Which antifungal drug is used to treat systemic fungal infections and can cause nephrotoxicity?

Choice A reason: Aspirin inhibits platelet aggregation by irreversibly blocking cyclooxygenase-1, reducing thromboxane A2 production, which increases bleeding risk. This is critical in patients with bleeding disorders, as it can exacerbate conditions like hemophilia or cause gastrointestinal bleeding, necessitating caution and monitoring during therapy.

Choice B reason: Taking aspirin on an empty stomach does not maximize effectiveness and may increase gastrointestinal irritation. Aspirin’s antiplatelet and analgesic effects are independent of food intake, but taking it with food reduces gastric mucosal damage, making this statement incorrect for patient safety.

Choice C reason: Aspirin is not safe with all medications, as it interacts with anticoagulants, NSAIDs, or corticosteroids, increasing bleeding risk. It also affects drugs like methotrexate by altering renal clearance. Drug interactions are common, requiring careful review of concurrent medications, making this statement misleading and unsafe.

Choice D reason: Moderate alcohol consumption with aspirin is not safe, as both irritate the gastric mucosa, increasing the risk of gastrointestinal bleeding. Aspirin’s antiplatelet effect combined with alcohol’s mucosal damage heightens this risk, making this statement incorrect and potentially harmful for patient education.

Choice A reason: Fibric acid derivatives, like fenofibrate, lower triglycerides by activating PPAR-alpha, reducing VLDL production. They are not commonly associated with myopathy, though gastrointestinal upset or liver enzyme elevation may occur. Myopathy is more characteristic of statins, making this an incorrect class for monitoring.

Choice B reason: Niacin lowers lipids by inhibiting VLDL synthesis but is not significantly linked to myopathy. Its primary side effects include flushing and hepatotoxicity due to prostaglandin release and metabolic stress. Muscle pain is a hallmark of statins, not niacin, making this incorrect.

Choice C reason: Bile acid sequestrants, like cholestyramine, bind bile acids, reducing cholesterol absorption. They cause gastrointestinal side effects like constipation but not myopathy. Their mechanism does not affect muscle tissue, unlike statins, which inhibit HMG-CoA reductase, making this class irrelevant for myopathy monitoring.

Choice D reason: Statins, like simvastatin, inhibit HMG-CoA reductase, reducing cholesterol synthesis. They can cause myopathy by disrupting muscle cell membranes or mitochondrial function, leading to muscle pain or rare rhabdomyolysis. Monitoring for myopathy is critical, as it can progress to severe muscle damage, making this the correct class.