Question

A woman is placed on fluconazole to treat renal candidiasis. Which pharmacologic property is associated with this drug? (A) poor oral bioavailability (B) low cerebrospinal fluid concentrations (C) primarily excreted in the urine (D) short elimination half-life (E) must be given parenterally

Short answer

(C) primarily excreted in the urine.

Step-by-step solution

Understanding the Question

We need to identify a key pharmacologic property of fluconazole related to its pharmacokinetics and mechanism of action from the options provided.

Reviewing Pharmacologic Properties

Fluconazole is an antifungal medication. It is known for good oral bioavailability and can be administered orally. It reaches effective concentrations in the cerebrospinal fluid, which is beneficial for treating central nervous system infections.

Analyzing Elimination and Excretion

Fluconazole is primarily excreted in the urine. This is an important property since renal candidiasis involves the kidneys, and urinary excretion implies direct antifungal activity in the urinary tract.

Evaluating Other Options

Given the options, fluconazole is not known for poor oral bioavailability, low cerebrospinal fluid concentrations, or a short elimination half-life, nor does it require parenteral administration, as it can be effectively administered orally.

Selecting the Correct Option

Considering the steps above, the correct pharmacologic property associated with fluconazole for the given condition is that it is primarily excreted in the urine.

Key concepts

Fluconazole

Fluconazole is a powerful antifungal medication, often used to treat infections caused by fungi and yeasts like Candida. It is part of a group of drugs known as azoles, which work by inhibiting a fungal enzyme crucial for building their cell membranes. This leads to leakage of the cell contents, effectively killing the fungus.
Fluconazole stands out because it can be taken orally, making it more convenient than some antifungals that require intravenous administration. It is commonly prescribed for conditions like oral thrush, yeast infections, and systemic infections such as renal candidiasis. Patients need to take it as advised by their healthcare providers to ensure the best results while minimizing potential side effects.

Pharmacokinetics

Pharmacokinetics involves how a drug moves through the body. For fluconazole, this includes its absorption, distribution, metabolism, and excretion. Fluconazole has excellent pharmacokinetic properties that contribute to its effectiveness.
After oral administration, fluconazole is rapidly absorbed into the bloodstream and distributed throughout the body. This makes it effective for both superficial and systemic fungal infections. The drug has a good half-life, meaning it stays active in the body long enough to maintain therapeutic levels.
The primary route of elimination is the kidneys, where it is excreted mostly unchanged. This makes fluconazole particularly useful for infections in the urinary tract, aligning with its efficacy in treating renal candidiasis.

Renal Candidiasis

Renal candidiasis is a condition where the Candida fungus infects the kidneys. This can occur when Candida invades the bloodstream and spreads to various organs. Patients with weakened immune systems or those undergoing specific medical interventions are more at risk.
Early diagnosis and treatment are crucial in managing renal candidiasis. Fluconazole is an effective treatment option because it is excreted in the urine, allowing high drug concentrations to directly target the infection site. This direct treatment makes controlling the fungal infection in the kidneys more manageable, helping prevent further complications.

• Patients should be monitored regularly to ensure the effectiveness of the treatment.
• Being aware of potential side effects helps manage and adjust treatment as needed.

Oral Bioavailability

Oral bioavailability refers to the proportion of a drug that enters circulation when introduced into the body and is available for therapeutic action. Fluconazole is notable for its excellent oral bioavailability. This means that, when taken by mouth, a significant amount of the drug reaches the bloodstream and becomes active.
The high oral bioavailability of fluconazole simplifies treatment for patients, allowing for easy oral dosing rather than invasive intravenous administration. This property not only improves patient compliance but also expands the situations in which fluconazole can be effectively used, making it a versatile treatment for a variety of fungal infections.