1NAPLEX practice questions Questions &Answers (RATED A)

NAPLEX STUDY SET (EVERYTHING)
QUESTIONS WITH CORRECT ANSWERS
Hypercalcemia is caused by the following medications - ANSWER -Vitamin D,
Thiazide Diuretics

Hypocalcemia caused by the following medications - ANSWER -Long term Heparin
Loop Dirtuetics
Bisphosphonates
Cinacalcet, calcitonin, Foscamet
Topiramate

Hyper-magnesium caused by the following medications - ANSWER -Antacids (Makes
sense because contain mg)
Laxatives (Phillips milk of magnesia)

Hypo-magnesium caused by the following medications - ANSWER -PPIs
Diruetics
Amphotericin

Hyper phosphatemia caused by - ANSWER -Renal Failure

Hypo-phosphatemia caused by - ANSWER -Phosphate binders

Hyper-Natremia caused by - ANSWER -Hypertonic Saline

Hypo-Natremia caused by - ANSWER -Diruetics
SSRI
Carbamazepine
Oxcarbamazepine

Increase Bicarbonate caused by - ANSWER -Loop Diuretics
Systemic steroids

What are some medications that decrease bicarb levels - ANSWER -Topiramate
Zonisamide
Salicylate Overdose (make sense because its an acid)

What is the use of Blood Urea Nitrogen (BUN) - ANSWER -Used to asses fluid status
Increase in renal impairment and dehydration

ABX that cause QT Prolongation - ANSWER -Quinolones and Macrolides

,Anti Fungals that cause QT Prolongation - ANSWER -Azole Antifungal except
Isavuconazonium

Anti emetic drugs that cause QT prolongation - ANSWER -5HT3 Receptor Antagonist
Drosperidol and phenothiazines

Anti psychotics that cause QT prolongation - ANSWER -Most of them do (Less common
ones include thioraridazine,)

Anti Arrhythmic drug class that cause QT prolonagtion - ANSWER -Class Ia and Ic and
Class III

Anti depressants that cause QT prolonagtion (most of the classes) - ANSWER -Tri-
cyclics, SSRIs, SNRI
Mirtazepine and trazadone

Setraline is preffered in patients with Heart conditons

Class Ia Anti-arrhythmics MOA - ANSWER -Negative ionotrophs

Disopyramide, Quinidine, Procainamide
(Double , Quater Pounder)

Class II Anti-arrhythmics MOA - ANSWER -Block Sympathetic Activity which decrease
HR
Beta Blockers

Because

Class Ib Anti-arrhythmics MOA - ANSWER -Same MOA as Class Ia

Lidocaine, Mexiletine
Lettuce, Mayo

Class Ic Anti arrhythmic Drugs - ANSWER -Flecainide, Propafenone
Fries, Please

Class III Anti-arrhythmics MOA - ANSWER -Block K+ channels, alpha and beta
adrenergic receptors, Ca2+ and Na+ Channels (Block every channel)

Dronedarone, Dofetilide, Sotalol, Isbutilide, Amiodarone (Bolded = Preferred in HF)

*Dieting During Stress Is Always*

Class IV Anti-arrhythmics MOA - ANSWER -Slow rate in V-tach, Negative Ionotropic

,Verapimil, Diltiazem,
(Very Difficult)
**Donot use in HF*

Characteristics of Amiodarone - ANSWER -- BBW: Pulmonary, Liver, Eye toxicity
- Hypothyrodism and hypethyrodism
- Avoid in Iodine sensitivty
- Correct Electrolyes (HYPO- Kalemia, Magnesemia, Calcemia)
- Monitor LFT and Thyroid Q6 mos
- Decrease Warfarin and digoxin dose by 50%
- No more than Lovastatin or Simvastatin 40mg/dy
- Additive effect with drugs that decrease HR ( BB, NDHP CCB, Digoxin, clonidine,
precedex)
- Use filter 0.22 micron

Characteristics of NDHPs CCB - ANSWER -only CCB to be used in Arrhythmias,
SE: Edema, constipation, Gingival Hyperplasia

Characteristics of Digoxin - ANSWER -Add on in HF and Arrhythmia
Typical dose: 0.125-0.25mg
Decrease dose by 20-25% IV-PO
Toxicity: N/V, appetite loss, bradycardia
Worsening toxicity: Blurred vision, greenish yellow halos

DIGITAB: ANTIDOTE

HYPO (Kalemia, Magnesemia, thyrodism) HYPER (calcemia) increase digoxin levels

Characteristics of Quinidine - ANSWER -Use in arrhythmias
Avoid in GDP6 deficiency (cause hemolysis)
SE: DILE, Diarrhea,
toxicity: Cinchonism (Tinnitus, blurred vision, delirium)
Take with food/ milk to avoid GI upset

Increase in alkaline food and Decrease in Na+ increase drug levels

Characteristics of Dronedarone - ANSWER -BBW: Increase risk of death in HF or
Permanent AFIB
Causes: liver failure and PF
SE: QT prolongation

Does not contain iodine
*Decrease digoxin by 50%*

Clopidogrel - ANSWER -Anti-Platelet and pro-drug that irreversibly binds to P2Y12.

, Stop 5 days prior to surgery
Do not use esomeprazole and omeprazole
Can cause Thrombocytopenia Pupura is d/c prematurely.

*Metabolized by 2C19.*

Gram Positive Bacteria Cocci - ANSWER -Streptococcus Pyogene
Steptococcus Pneumoniae
Enterococcus (VRE)
Staph Aureus

Gram Positive Bacteria Rods - ANSWER -Listeria Monocytes

Gram Positive Anaerobes - ANSWER -Peptostreptococcus
Actinomyces
Clostridium

Gram Negative Bacteria Cocci - ANSWER -Neiseria Gonorhea

Gram Negative Rods that colonize the gut - ANSWER -Proteus Mirabilis
E-coli
Klebsilla Pneumonaie
Serratis
Enterobacter and Citro Bacter

PEK and SEC (Which is part of capes)

Gram Negative Rods that DONOT colonize the gut - ANSWER -Pseudmonas
Aeuruginosa
H-flu

Gram Negative Anaerobes - ANSWER -Bacteroides fragilis
Prevotella species

Gram Negative coccobacilli - ANSWER -Acinetobacter baumannii
Bordetella pertussis
Moraxella catarrhalis

Gram Negative curved and spiral - ANSWER -H-pylori
Treponema species

Common Resistant Pathogens - ANSWER -- K. pnemoniae (ESBL, CRE)
- E. coli (ESBL,CRE)
- Acinetobacter baumannii
- E. faecalis/faecium (VRE)
- S. aureus (MRSA)