PC PC Pharmacology & Medications 2 — Questions and Answers
Question 1: Which topical medication is FDA-approved for the treatment of onychomycosis and applied directly to the nail?
- Efinaconazole (Jublia) (Correct answer)
- Clotrimazole cream
- Mupirocin ointment
- Ciclopirox cream
Correct answer: Efinaconazole (Jublia)
Efinaconazole solution is FDA-approved as a topical antifungal specifically formulated to penetrate the nail plate for treating onychomycosis.
Question 2: A podiatrist considers prescribing allopurinol. For which condition is this urate-lowering therapy indicated?
- Chronic gout to prevent recurrent attacks (Correct answer)
- Acute gout flare
- Plantar fasciitis
- Peripheral neuropathy
Correct answer: Chronic gout to prevent recurrent attacks
Allopurinol lowers uric acid production and is used for long-term prophylaxis in chronic gout, not for treating acute flares.
Question 3: Which antibiotic class is most appropriate for a diabetic foot infection caused by MRSA?
- Trimethoprim-sulfamethoxazole (TMP-SMX) or vancomycin (Correct answer)
- Amoxicillin-clavulanate
- Metronidazole
- Clindamycin alone
Correct answer: Trimethoprim-sulfamethoxazole (TMP-SMX) or vancomycin
TMP-SMX is effective for mild-moderate community-acquired MRSA infections, while vancomycin is used for serious or hospital-acquired MRSA.
Question 4: What is the mechanism of action of terbinafine, commonly used for fungal nail infections?
- Inhibits squalene epoxidase, disrupting fungal cell membrane synthesis (Correct answer)
- Inhibits ergosterol binding to cell membranes
- Disrupts fungal DNA replication
- Inhibits fungal cell wall glucan synthesis
Correct answer: Inhibits squalene epoxidase, disrupting fungal cell membrane synthesis
Terbinafine inhibits squalene epoxidase, blocking ergosterol synthesis and causing squalene accumulation, which is toxic to fungal cells.
Question 5: A patient on warfarin presents for podiatric surgery. Which pharmacological concern requires pre-operative evaluation?
- Elevated INR increasing bleeding risk (Correct answer)
- Risk of malignant hyperthermia
- Allergy to local anesthetics
- Interaction with topical antifungals
Correct answer: Elevated INR increasing bleeding risk
Warfarin prolongs clotting time, and the INR must be within an acceptable range (typically ≤1.5–2.0) before elective podiatric surgery to minimize bleeding complications.
Question 6: Which medication class is commonly injected by podiatrists directly into a joint or soft tissue for anti-inflammatory relief?
- Corticosteroids (e.g., triamcinolone, methylprednisolone) (Correct answer)
- Aminoglycosides
- Antifungals
- Urate-lowering agents
Correct answer: Corticosteroids (e.g., triamcinolone, methylprednisolone)
Corticosteroid injections provide potent local anti-inflammatory effects and are widely used in podiatry for conditions such as plantar fasciitis, bursitis, and joint inflammation.
PC PC Pharmacology & Medications 2
Which topical medication is FDA-approved for the treatment of onychomycosis and applied directly to the nail?