NAPLEX PHARMACY FOUNDATION TEST BANK NEWEST
ACTUAL QUESTIONS WITH WELL ELABORATED
ANSWERS (100% CORRECT VERIFIED ANSWERS) LATEST
UPDATED VERSION |GUARANTEED PASS. (BRAND
NEW!!)
Abacavir HLA test - ANSWER: HLA-B*5701
if positive, DO NOT USE due to hypersensitivity
Allopurinol HLA test - ANSWER: HLA-B*5801
if positive DO NOT USE due to SJS
what meds do you test HLA-B*1502 for - ANSWER: Carbemazepine
Oxcarbazepine
Phentoin, Fosphenytoin
HLA test for trileptal - ANSWER: HLA-B*1502
increased risk of SJS, toxic epidermal necrolysis (TEN)
what do you test for clopidogrel start - ANSWER: CYP2C19*1 (functional)
CYP2C19*2 or *3 consider alternatives
(less active metabolite formed - increased clotting risk)
what do you test for codeine start - ANSWER: CYP2D6
Codeine is a pro-drug, if you are ultra rapid metabolizer you have increased toxicity
risk
what do you test for warfarin start - ANSWER: CYP2C9 and VKORC1
increased bleeding risk if CYP2C9*2 and *3 and VKORC1 (start at lower doses)
Traztusumab requires ___gene expression - ANSWER: HER2+, if HER2- drug will not
work
cetuximab requires _____ mutation - ANSWER: KRAS-negative (if Kras + CANNOT
USE)
Capecitabine, fluorouracil require ____ gene expression - ANSWER: if
dihydrophyrimidine dehydrogenase (DPD) deficient, increased risk for severe toxicity
(diarrhea, neutropenia, neurotxocity)
testing is required/strongly recommended for the following: - ANSWER: abacavir
azathioprine
carbemazepine
cetuximab and panitumumab
trastuzumab, ado-traztusumab, lapatinib, pertunzumab
, (may consider yet not routine: allopurinol, capecitabine/5FU, clopidogrel, codeine,
phenytoin/fosphenytoin, warfarin)
genetic test for azathioprine - ANSWER: TPMT (thiopurine methytransferase)
low/absent TPMT activity increases risk of severe myelosupression
if TPMT is low/absent, start at very low dose or consider alternative treatment
risks of saint johns wort - ANSWER: 1. enzyme inducer (3A4, 2C19, 2C9, 1A2, PGP)
2. serotengeric (do not use with MAOI, SSRI, SNRI)
3. photosensitivity (avoid with other photosensitive drugs)
4. lowers seizure threshold
supplements that increase bleeding risk - ANSWER: 1. 5 G's (garlic, ginger, gingko,
ginseng, glucosamine)
2. fish oils (at higher doses)
3. vitamine E
4. Dong quai
5. Willow bark (salicylate)
depleted nutrient with antiepilleptics - ANSWER: calcium (or sodium, depends on
MOA)
depleted nutrients with ampho B - ANSWER: magnesium, potassium
depleted nutrients with isoniazid - ANSWER: vitamin B6
depleted nutrient with metformin - ANSWER: vitamin B12
depleted nutrient with methotrexate - ANSWER: folate
depleted nutrient with orlistat - ANSWER: beta-carotene, fat-soluble vitamins
depleted nutrients with proton pump inhibitors - ANSWER: magnesium, vitamin B12
(> 2 years of treatment)
what do you give for bradycardia - ANSWER: atropine, inotropes
what do you give for QRS widening - ANSWER: sodium bicarbonate
activated charcoal dose - ANSWER: 1 g/kg (must be given one hour of ingestion for
orally ingested drugs)
contraindicated in patients when airway is unprotected
APAP overdose treatment - ANSWER: N-acetylchestine - restores hepatic glutathione
ACTUAL QUESTIONS WITH WELL ELABORATED
ANSWERS (100% CORRECT VERIFIED ANSWERS) LATEST
UPDATED VERSION |GUARANTEED PASS. (BRAND
NEW!!)
Abacavir HLA test - ANSWER: HLA-B*5701
if positive, DO NOT USE due to hypersensitivity
Allopurinol HLA test - ANSWER: HLA-B*5801
if positive DO NOT USE due to SJS
what meds do you test HLA-B*1502 for - ANSWER: Carbemazepine
Oxcarbazepine
Phentoin, Fosphenytoin
HLA test for trileptal - ANSWER: HLA-B*1502
increased risk of SJS, toxic epidermal necrolysis (TEN)
what do you test for clopidogrel start - ANSWER: CYP2C19*1 (functional)
CYP2C19*2 or *3 consider alternatives
(less active metabolite formed - increased clotting risk)
what do you test for codeine start - ANSWER: CYP2D6
Codeine is a pro-drug, if you are ultra rapid metabolizer you have increased toxicity
risk
what do you test for warfarin start - ANSWER: CYP2C9 and VKORC1
increased bleeding risk if CYP2C9*2 and *3 and VKORC1 (start at lower doses)
Traztusumab requires ___gene expression - ANSWER: HER2+, if HER2- drug will not
work
cetuximab requires _____ mutation - ANSWER: KRAS-negative (if Kras + CANNOT
USE)
Capecitabine, fluorouracil require ____ gene expression - ANSWER: if
dihydrophyrimidine dehydrogenase (DPD) deficient, increased risk for severe toxicity
(diarrhea, neutropenia, neurotxocity)
testing is required/strongly recommended for the following: - ANSWER: abacavir
azathioprine
carbemazepine
cetuximab and panitumumab
trastuzumab, ado-traztusumab, lapatinib, pertunzumab
, (may consider yet not routine: allopurinol, capecitabine/5FU, clopidogrel, codeine,
phenytoin/fosphenytoin, warfarin)
genetic test for azathioprine - ANSWER: TPMT (thiopurine methytransferase)
low/absent TPMT activity increases risk of severe myelosupression
if TPMT is low/absent, start at very low dose or consider alternative treatment
risks of saint johns wort - ANSWER: 1. enzyme inducer (3A4, 2C19, 2C9, 1A2, PGP)
2. serotengeric (do not use with MAOI, SSRI, SNRI)
3. photosensitivity (avoid with other photosensitive drugs)
4. lowers seizure threshold
supplements that increase bleeding risk - ANSWER: 1. 5 G's (garlic, ginger, gingko,
ginseng, glucosamine)
2. fish oils (at higher doses)
3. vitamine E
4. Dong quai
5. Willow bark (salicylate)
depleted nutrient with antiepilleptics - ANSWER: calcium (or sodium, depends on
MOA)
depleted nutrients with ampho B - ANSWER: magnesium, potassium
depleted nutrients with isoniazid - ANSWER: vitamin B6
depleted nutrient with metformin - ANSWER: vitamin B12
depleted nutrient with methotrexate - ANSWER: folate
depleted nutrient with orlistat - ANSWER: beta-carotene, fat-soluble vitamins
depleted nutrients with proton pump inhibitors - ANSWER: magnesium, vitamin B12
(> 2 years of treatment)
what do you give for bradycardia - ANSWER: atropine, inotropes
what do you give for QRS widening - ANSWER: sodium bicarbonate
activated charcoal dose - ANSWER: 1 g/kg (must be given one hour of ingestion for
orally ingested drugs)
contraindicated in patients when airway is unprotected
APAP overdose treatment - ANSWER: N-acetylchestine - restores hepatic glutathione
