Naplex 2026

NAPLEX 2026 EXAM QUESTIONS WITH CORRECT VERIFIED ANSWERS | 100% PASS (A+ CERTIFIED) Intranasal steroids Answer 1st line for chronic, moderate-to-severe allergy sx Budesonide (Rhinocort allergy) Fluticasone (Flonase) Triamcinolone (nasacort) AEs: epistaxis Can take up to 1 week to get full relief Budesonide, beclomethasone preferred in pregnancy First Generation antihistamines Answer mild-moderate allergy symptoms Diphenydramine (Benadryl): 25 mg q4-6h or 50 mg q6-8h (max 300 mg/day) Chlorpheniramine (Aller-chlor) Doxylamine (unisom) *avoid in elderly; use caution in patients with CV disease, prostate enlargement, glaucoma, asthma, thyroid disease AE: somnolence, cognitive impairment, anticholinergic effects Second generation oral antihistamines Answer Cetirizine (Zyrtec) Levocetirizine (Xyzal) Fexofenadine (Allegra): take with water, not fret juice Loratadine (Claratin) Use loratadine and cetirizine in pregnancy cetirizine and levocetirizine have fast onset more sedating: cetirizine, levocetirizine less sedating: fexofenadine, loratadine Intranasal antihistamines Answer Azelastine (Astellin, Astepro) can be combined with intranasal steroid Decongestants Answer max amount allowed: 3.6 g/day, 9 g in 30 days Phenlephrine (Sudafed PE) Pseudoephedrine (Sudafed, Nexafed, Zephrex-D) Avoid in children 2 (FDA), 4 (package labeling) Caution in CV disease, uncontrolled htn, hyperthyroidism, diabetes, bowel obstruction, glaucoma, BPH, renal impairment, seizure disorder, elderly CI: do not use within 14 days of MAOIs *onset 15-30 minutes Intranasal decongestants Answer Oxymetazoline (Afrin) CI: do not use for more than 3 days Warning: do not use with MAOis, caution in CV disease/uncontrolled htn/diabetes/bph AE: rebound congestion if used longer than 3 days Intranasal Cromolyn Answer OTC mast cell stabilizer for tx/prophy of allergic rhinitis used regularly, not PRN safe for children /=2 and pregnancy Montelukast (Singulair) Answer Leukotriene modifying agent used for tx of allergic rhinitis and asthma Commonly used in children Intranasal ipratropium Answer effective for decreasing rhinorrhea by causing nasal dryness Immunotherapy Answer Preventative treatment for allergies - SQ, SL Slowly increase exposure to allergen; first dose must be given in medical office where pt can be monitored for at least 30 minutes for s/sx of allergic rxn - epi pen rx Oralair: 5 different grass pollen extracts Grastek: Timothy grass pollen extracts Ragwitek: ragweed pollen extract Odactra: house dust mite allergen extract Natural products used for colds Answer Zinc - Do not use longer than 5-7 days because it cause copper deficiency - Do not recommend zinc nasal swab or nasal spray due to risk of loss of smell Vitamin C - may decrease duration of cold