Practice Exam NAPLEX #1 (Access Pharmacy) Flashcards
Vaccines are available against which bacteria that cause meningitis?
S. pneumoniae
H. influenzae,
N. meningitidis
SIADH is caused by what underlying disorder and common cause?
Euvolemic hypotonic hyponatremia & sertraline
Prozac is available in what dosage forms?
Once daily capsules
Oral solution
Weekly capsule
mEq Calcium concentration from lowest to highest
Gluconate 90 mg
Acetate 250 mg
Carbonate 400 mg
Bisphosphonates in order from lowest available dosage (mg per tablet) to highest.
Risedronate
Alendronate
Ibandronate
What is the recommended type of screening is done annually for lung cancer?
Helical CT scan
What is considered a stand alone ASCVD risk-enhancing factor?
HIV
What medications may interact with medicinal doses of garlic?
Metoprolol
Oral contraceptives
Rilpivirine
Fentanyl
By what MOA does glucagon reverse beta-blocker induced hypotension and bradycardia?
Stimulation of the glucagon receptors on the beta-receptor complex
What laboratory parameters need to be checked prior to starting Lithium?
Serum creatinine
Electrocardiogram
Thyroid function tests
Electrolytes
What would be a contraindication to administration of tamoxifen for the prevention of breast cancer in a “high risk” premenopausal patient?
History of deep venous thrombosis “DVT”
Tumor lysis syndrome (TLS) prevention and management for a newly diagnosed patient with acute lymphocytic leukemia (ALL).
- Initiate allopurinol
- Treating electrolyte disturbances
- Aggressive hydration
What is the most common side effect of ondansetron?
Constipation and headache
Risk factors associated with melanoma AE:
- Presence of multiple dysplastic nevi
- Presence of genetic factors
- Individuals with fair skin type who sunburns easily
- Individuals who are immunosuppressed
What is a safe option for treatment of postmenopausal osteoporosis that does not have any restrictions in renal impairment?
Calcitonin
What is the total calcium requirement for a pregnant woman?
1000 - 1300 mg daily
Important counseling point for Migranal (dihydroergotamine)
Once prepared, use within 8 hours.
Nasal spray
What adjunctive measures is used to lessen the occurrence of nephrotoxicity associated with amphotericin B?
Normal saline boluses
Females weighing more than 198 lbs should have no issues using what contraceptives?
- Depo-Provera (causes wt gain)
- NuvaRing
- Yasmin
Xulane is not recommended in patient > 198 lbs
What percentage of total calories is provided by the fat content?
10%
fats provide 9 kcal/g
What was the main requirement of the Poison Prevention and Packaging Act?
Reducing the oral-prescription medication death rates in children under 5 yoa
Parkinson Disease drugs in order according to ability to control motor symptoms (bradykinesia, rigidity, tremor) from most efficacious to least
- Carbidopa/levodopa
- Amantadine IR
- Rasagiline
- Ropinirole
What monoclonal antibodies used in the treatment of colorectal cancer is associated with causing hypomagnesemia?
Panitumumab & Cetuximab
What adverse events should be discussed prior to first cycle infusion of rituximab?
- Hep B reactivation
- Infusion related reactions
- Tumor lysis syndrome
- Flu-like symptoms
What common oral iron formulation contains 20% of elemental iron?
Ferrous sulfate 60 mg per 5 ml syrup
What measure of central tendency should be utilize for primary outcome for nominal data?
Mode
What is the best recommended oral contraceptive for a patient with premenstrual dysphoric disorder (PMDD)?
YAZ is FDA approved for PMDD
What oral contraceptives are FDA approved for acne treatment?
Ortho Tri-Cyclen & Estrostep
Side effects associated with interferon
- Flu-like symptoms requiring premedication with antipyretic
- Fatigue
- Depression
- Somnolence and confusion
Side effects associated with oral evening primrose oil use
Overall, evening primrose oil is well tolerated with some GI side effects (abdominal pain, N/V/D, flatulence, dyspepsia)
What type of pharmacoeconomic analysis assumes the outcomes are equal?
Cost-minimization
*measures cost in dollars and outcomes equal
What is the percentage error of the inaccurate balance equation?
Error x 100% / Desired Quantity
List the disease that requires the least total number of doses of penicillin to the least most.
- Secondary syphilis
- Late Latent syphilis
- Neurosyphilis
Define intent to treat (ITT)
The analysis includes all participants in the arm to which they were randomized originally
What is a potential adverse effect when using oral antihistamines for the management of allergic rhinitis in a 3 yo child?
Paradoxical agitation
What is a potential adverse effect related to intranasal corticosteroids?
HPA axis suppression
What is an adverse effect related to overuse of topical decongestants?
Rebound congestion
What patient population or condition often leads to fast titration of antipsychotic drugs (ASDs)?
Children
because they require prompt control of seizures to avoid interference with brain development and cognition
What is an important counseling point for Humira?
Proper injection technique
SQ and available as a single-dose syringe or pen device
What agents have been associated with osteonecrosis of the jaw?
Teriparatide
Alendronate
Denosumab
What data pertaining to prostate cancer screening is reviewed to determine diagnosis?
DRE and PSA combined
Neutrophils function/role
To engulf and destroy the infectious pathogen
What is the best empiric regimen against C. glabrata?
