Which of the following is/are FDA-approved indication(s) for valacyclovir hydrochloride? Select all that apply
Herpes zoster
Tinea Pedis
Genital herpes
Infections caused by Methicillin Resistant Staphylococcus Aureus
Correct Answer : A,C
Valacyclovir is an L-valyl ester prodrug of the purine nucleoside analogue acyclovir, utilized for the inhibition of viral DNA polymerase. It exhibits high oral bioavailability and is converted in the liver to acyclovir, which competes with deoxyguanosine triphosphate. It is primarily indicated for DNA viruses such as Varicella-Zoster and Herpes Simplex. Side effects include headache and nausea, while severe cases may involve thrombotic thrombocytopenic purpura.
Rationale:
A. Herpes zoster, commonly known as shingles, is a primary FDA-approved indication for valacyclovir. The drug accelerates the resolution of lesions and reduces the duration of postherpetic neuralgia by inhibiting viral replication. Treatment is most effective when initiated within 72 hours of rash onset to limit neuralgic damage. Its high plasma concentration facilitates effective suppression of the Varicella-Zoster virus.
B. Tinea pedis is a fungal infection of the feet caused by dermatophytes, such as Trichophyton rubrum. Valacyclovir is strictly an antiviral agent and possesses no pharmacological activity against fungal organisms. Fungal cell walls contain ergosterol, whereas valacyclovir targets viral DNA synthesis. Consequently, this medication is completely ineffective for treating athlete's foot or any other mycotic infection.
C. Genital herpes is a major FDA-approved indication for valacyclovir, used for both acute outbreaks and long-term suppressive therapy. By decreasing viral shedding, the medication reduces the risk of transmission to seronegative partners. It is effective against both Herpes Simplex Virus type 1 and type 2. Suppression protocols typically involve daily dosing to maintain adequate virological control in the host.
D. Infections caused by Methicillin-Resistant Staphylococcus aureus (MRSA) require bactericidal or bacteriostatic antibiotics like vancomycin or daptomycin. Valacyclovir has no effect on bacterial cell wall synthesis or protein synthesis. Bacteria are prokaryotic organisms, while valacyclovir is specifically designed to interfere with viral replication machinery. Using an antiviral for a bacterial pathogen like MRSA would result in treatment failure.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Step 1 is to convert the aspirin dose per suppository to grams
300 ÷ 1000 = 0.3
Result at this step = 0.3 g
Step 2 is to calculate the weight of the base displaced by the drug
(Drug weight ÷ Density factor)
(0.3 ÷ 1.3) = 0.2307
Result at this step = 0.2307 g
Step 3 is to calculate the actual weight of the base needed per suppository
(Weight of blank base - Weight of base displaced)
2 - 0.2307 = 1.7693
Result at this step = 1.7693 g
Step 4 is to calculate the total number of suppositories
(Total base available ÷ Base needed per suppository)
31 ÷ 1.7693 = 17.52
Result at this step = 17.52
Step 5 is to round down to the nearest whole number for completed suppositories
17.52 ≈ 17
Answer: 17
Correct Answer is B
Explanation
SCHOLAR-MAC is a standardized patient assessment mnemonic used in community pharmacy and primary care to systematically evaluate a patient's self-reported symptoms. The "A" in the acronym stands for Aggravating factors, which are specific triggers that exacerbate the patient's discomfort. Identifying these factors helps the clinician distinguish between different pathological conditions and determine the appropriate level of intervention or referral.
Rationale:
A. Asking what makes the symptoms better addresses the Remediating factors of the clinical presentation. This information is valuable for understanding what treatments or positions provide relief, but it does not identify what causes the condition to worsen. It is the functional opposite of assessing aggravating triggers during the patient interview.
B. Asking "What makes the symptoms worse?" directly identifies aggravating factors. This question uncovers external or internal stimuli, such as specific foods, physical activities, or environmental exposures, that increase the severity of the illness. Pinpointing these triggers is essential for forming a differential diagnosis and providing effective lifestyle advice to the patient.
C. Asking when the symptoms started is used to assess the Onset of the condition. This helps the provider establish a timeline and determine if the issue is acute or chronic. While the timing is a critical component of the SCHOLAR assessment, it does not provide information regarding the factors that worsen the patient's distress.
D. Asking if this has happened in the past is part of the History section of the assessment. Understanding the recurrence of a symptom can indicate a chronic underlying problem or a pattern of seasonal triggers. However, a past occurrence is a temporal observation and does not explain the specific stimuli that aggravate the current episode.
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