NAPLEX 2025 Study Guide
(185 Pages) |
Comprehensive Pharmacy
Exam Review, Practice
Questions & High-Yield
Topics
|Graded A+ | Guaranteed
success|
Updated 2026 Questions and Answers
100% Verified Exam Prep and Comprehensive
Rationales
Included
,Levothyroxine tablet colors Orangutans Will Vomit On You Right Before They Become Large Proud Giants
25 Orange
50 White (no dye)
75 Violet
88 Olive
100 Yellow
112 Rose
125 Brown
137 Turquoise
150 Blue
175 Lilac
200 Pink
300 Green
Drug induced causes of hyperthyroidism Iodine
Amiodarone
Interferons
Radiographic contrast media
treatment for thyroid storm Antithyroid (PTU preferred- give 1 hour before iodide)
Inorganic iodide therapy (SSKI or Lugol's)
Beta Blocker (Propranolol)
Systemic steroid (dexamethasone)
Aggressive cooling (APAP, cooling blankets, supportive treatments)
Hyperthyroid in pregnancy Hyperthyroidism during pregnancy should be treated with propylthiouracil
(PTU) during the first trimester then methimazole during the second and third
trimesters. Although methimazole is a teratogen, the teratogenic effects are
less during the second and third trimesters, and PTU can cause liver failure,
which is why it is substituted out.
Cushing's syndrome Adrenal gland produces too much cortisol or exogenous steroids are taken in
doses higher than normal amounts of endogenous cortisol
Addison's disease a condition that occurs when the adrenal glands do not produce enough
cortisol; Addisonian crisis (volume depletion and hypotension, which can be
fatal)
Steroids: least to most potent (Cute Hot Pharmacists and Physicians Marry Together & Deliver Babies)
o Cortisone (25 mg): short acting
o Hydrocortisone (20 mg): short acting
o Prednisone (5 mg): intermediate acting
o Prednisolone (5 mg): intermediate acting
o Methylprednisolone (4 mg): intermediate acting
o Triamcinolone (4 mg): intermediate acting
o Dexamethasone (0.75 mg): long acting, highest potency
o Betamethasone (0.6 mg): long acting, highest potency
,Immunosuppression from steroids A patient is immunosuppressed when using >/= 2mg/kg/day or >/= 20mg/day of
prednisone or prednisone equivalent for >2 weeks
Immunosuppressed patients cannot receive live vaccines and have a high risk
of infection
steroid will need to be slowly tapered off: reduce 10-20% every few days
(tapers can last 7-14 days, longer or shorter)
Traditional DMARDs (disease modifying anti-rheumatic MTX (Trexall): first line in RA
drugs) Hydroxychloroquine (Plaquenil)
Sulfasalazine
Leflunomide (Arava)
Traditional DMARDs (disease modifying anti-rheumatic MTX (Trexall): first line in RA
drugs): MTX - irreversibly binds and inhibit dihydrofolate reductase, inhibiting folate
- 7.5 to 20 mg once weekly
- hepatotoxicity (avoid alcohol), myelosuppression, mucosistis/stomatitis,
teratogenic
- monitor: CBC, LFTs, chest X-ray, hep B/C
- folate replacement
- renal elimination is decreased by aspirin/NSAIDs
Traditional DMARDs (disease modifying anti-rheumatic Hydroxychloroquine (Plaquenil)
drugs): hydroxychloroquine - Irreversible retinopathy
- take with food or milk
- alternative to MTX in liver disease
Traditional DMARDs (disease modifying anti-rheumatic Sulfasalazine
drugs): Sulfasalazine - CI in sulfa/salicylate allergy
