NAPLEX Practice Actual Questions with 100% Correct Answers

NAPLEX Practice Actual Questions with 100% Correct Answers what type of metabolism do tacrolimus and cyclosporine undergo? these are both CYP3A4 & PgP SUBSTRATES susceptible to many drug interactions by GPACMAN & PS PORCS can erythopoetin / erythropoietin stimulating agents increase BP? yes! must monitor BP w/ ESA also, remember these can worsen cancer growth also, Hg must be 10 to use them used in anemias... ESRD and cancer anemia what are the class effects of SSRI's? - sexual dysfunction - dry mouth - tremor and insomnia AND dizziness/somnolence - hyponatremia/SIADH - sertraline, citalopram, escilatopram, etc what are the class effects of NSAIDS? must be able to list them all and quickly identify - cause fluid retention which INCREASES BP - RENAL IMPAIRMENT; hurt the kidneys! - INCREASE RISK OF STROKE (especially those that are COX2 selective like nabumetone, Mobic, Celecoxib) - increase POTASSIUM - intestinal PERFORATION and BLEEDING and stomach ULCERS - rash they DO NOT increase BG! what are the class effects of BB? which BB are non-selective? non-selective = BAM; bisoprolol, atenolol, metropolol what are the class effects of CCB? - peripheral edema - amlodipine, felodipine what are the class effects of atypical/second generation antipsychotics? what are the class effects of steroids acutely vs long term? acute - insomnia, agitation/mood changes, long term - osteoporosis (need to supplement), cushing's syndrome, what are the 1st line induction and then maintenance drugs of transplant? what do these drugs do? 1st line for maintenance is basiliximab (Simulect), however, antithymocyte globulin can be used in high risk patients 1st line for maintenance is tacrolimus AND mycophenolate PLUS/MINUS prednisone these drugs WEAKEN the immune system so that it doesn't find back against the newly transplanted organ; termed immunosuppressants What are the contraindications to estrogen? - current or past history of VTE - liver disease - current or past history of estrogen dependent cancer - abnormal bleeding - pregnancy NEED TO ADD THE REST! are the triptans used in migraines serotonin receptor agonists or antagonists? agonists! agonist of 5HT = vasoconstriction which reduces the vasodilation that causes the migraine when you see these drug names, you should automatically think of a drug interaction problem - phenytoin, smoker, phenobarbital, oxcarbazepine, rifampin, CARBAMAZEPINE, st. john's wort (PS PORCS = inducers) = PS PORCS - grapefruit, protease inhibitors (-navir), itraconazole/ketoconazole (azole antifungals), cimetidine/cyclosporine/cipro, macrolides (azithromycin, erythromycin), amiodarone, non DHP CCB (verapamil, diltiazem) = G PACMAN - warfarin (2C9); - cyclosporine, CYP3A4 and Pgp substrate - tacrolimus, CYP3A4 and Pgp substrate which beta blockers are approved to be used in heart failure metoprolol SUCCINATE, carvedilol, and bisoprolol which electrolyte disturbance can potentiate toxicity with digoxin? LOW potassium what dose FAST stand for in the acronym for a stroke? Face; look for drooping Arms; downward drift Speech; slurred Time; call 911 now whats given with cisplatin to reduce nephrotoxicity? Amifostine (Ethyol) prophylactically to reduce nephrotoxicity with cisplatin what is the max lifetime dose of doxorubicin? 450 to 550 mg/m2 What are the two indications of Zinecard and Totect, respectively? both used with doxorubicin active ingredient is dexrazoxane Zinecard - PROPHYLAXIS for doxorubicin induced cardiomyopathy Totect - TREATMENT for anthracycline extravasation what are the appropriate adjuvant medication pairs and indications for these chemotherapeutic agents? 1- cisplatin 2- methotrexate 3- ifosfamide 4- doxorubicin 5- irinotecan 6- 1- cisplatin: Ethyol (amifostine); prophylaxis; nephrotoxicity 2- methotrexate: leucovorin; given after; mucositis 3- ifosfamide: Mesna (Mesnex); prophylaxis; hemorrhagic cystitis 4- doxorubicin: dexrazoxane - Zinecard; prophylaxis; cardiomyopathy; Totect; treatment; extravasation 5- irinotecan: Atropine; prophylaxis; diarrhea 6- which chemo agent has highest rate (90%) of nausea risk? cisplatin what is the mechanism of action of zofran? serotonin receptor ANTAGONIST (the triptans are agonists but zofran is an ANTagonist) what are the side effects and long-term/chronic side effects of phenytoin therapy? AE: LONG TERM: - hair growth - gingival hyperplasia - skin thickening - peripheral neuropathy - LIVER toxicity - increased BG