CPJE Clinical Prep Questions With 100%
Correct Answers/Graded A+ 2025
Tylenol (I,D,Overdose) - Answer-Acetaminophen
I: fever/pain
D: 325-650mg, max < 4000mg/day from all sources
*OD = liver damage, use NAC for antidote
no anti platelet activity
DOC for pain in pregnancy or use with warfarin
/.Ofirmev (IV) (I,D,Overdose) - Answer-Acetaminophen
I: fever/pain
D: < 4000mg/day from all sources
*Can treat more severe pain
*OD = liver damage, use NAC for antidote
no anti platelet activity
/.NAC (I) - Answer-N-acetylcysteine
I: APAP overdose
Compatible with: D5W, ½ NS, and Water for Injection
Stable for 24h at room temp
/.COX-1 selective NSAIDs - Answer-indomethacin, ketorlac
COX-1 selective = higher risk for GI bleeding
/.COX-2 selective NSAIDs - Answer-Celecoxib
Diclofenac
Meloxicam
Etodolac
Nabumetone
COX-2 selective = higher risk of CV events (MI, stroke)
/.COX 1 and COX 2 non-selective NSAIDs - Answer-ibuprofen, naproxen, piroxicam,
sulindac
COX-1 = higher risk for GI bleeding
COX-2 = higher risk of CV events (MI, stroke)
/.Daypro (I,D, BBW) - Answer-Oxaprozin
I: fever/pain/inflammation
,*Similar caution to piroxicam: high risk for GI tox and severe SJS
Dose: 1200 mg once daily w/ max of 1800 mg if >50 kg
BBW: COX non-selective: GI bleeding and CV thrombotic event risk
SE: anemia, skin rash, asthma exacerbation, renal (NSAID + diuretic + ACE/ARB) /
hepatic tox (least risk with ibuprofen / celecoxib)
**FDA safety alert: Caution with use in pregnancy after 20 weeks, can cause fetal renal
tox / oligohydroaminos, avoid use after 30 weeks due to risk of premature closure of
fetal ductus arteriosus
CI: for use in patients w/ CABG surgery
requires med guide to be dispensed
/.Ascriptin, Bufferin, Ecotrin (I,D,CI,OD,BBW) - Answer-Aspirin (Bayer)
I: fever/pain/inflammation
D: 81-325mg qd
CI: pregnancy (esp 3rd trimester), OD = tinnitis
*BBW: COX-1 selectivity NSAID = GI bleed
Avoid in children < 16 with any vial infection due to potential risk of Reye's syndrome
irreversible antiplatelet, GI toxicity
/.Naprosyn (I,D,BBW) - Answer-Naproxen, Aleve
I: fever/pain/inflammation
-OTC: 220mg qd
-Rx: 250-550mg bid
*Higher GI side effects
*BBW: COX-1/2 selectivity NSAID = GI bleed and CV tox
SE: anemia, skin rash, asthma exacerbation, renal (NSAID + diuretic + ACE/ARB) /
hepatic tox (least risk with ibuprofen / celecoxib)
CI: for use in patients w/ CABG surgery
requires med guide to be dispensed
/.Motrin, Advil (I,D,BBW, SE, CI) - Answer-Ibuprofen
I: fever/pain/inflammation
Dose
-OTC: 200-400mg q 4-6 hrs
-Rx: 600-800 mg tid, max 3200mg/d
child: 10mg/kg/dose with max 40mg/kg/day
COX non-selective: GI bleeding and CV thrombotic event risk
SE: anemia, skin rash, asthma exacerbation, renal (NSAID + diuretic + ACE/ARB) /
hepatic tox (least risk with ibuprofen / celecoxib)
**FDA safety alert: Caution with use in pregnancy after 20 weeks, can cause fetal renal
tox / oligohydroaminos, avoid use after 30 weeks due to risk of premature closure of
fetal ductus arteriosus
CI: for use in patients w/ CABG surgery
requires med-guide to be dispensed
, /.Vimovo (I,D,BBW) - Answer-Naproxen + esomeprazole
I: osteoarthritis, rheumatoid arthritis, pain
D: naproxen 375/ esomeprazole 20mg or naproxen 500 mg/esomeprazole 20mg twice
daily
*less GI side effects since combo with PPI
COX non-selective: GI bleeding and CV thrombotic event risk
SE: C-diff (PPI), anemia, skin rash, asthma exacerbation, renal
**FDA safety alert: Caution with use in pregnancy after 20 weeks, can cause fetal renal
tox / oligohydroaminos, avoid use after 30 weeks due to risk of premature closure of
fetal ductus arteriosus
CI: for use in patients w/ CABG surgery
requires med-guide to be dispensed
/.Voltaren (I,D) - Answer-Diclofenac (gel)
I: pain/inflammation
Dose: 1% gel, apply 2 (hand) - 4g (knee) up to 4x daily per joint. max per joint 16g/day,
max total body use is 32g/day. Does come as 3% for actinic keratosis (scaly patch of
skin) where 0.5g is used
Comes as solution 1.5 (Klofensaid II) - 2% (Pennsaid), patch 1.3% (Flecor, Licart)
COX-2 selectivity (CV events)
SE: anemia, skin rash, asthma exacerbation, renal (NSAID + diuretic + ACE/ARB) /
hepatic tox (least risk with ibuprofen / celecoxib)
**FDA safety alert: Caution with use in pregnancy after 20 weeks, can cause fetal renal
tox / oligohydroaminos, avoid use after 30 weeks due to risk of premature closure of
fetal ductus arteriosus
CI: for use in patients w/ CABG surgery
requires med guide to be dispensed
/.Cataflam, Cambia, Zipsor, Zorvolex (I,D, BBW, SE) - Answer-Diclofenac oral
