NAPLEX (North American Pharmacist Licensure Examination) Practice Exam

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Which class of drugs is known for increased LFTs and QT prolongation as class effects?

Azole antifungals
Amphotericin B
Echinocandins
Neuraminidase Inhibitors

The correct answer is: Azole antifungals

Azole antifungals are known for causing increased liver function tests (LFTs) and QT prolongation as class effects. This is due to their mechanism of action and metabolism. Azole antifungals inhibit the enzyme CYP3A4, which can lead to drug interactions with many other medications metabolized by the same enzyme. This can result in elevated drug levels and potential hepatotoxicity. In terms of QT prolongation, azole antifungals can block cardiac potassium channels, leading to QT interval prolongation and an increased risk of arrhythmias. Amphotericin B, echinocandins, and neuraminidase inhibitors do not typically exhibit the same issues with LFTs or QT prolongation as class effects. Amphotericin B is more commonly known for nephrotoxicity rather than hepatotoxicity. Echinocandins are well-tolerated with minimal adverse effects on liver function or cardiac conduction. Neuraminidase inhibitors are generally well-tolerated, although some rare cases of liver injury have been reported with their use.