn't recognize the drug or it has a protective mechanism to destroy the drug on contact.
C) Using multiple drugs in combination at the same time speeds the development of resistance to a single drug primarily because of their antagonistic effect on each other.
D) None of these are correct.

Question 36

Select the statement that describes the physical requirements that must be present for a diagnosis of AIDS to be made.

A) AIDS is diagnosed as a result of a profound depletion of regulatory cells to less than 200 to 500 cells/mm³.
B) AIDS is diagnosed as a result of a profound depletion of memory cells to 200 to 500 cells/mm³.
C) AIDS is diagnosed as a result of a profound depletion of T-lymphocytes to less than 200 to 500 cells/mm³.
D) None of these are correct.

Question 37

Differentiate between antigenic drift and antigenic shift,and select the true statement.

A) Small changes in viral surface proteins are known as an antigenic drift and result in decreased vaccine effectiveness. When the virus undergoes a major change in its surface proteins such as hemagglutinin and neuraminidase, this is considered an antigenic shift.
B) Small changes in viral surface proteins are known as an antigenic shift and result in decreased vaccine effectiveness. When the virus undergoes a major change in its surface proteins such as hemagglutinin and neuraminidase, this is considered an antigenic drift.
C) Antigenic drift can prevent the antibody from recognizing the organism if exposure reoccurs.
D) None of these are correct.

Question 38

Select the reason why terbinafine (Lamisil) is contraindicated for patients taking tricyclic antidepressants,SSRIs,beta-blockers,and antiarrhythmics.

A) Terbinafine (Lamisil) is an ergosterol biosynthetic inhibitor that is metabolized by the cytochrome P450 enzymes before being excreted in the urine. It is contraindicated in patients taking tricyclic antidepressants, SSRIs, beta-blockers, and antiarrhythmics because these drugs are metabolized through the ergosterol enzyme system, which is inhibited by terbinafine, thereby decreasing the effectiveness of these drug agents.
B) Terbinafine (Lamisil) is an ergosterol biosynthetic inhibitor that is metabolized by the cytochrome P450 enzymes before being excreted in the urine. It is contraindicated in patients taking tricyclic antidepressants, SSRIs, beta-blockers, and antiarrhythmics because these drugs are metabolized through the cytochrome P450 enzyme system and the effectiveness of these drug agents would be affected.
C) Terbinafine (Lamisil) is an ergosterol biosynthetic inhibitor that is metabolized by the cytochrome P450 enzymes before being excreted in the urine. It is contraindicated in patients taking tricyclic antidepressants, SSRIs, beta-blockers, and antiarrhythmics because these drugs increase the rate of metabolism of the terbinafine, thereby decreasing terbinafine's effectiveness.
D) None of these are correct.