Caspofungin 70 mg x 1 dose, then 50 mg daily
What type of biological safety cabinet (BSC) should the cytarabine be prepared in?
Vertical flow, class II
*HEPA filtered air “ISO class 5” is required for personnel in handling hazardous agents)
Counseling point for capecitabine
Take tablets with food
What natural products could increase the risk of bleed with concomitant warfarin use due to the supplement’s antiplatelet/anticoagulant properties?
- Chondroitin & glucosamine sulfate
- Evening primrose oil
- Garlic
- High doses of fish oil
What medical condition may be exacerbated when receiving bevacizumab?
Hypertension
Counsel points when starting metoprolol
- Hypotension
- Bradycardia
- SOB
What is the recommended duration of a COC before changing products?
3 months
What agent has been associated with liver toxicity and failure, and its use is contraindicated in patients with pre-existing liver disease in Parkinson Disease?
Tolcapone
What is considered the gold standard for measurement of GFR?
Insulin clearance
Which insulin can be mixed with insulin glargine in one syringe in order to decrease daily insulin injections?
None
Which insulins can be mixed with insulin NPH?
Insulin aspart and insulin regular
What therapy should be administered within 1 hour of the recognition of sepsis?
Broad-spectrum antimicrobial therapy
What patient groups are considered to have complicated UTIs?
- Children
- Men
- Pregnant women
- Catheter-associated
What agent should be utilized in patients with castration-resistant prostate cancer with bone pain for assistance with pain reduction?
Radium-223
Main adverse effect about lamotrigine
rash
What agents can cause constriction of the afferent arteriole?
- Tacrolimus
- Ibuprofen
- Cyclosporine
Counseling point when ibuprofen and aspirin is being taking
Take ibuprofen at least 30 minutes after aspirin or aspirin 8 hours after ibuprofen. Monitor BP often
What is the pretreatment for paclitaxel infusion to prevent infusion reactions?
- Dexamethasone
- Ranitidine
- Diphenhydramine
Why is folic acid recommended along with methotrexate therapy?
Folic acid can prevent GI toxicity caused by MTX.
What TNF-inhibitors can be self-administered SQ?
Cimzia and Humira
Unfractionated heparin routes of administration
IV and SQ
What is the primary therapy for early stage colon cancers?
Surgery
What is the best treatment option for a 61 yoM who is chemotherapy naive and was recently diagnosed with extensive-stage small-cell lung cancer?
Cisplatin + Etoposide + Atezolizumab
Counseling tips for someone starting levothyroxine for hypothyroidism
- Levothyroxine will need to be continued lifelong
- Should be taken OES
- Separated at least 4 hours from other medications
What IV vasodilator therapies would be contraindicated in a pregnant patient with ADHF?
Enalaprilat
ACE-I
What agent best targets the symptoms of rhinorrhea?
Ipratropium
What classes of medication can be used for management of allergic rhinitis after the first trimester of pregnancy?
- Oral antihistamines (cetirizine/levocetirizine)
- Intranasal corticosteroids (budesonide)
- Oral decongestants (not during 1st trimester)
- Topical decongestants (safer option)
What is the duration of antimicrobial therapy in most patients with septic shock?
7-10 days
List the NNRTIs in order based upon initial starting dose (lowest to highest)
- Rilpivirine
- Nevirapine
- Etravirine
- Efavirenz
What agent is FDA indicated for social anxiety disorder and can be used first-line?
Effexor XR (venlafaxine XR)
What medications contains tenofovir alafenamide (taf)?
- Odefsey (Emtricitabine, rilpivirine, tenofovir-taf)
2. Genvoya )Elvitegravir, cobicistat, emtricitabine, tenofovir-taf)
What class of antihypertensive overdose is bradycardia, hypotension and hyperglycemia hallmarks of toxicity?
Calcium channel blockers
What agents are utilized in the prophylactic management for PJP and Toxoplasmosis?
Atovaquone, dapsone and leucovorin
What is the most commonly utilized agent in the management of PJP and Toxoplasmosis?
SMZ/TMP
What is the appropriate dose of ondansetron to prevent PONV?
4 mg IV given at the end of surgery
MOA of isoniazid
Inhibition of mycolic acid production which is necessary for mycobacterial cell walls
MOA of ethambutol
Inhibition of mycobacterial arabinosyl transferase to inhibit cell wall production
MOA of rifamycins
Inhibition of DNA-dependent RNA polymerase in bacterial cells
Rank the glaucoma eye drops from highest to lowest ability to lower IOP
- Latanoprost (35%)
- Timolol (30%)
- Brinzolamide (26%)
- Brimonidine (18%)
When should a serum digoxin concentration be obtained at least __ hours, but preferably _____ hours following last dose?
At least 6 hours but preferably 12-24 hours after last dose
What is used for empiric treatment of a moderate-severe, polymicrobial cellulitis?
Ertapenem 1 g IV daily
Broad-spectrum: covers S. aureus, streptococci, Gram-negatives, anaerobes. NO Pseudomonas
What is the appropriate BUD for a Mini Bag Plus product assembled in the LAFW under proper conditions as part of batch?
BUD assignment of the assembled system does not apply. As with proprietary products, expiration date is assigned based on manufacturer’s recommendations.
Hyperkalemia may result from AKI and can lead to what life-threatening complications?
Arrhythmias