- can cause yellow-orange coloration of skin/urine
- caution in patients with G6PD deficiency
Traditional DMARDs (disease modifying anti-rheumatic Leflunomide (Arava)
drugs): Leflunomide - inhibits pyrimidine synthesis
- teratogenic - must wait 2 years after use to become pregnant or use
accelerated drug elimination (cholestyramine + activated charcoal)
- hepatotoxic
JAK inhibitors Tofacitinib (Xeljanz)
Baracitinib (Olumiant)
Upadacitinib (Rinvoq)
Boxed warnings: serious infections, malignancy, thrombosis
Do not use with biologic DMARDs or potent immunosuppressants
, Anti-TNF Biologic DMARDs Etanercept: Enbrel
Adalimumab: Humira
Infliximab: Remicade
Certolizumab: Cimzia
Golimumab: Simponi
Used for a variety of diseases including RA (typically add on therapy to MTX)
Needles are provided
Each has a pregnancy registry
Boxed warnings: serious infections, malignancies
Warnings: demyelinating desease, hep B reactivations, HF, hepatotoxicity,
lupus-like syndrome, seizures, myelosuppression
Can cause: injection site reactions, infection, liver damage, HF
*Do NOT use with other biologic DMARDs or live vaccines
Notes: do not shake or freeze, requires refrigeration
Anti-TNF Biologic DMARDs: Etancercept Enbrel
SC weekly
CI: doses greater than 5 mg/kg in sepsis
stored at RT for max of 14 days
inject SC into abdomen, thigh, or upper arm
Anti-TNF Biologic DMARDs: Adalimumab Humira
every other week dosing
stored at RT for max of 14 days
inject SC into abdomen or thigh
Anti-TNF Biologic DMARDs: Infliximab Remicade
Weeks 0, 2, and 6, then every 8 weeks (can treat every 4 weeks based on need)
Requires filter and is stable in NS only
Infusion rxns and delayed hypersensitivity rxns (3-12 days after admin)
Anti-TNF Biologic DMARDs: Certolizumab pegol Cimzia
Every other week
Anti-TNF Biologic DMARDs: Golimumab Simponi
Monthly
IV requires a filter
Inject SC into the abdomen, thigh, or upper arm
Other Biologic DMARDs (Non-TNF inhibitors) Rituximab: Rituxan (depletes CD20)
Anakinra: Kineret
Abatacept: Orencia
Tocilizumab: Actemra
Sarilumab: Kevzara
(185 Pages) |
Comprehensive Pharmacy
Exam Review, Practice
Questions & High-Yield
Topics
|Graded A+ | Guaranteed
success|
Updated 2026 Questions and Answers
100% Verified Exam Prep and Comprehensive
Rationales
Included
,Levothyroxine tablet colors Orangutans Will Vomit On You Right Before They Become Large Proud Giants
25 Orange
50 White (no dye)
75 Violet
88 Olive
100 Yellow
112 Rose
125 Brown
137 Turquoise
150 Blue
175 Lilac
200 Pink
300 Green
Drug induced causes of hyperthyroidism Iodine
Amiodarone
Interferons
Radiographic contrast media
treatment for thyroid storm Antithyroid (PTU preferred- give 1 hour before iodide)
Inorganic iodide therapy (SSKI or Lugol's)
Beta Blocker (Propranolol)
Systemic steroid (dexamethasone)
Aggressive cooling (APAP, cooling blankets, supportive treatments)
Hyperthyroid in pregnancy Hyperthyroidism during pregnancy should be treated with propylthiouracil
(PTU) during the first trimester then methimazole during the second and third
trimesters. Although methimazole is a teratogen, the teratogenic effects are
less during the second and third trimesters, and PTU can cause liver failure,
which is why it is substituted out.
