You are taking care of a patient with renal failure secondary to anti-fungal therapy. The patient is a 66-year-old male being treated for cryptococcal meningitis. This drug has a variety of known side effects including acute febrile reactions to infusions, anemia, hypokalemia and hypomagnesemia. What is the mechanism of action of this drug?
AInhibition of squalene epoxidase
BBinding of the 50S subunit
CPore formation secondary to ergosterol binding
DDisruption of microtubule formation
EInhibition of 1,3-beta-glucan synthase
A 58-year-old man with a 10-year history of type 2 diabetes mellitus and hypertension comes to the physician for a routine examination. Current medications include metformin and captopril. His pulse is 84/min and blood pressure is 120/75 mm Hg. His hemoglobin A1c concentration is 9.5%. The physician adds repaglinide to his treatment regimen. The mechanism of action of this agent is most similar to that of which of the following drugs?
ALinagliptin
BGlyburide
CPioglitazone
DMiglitol
EMetformin
A 67-year-old man presents to his family physician’s office for a routine visit and to discuss a growth on his toenail that has been gradually enlarging for a month. He has a history of diabetes mellitus, hyperlipidemia, and hypertension and is on metformin, atorvastatin, and lisinopril. He admits to smoking 2 packs of cigarettes daily for the past 45 years. His blood pressure reading today is 132/88 mm Hg, heart rate is 78/min, respiration rate is 12/min and his temperature is 37.1°C (98.8°F). On exam, the patient appears alert and in no apparent distress. Capillary refill is 3 seconds. Diminished dull and sharp sensations are present bilaterally in the lower extremities distal to the mid-tibial region. An image of the patient’s toenail is provided. A potassium hydroxide (KOH) preparation of a nail clipping sample confirms the presence of hyphae. Which of the following treatment options will be most effective for this condition?
AFluconazole
BBetamethasone + vitamin D analog
CGriseofulvin
DTerbinafine
ECephalexin
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