A patient with coronary artery disease asks the nurse about the "good cholesterol" laboratory values. The nurse knows that "good cholesterol" refers to which lipids?

Choice A reason: Itraconazole is a systemic antifungal used for infections like histoplasmosis. It inhibits ergosterol synthesis but is not typically used topically for athlete’s foot due to its oral or intravenous administration. Its systemic use carries risks like hepatotoxicity, making it unsuitable for localized dermatophyte infections.

Choice B reason: Ketoconazole is available as a topical cream but is less commonly used for athlete’s foot compared to terbinafine. It inhibits fungal ergosterol synthesis and is effective for cutaneous infections, but its topical use is more associated with seborrheic dermatitis or candidiasis, not primarily tinea pedis.

Choice C reason: Terbinafine is a topical antifungal commonly used for athlete’s foot (tinea pedis). It inhibits squalene epoxidase, disrupting fungal cell membrane synthesis, leading to fungal death. Its topical application effectively treats dermatophyte infections like Trichophyton, making it a first-line choice for localized fungal infections.

Choice D reason: Amphotericin B is a systemic antifungal used for severe fungal infections. It binds to ergosterol, causing fungal cell lysis, but is not used topically for athlete’s foot due to its toxicity and intravenous administration. It is reserved for life-threatening systemic infections, not cutaneous conditions.

Choice A reason: Nystatin lozenges must dissolve slowly in the mouth to ensure prolonged contact with oral mucosa, effectively treating candidiasis by disrupting fungal cell membranes. Slow dissolution maximizes local antifungal activity, targeting Candida albicans in the oral cavity, a common complication of inhaled corticosteroid use.

Choice B reason: Rinsing the mouth with water before using an inhaler is appropriate for corticosteroids to prevent thrush but is irrelevant for nystatin lozenges. Nystatin treats existing oral candidiasis, and rinsing beforehand may reduce its contact time with affected mucosa, decreasing efficacy.

Choice C reason: Rinsing with mouthwash after an inhaler is not standard for nystatin or corticosteroid use. Mouthwash may contain alcohol, irritating oral mucosa or reducing nystatin’s antifungal effect. Rinsing with water after corticosteroids prevents thrush, but this instruction is misapplied to nystatin lozenges.

Choice D reason: Chewing nystatin lozenges is incorrect, as it reduces contact time with oral mucosa, decreasing antifungal efficacy. Swallowing the drug shifts its action to the gastrointestinal tract, ineffective for oral candidiasis. Slow dissolution ensures targeted treatment of Candida in the mouth, preventing recurrence.