AGNP BOARD EXAM
QUESTIONS Men's health
Prescription (Questions 53) and
Answers
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,AGNP BOARD EXAM QUESTIONS Men's health Prescription (Questions 53)
Question:
Levofloxacin (Levaquin), used to treat acute bacterial prostatitis, is a:
fluoroquinolone. Correct
penicillin.
macrolide.
tetracycline.
Explanation:
Levofloxacin (Levaquin) is classified as a fluoroquinolone. An example of a penicillin is amoxicillin
(Moxatag); macrolide is azithromycin (Zithromax); and a tetracycline is doxycycline (Doryx).
Question:
Ciprofloxacin, used for the treatment of bacterial prostatitis, is a potent CYP1A2 inhibitor and is absolutely
contraindicated with other CYP1A2 inhibitors. An example of another CYP1A2 inhibitor is:
ketoconazole.
tizanidine (Zanaflex). Correct
fluoxetine hydrochloride (Sarafem).
celecoxib (Celebrex).
Explanation:
Ciprofloxacin, a fluoroquinolone, is a strong CYP1A2 inhibitor and is absolutely contraindicated for
concomitant administration of tizanidine (Zanaflex). Concomitant use may increase the serum
concentration of tizanidine. If use with another strong inhibitor cannot be avoided, initiate tizanidine at an
adult dose of 2 mg and increase in 2-4 mg increments based on response. Ketoconazole is a CYP3A4
inhibitor; celecoxib is a CYP2D6 inhibitor; and fluoxetine is a YP2C19 inhibitor. CYP1A2 inhibitors are
enzymes that catalyze many reactions involved in drug metabolism and synthesis of cholesterol, steroids
and other lipids.
Question:
A 33-year-old man has been taking sulfamethoxazole/trimethoprim for the treatment of bacterial
prostatitis. Brand names of this medication do NOT include:
Azulfidine. Correct
Bactrim DS.
SMX-TMP DS.
Sulfatrim.
Explanation:
Brand names of sulfamethoxazole/trimethoprim does NOT include sulfasalazine (Azulfidine).
Question:
Patients with uncomplicated acute bacterial prostatitis who are NOT good candidates for treatment with a
fluoroquinolone should take:
Explanation:
Patients with uncomplicated acute bacterial prostatitis who cannot take a fluoroquinolone should take
trimethoprim-sulfamethoxazole. Trimethoprim-sulfamethoxazole has good to excellent penetration into
prostatic and seminal fluids and tissues. Levofloxacin is a fluoroquinolone. Cephalosporins, such as
ceftriaxone, may not be effective unless an STD is suspected. Azithromycin is a macrolide and macrolides
are indicated for the treatment of chronic bacterial prostatitis.
Question:
PDE-5 inhibitors, such as tadalafil (Cialis) for the treatment of erectile dysfunction, should be avoided in
patients with:
infertility.
a history of epididymitis.
benign prostatic hyperplasia (BPH).
recent ST elevation myocardial infection (STEMI). Correct
Explanation:
PDE-5 inhibitors (ie. Levitra, Viagra, Cialis) should not be used in men with underlying cardiovascular
disease who have been advised to avoid sexual activity. These medications have systemic vasodilatory
properties that result in transient decreases in supine blood pressure. Cardiovascular status should be
considered on an individual basis, weighing the risks versus the benefits, before prescribing PDE-5
inhibitors.
Question:
The choice for initial treatment of acute bacterial prostatitis is:
doxycycline (Vibramycin).
ceftriaxone (Rocephin).
ciprofloxacin (Cipro). Correct
azithromycin (Zithromax).
Explanation:
The choice of antibiotic for treatment of acute bacterial prostatitis (ABP) is based on the results of the
initial culture and sensitivity. However, initial therapy should be directed at gram-negative enteric
bacteria. Useful agents include fluoroquinolones, trimethoprim-sulfamethoxazole, and ampicillin with
gentamicin. Examples of fluoroquinolones are ciprofloxacin (Cipro) and levofloxacin (Levaquin).
Question:
Patients who take sildenafil (Viagra) for the treatment of erectile dysfunction, should be instructed to
avoid:
the ingestion of grapefruit-containing products. Correct
dark green, leafy vegetables.
night time dosing.
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