PC PC Pharmacology & Medications 1 — Questions and Answers
Question 1: Which class of medications is most commonly used to treat onychomycosis (fungal nail infections) in podiatric practice?
- Oral antifungals (terbinafine, itraconazole) (Correct answer)
- Topical corticosteroids
- Oral antibiotics (penicillins)
- NSAIDs
Correct answer: Oral antifungals (terbinafine, itraconazole)
Oral antifungals such as terbinafine and itraconazole are the first-line systemic treatments for onychomycosis due to their superior nail penetration.
Question 2: A patient with diabetes requires a local anesthetic injection for a minor foot procedure. Which agent is generally avoided due to its vasoconstrictive properties in digits?
- Epinephrine-containing anesthetic (Correct answer)
- Plain lidocaine
- Plain bupivacaine
- Mepivacaine without vasoconstrictor
Correct answer: Epinephrine-containing anesthetic
Epinephrine causes vasoconstriction that can compromise digital blood flow, making it potentially dangerous in toe blocks, especially in patients with vascular compromise.
Question 3: Metformin is a common medication in diabetic patients presenting for podiatric care. What is the primary concern related to metformin before a contrast-enhanced procedure?
- Risk of lactic acidosis if renal function is impaired (Correct answer)
- Increased bleeding risk
- Hypersensitivity to anesthetics
- Elevated potassium levels
Correct answer: Risk of lactic acidosis if renal function is impaired
Metformin can accumulate in patients with renal impairment when contrast dye is used, increasing the risk of lactic acidosis, so it is typically held before contrast procedures.
Question 4: Which NSAID is most commonly used for short-term management of acute gout flares in podiatric patients?
- Indomethacin (Correct answer)
- Aspirin
- Acetaminophen
- Tramadol
Correct answer: Indomethacin
Indomethacin is the classic NSAID of choice for acute gout due to its potent anti-inflammatory properties and rapid onset of action.
Question 5: A podiatrist prescribes colchicine to a patient for gout. What is the most important adverse effect to counsel the patient about?
- Gastrointestinal toxicity (nausea, vomiting, diarrhea) (Correct answer)
- Nephrotoxicity
- Hepatotoxicity
- Cardiotoxicity
Correct answer: Gastrointestinal toxicity (nausea, vomiting, diarrhea)
Gastrointestinal symptoms are the most common dose-limiting adverse effects of colchicine and serve as an early warning sign of toxicity.
Question 6: When prescribing a fluoroquinolone antibiotic (e.g., ciprofloxacin) for a foot infection, which important side effect must the podiatrist warn the patient about?
- Increased risk of tendon rupture (Correct answer)
- Bone marrow suppression
- Severe hypoglycemia
- Pulmonary fibrosis
Correct answer: Increased risk of tendon rupture
Fluoroquinolones carry a black-box warning for tendinopathy and tendon rupture, particularly affecting the Achilles tendon.
PC PC Pharmacology & Medications 1
Which class of medications is most commonly used to treat onychomycosis (fungal nail infections) in podiatric practice?