Cushing's syndrome Adrenal gland produces too much cortisol or exogenous steroids are taken in
doses higher than normal amounts of endogenous cortisol
Addison's disease a condition that occurs when the adrenal glands do not produce enough
cortisol; Addisonian crisis (volume depletion and hypotension, which can be
fatal)
Steroids: least to most potent (Cute Hot Pharmacists and Physicians Marry Together & Deliver Babies)
o Cortisone (25 mg): short acting
o Hydrocortisone (20 mg): short acting
o Prednisone (5 mg): intermediate acting
o Prednisolone (5 mg): intermediate acting
o Methylprednisolone (4 mg): intermediate acting
o Triamcinolone (4 mg): intermediate acting
o Dexamethasone (0.75 mg): long acting, highest potency
o Betamethasone (0.6 mg): long acting, highest potency
,Immunosuppression from steroids A patient is immunosuppressed when using >/= 2mg/kg/day or >/= 20mg/day of
prednisone or prednisone equivalent for >2 weeks
Immunosuppressed patients cannot receive live vaccines and have a high risk
of infection
steroid will need to be slowly tapered off: reduce 10-20% every few days
(tapers can last 7-14 days, longer or shorter)
Traditional DMARDs (disease modifying anti-rheumatic MTX (Trexall): first line in RA
drugs) Hydroxychloroquine (Plaquenil)
Sulfasalazine
Leflunomide (Arava)
Traditional DMARDs (disease modifying anti-rheumatic MTX (Trexall): first line in RA
drugs): MTX - irreversibly binds and inhibit dihydrofolate reductase, inhibiting folate
- 7.5 to 20 mg once weekly
- hepatotoxicity (avoid alcohol), myelosuppression, mucosistis/stomatitis,
teratogenic
- monitor: CBC, LFTs, chest X-ray, hep B/C
- folate replacement
- renal elimination is decreased by aspirin/NSAIDs
Traditional DMARDs (disease modifying anti-rheumatic Hydroxychloroquine (Plaquenil)
drugs): hydroxychloroquine - Irreversible retinopathy
- take with food or milk
- alternative to MTX in liver disease
Traditional DMARDs (disease modifying anti-rheumatic Sulfasalazine
drugs): Sulfasalazine - CI in sulfa/salicylate allergy
- can cause yellow-orange coloration of skin/urine
- caution in patients with G6PD deficiency
Traditional DMARDs (disease modifying anti-rheumatic Leflunomide (Arava)
drugs): Leflunomide - inhibits pyrimidine synthesis
- teratogenic - must wait 2 years after use to become pregnant or use
accelerated drug elimination (cholestyramine + activated charcoal)
- hepatotoxic
JAK inhibitors Tofacitinib (Xeljanz)
Baracitinib (Olumiant)
Upadacitinib (Rinvoq)
Boxed warnings: serious infections, malignancy, thrombosis
Do not use with biologic DMARDs or potent immunosuppressants
, Anti-TNF Biologic DMARDs Etanercept: Enbrel
Adalimumab: Humira
Infliximab: Remicade
Certolizumab: Cimzia
Golimumab: Simponi
Used for a variety of diseases including RA (typically add on therapy to MTX)
Needles are provided
Each has a pregnancy registry
Boxed warnings: serious infections, malignancies
Warnings: demyelinating desease, hep B reactivations, HF, hepatotoxicity,
lupus-like syndrome, seizures, myelosuppression
Can cause: injection site reactions, infection, liver damage, HF
*Do NOT use with other biologic DMARDs or live vaccines
Notes: do not shake or freeze, requires refrigeration
Anti-TNF Biologic DMARDs: Etancercept Enbrel
SC weekly
CI: doses greater than 5 mg/kg in sepsis
stored at RT for max of 14 days
inject SC into abdomen, thigh, or upper arm
Anti-TNF Biologic DMARDs: Adalimumab Humira
every other week dosing
stored at RT for max of 14 days
inject SC into abdomen or thigh
Anti-TNF Biologic DMARDs: Infliximab Remicade
Weeks 0, 2, and 6, then every 8 weeks (can treat every 4 weeks based on need)
Requires filter and is stable in NS only
Infusion rxns and delayed hypersensitivity rxns (3-12 days after admin)
Anti-TNF Biologic DMARDs: Certolizumab pegol Cimzia
Every other week
Anti-TNF Biologic DMARDs: Golimumab Simponi
Monthly
IV requires a filter
Inject SC into the abdomen, thigh, or upper arm
Other Biologic DMARDs (Non-TNF inhibitors) Rituximab: Rituxan (depletes CD20)
Anakinra: Kineret
Abatacept: Orencia
Tocilizumab: Actemra
Sarilumab: Kevzara
