What assessment finding indicates ineffective therapy when a patient is receiving ketoconazole?

When a patient is being treated with ketoconazole, an antifungal medication that also inhibits adrenal steroid synthesis, an assessment finding that indicates ineffective therapy is an increase in cholesterol levels. Ketoconazole works by blocking the production of adrenal hormones, which includes cortisol and, indirectly, affects cholesterol metabolism.

If cholesterol levels are elevated during treatment, it may suggest that the medication is not effectively suppressing adrenal steroid production, leading to a persistent elevation of cholesterol due to decreased metabolism. Conversely, if blood glucose levels are decreased, this could reflect an effective potentiation of insulin action or other metabolic changes, normal liver function tests indicate that the liver is functioning well and not affected adversely by the medication, and stable blood pressure could suggest that the treatment is not causing significant adverse endocrine effects. Therefore, increased cholesterol levels during treatment serve as a clear indicator of ineffective therapy with ketoconazole.