Which patient would be considered inappropriate for ketoconazole therapy?

Ketoconazole is an antifungal medication that can also be used to treat conditions like Cushing's syndrome due to its ability to inhibit steroidogenesis. However, its use is contraindicated in patients with elevated liver function tests. This is primarily due to the potential for hepatotoxicity associated with ketoconazole, which can worsen existing liver disease or impair liver function further.

Patients with elevated liver enzymes indicate an ongoing process that could lead to liver damage, making the use of ketoconazole risky. Therefore, initiating therapy with ketoconazole in a patient who already has compromised liver function could lead to serious adverse effects, including liver failure.

In contrast, the other options—headache, fatigue, and mild asthma—do not inherently indicate conditions that would directly contraindicate the use of ketoconazole. While these symptoms may require evaluation and management, they do not present the same critical risk profile as elevated liver function tests in the context of ketoconazole therapy.