The nurse is providing instructions about the fluticasone propionate and salmeterol combination inhaler. Which statement about this inhaler is accurate?

Choice A reason: Penicillin antibiotics, like amoxicillin, inhibit bacterial cell wall synthesis and are not associated with photosensitivity. Their side effects include allergic reactions and gastrointestinal upset. Photosensitivity requires drugs that absorb UV light, altering skin response, which is not a mechanism of penicillin’s action on bacterial peptidoglycan.

Choice B reason: Cephalosporins, similar to penicillins, target bacterial cell walls and are not commonly linked to photosensitivity. Their side effects include hypersensitivity and gastrointestinal issues. Unlike drugs that cause phototoxic reactions by absorbing UV light, cephalosporins lack chromophores that trigger skin photosensitivity, making this incorrect.

Choice C reason: Tetracyclines, like doxycycline, are known to cause photosensitivity by forming phototoxic compounds under UV light exposure. These compounds generate reactive oxygen species, damaging skin cells and causing exaggerated sunburn or rashes. Patients must avoid sun exposure and use sunscreen to prevent this adverse effect during therapy.

Choice D reason: Vancomycin, used for gram-positive infections, inhibits cell wall synthesis but is not associated with photosensitivity. Its primary side effects include nephrotoxicity and red man syndrome. It does not absorb UV light or form phototoxic metabolites, making it an unlikely cause of skin reactions to sunlight.

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.