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1NAPLEX practice questions Questions &Answers (RATED A)

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. Which of the following is an orally disintegrating tablet formulation of prednisolone, used to treat exacerbations of asthma and other inflammatory diseases and conditions in children? a. Celestone Soluspan b. PediaPred c. Orapred d. Vasocidin e. Juvéderm - ANSWER -1(c). Orapred ODT (Prednisolone sodium phosphate disintegrating tablets) is a sodium salt of the phosphoester of the glucocorticoid prednisolone. It is indicated in the treatment of the atopic dermatitis, Crohn's disease, ulcerative colitis and acute exacerbations of chronic obstructive pulmonary disease (COPD). Dosage of Orapred ODT should be individualized according to the severity of the disease and the response of the patient. The initial dose of Orapred ODT may vary from 10 to 60 mg (prednisolone base) per day, depending on the specific disease entity being treated. Fluid retention, alteration in glucose tolerance, elevation in blood pressure, behavioral and mood changes, increased appetite and weight gain are commonly reported side effects of Orapred. 2. An active ingredient of Ablecet (and recommended dosage) is: a. Rifampicin b. Ketoconazole c. Amphotericin B d. Lisinopril e. Isradipine - ANSWER -2(c). The active ingredient of Abelcet is Amphotericin B. It is also available under the following trade names: Amphotec (a powder for injection), and Ambisome (a liposomal form). It should be given parenterally via an I.V. infusion. It is an antifungal agent. It is indicated for the treatment of invasive fungal infections caused by invasive aspergillosis. The recommended daily dosage for adults and children is 5 mg/kg given as a single infusion. Abelcet should be administered by intravenous infusion at a rate of 2.5 mg/kg/h. If the infusion time exceeds 2 hours, mix the contents by shaking the infusion bag every 2 hours. Patients should be pretreated with antipyretics, antihistamines, antiemetics and with Meperidine to reduce the signs and symptoms of shaking chills and fever. Abdominal pain, anorexia, anxiety, hypokalemia, anemia, nephrotoxicity and diarrhea are reported side effects of the drug. 5. What is the name of the active ingredient in Xolegel? a. Fluconazole b. Metronidazole c. Ketoconazole d. Itraconazole e. Clotrimazole - ANSWER -5(c). Xolegel contains the antifungal agent Ketoconazole 2% in a topical anhydrous gel vehic

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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)
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