I: Gout, dysmenorrhea, ankylosing spondylitis, migraine, arthritis, pain
D: 100 - 150mg per day in divided doses (50-75mg BID)
COX-2 selectivity (CV events)
SE: edema, constipation, nausea, rash, HTN, anemia
**FDA safety alert: Caution with use in pregnancy after 20 weeks, can cause fetal renal
tox / oligohydroaminos, avoid use after 30 weeks due to risk of premature closure of
fetal ductus arteriosus
CI: for use in patients w/ CABG surgery
Requires med guide to be dispensed
/.Flector / Licart - Answer-diclofenac patch 1.3%
Flector: 1 patch (180mg) placed to most painful area BID
Licart: 1 patch daily
COX-2 selectivity (CV events)
Correct Answers/Graded A+ 2025
Tylenol (I,D,Overdose) - Answer-Acetaminophen
I: fever/pain
D: 325-650mg, max < 4000mg/day from all sources
*OD = liver damage, use NAC for antidote
no anti platelet activity
DOC for pain in pregnancy or use with warfarin
/.Ofirmev (IV) (I,D,Overdose) - Answer-Acetaminophen
I: fever/pain
D: < 4000mg/day from all sources
*Can treat more severe pain
*OD = liver damage, use NAC for antidote
no anti platelet activity
/.NAC (I) - Answer-N-acetylcysteine
I: APAP overdose
Compatible with: D5W, ½ NS, and Water for Injection
Stable for 24h at room temp
/.COX-1 selective NSAIDs - Answer-indomethacin, ketorlac
COX-1 selective = higher risk for GI bleeding
/.COX-2 selective NSAIDs - Answer-Celecoxib
Diclofenac
Meloxicam
Etodolac
Nabumetone
COX-2 selective = higher risk of CV events (MI, stroke)
/.COX 1 and COX 2 non-selective NSAIDs - Answer-ibuprofen, naproxen, piroxicam,
sulindac
COX-1 = higher risk for GI bleeding
COX-2 = higher risk of CV events (MI, stroke)
/.Daypro (I,D, BBW) - Answer-Oxaprozin
I: fever/pain/inflammation
,*Similar caution to piroxicam: high risk for GI tox and severe SJS
Dose: 1200 mg once daily w/ max of 1800 mg if >50 kg
BBW: COX non-selective: GI bleeding and CV thrombotic event risk
SE: anemia, skin rash, asthma exacerbation, renal (NSAID + diuretic + ACE/ARB) /
hepatic tox (least risk with ibuprofen / celecoxib)
**FDA safety alert: Caution with use in pregnancy after 20 weeks, can cause fetal renal
tox / oligohydroaminos, avoid use after 30 weeks due to risk of premature closure of
fetal ductus arteriosus
CI: for use in patients w/ CABG surgery
requires med guide to be dispensed
/.Ascriptin, Bufferin, Ecotrin (I,D,CI,OD,BBW) - Answer-Aspirin (Bayer)
I: fever/pain/inflammation
D: 81-325mg qd
CI: pregnancy (esp 3rd trimester), OD = tinnitis
*BBW: COX-1 selectivity NSAID = GI bleed
Avoid in children < 16 with any vial infection due to potential risk of Reye's syndrome
irreversible antiplatelet, GI toxicity
/.Naprosyn (I,D,BBW) - Answer-Naproxen, Aleve
I: fever/pain/inflammation
-OTC: 220mg qd
-Rx: 250-550mg bid
*Higher GI side effects
*BBW: COX-1/2 selectivity NSAID = GI bleed and CV tox
SE: anemia, skin rash, asthma exacerbation, renal (NSAID + diuretic + ACE/ARB) /
hepatic tox (least risk with ibuprofen / celecoxib)
CI: for use in patients w/ CABG surgery
requires med guide to be dispensed
/.Motrin, Advil (I,D,BBW, SE, CI) - Answer-Ibuprofen
I: fever/pain/inflammation
Dose
-OTC: 200-400mg q 4-6 hrs
-Rx: 600-800 mg tid, max 3200mg/d
child: 10mg/kg/dose with max 40mg/kg/day
COX non-selective: GI bleeding and CV thrombotic event risk
SE: anemia, skin rash, asthma exacerbation, renal (NSAID + diuretic + ACE/ARB) /
hepatic tox (least risk with ibuprofen / celecoxib)
**FDA safety alert: Caution with use in pregnancy after 20 weeks, can cause fetal renal
tox / oligohydroaminos, avoid use after 30 weeks due to risk of premature closure of
fetal ductus arteriosus
CI: for use in patients w/ CABG surgery
requires med-guide to be dispensed
, /.Vimovo (I,D,BBW) - Answer-Naproxen + esomeprazole
I: osteoarthritis, rheumatoid arthritis, pain
D: naproxen 375/ esomeprazole 20mg or naproxen 500 mg/esomeprazole 20mg twice
daily
*less GI side effects since combo with PPI
COX non-selective: GI bleeding and CV thrombotic event risk
SE: C-diff (PPI), anemia, skin rash, asthma exacerbation, renal
**FDA safety alert: Caution with use in pregnancy after 20 weeks, can cause fetal renal
tox / oligohydroaminos, avoid use after 30 weeks due to risk of premature closure of
fetal ductus arteriosus
CI: for use in patients w/ CABG surgery
requires med-guide to be dispensed
/.Voltaren (I,D) - Answer-Diclofenac (gel)
I: pain/inflammation
Dose: 1% gel, apply 2 (hand) - 4g (knee) up to 4x daily per joint. max per joint 16g/day,
max total body use is 32g/day. Does come as 3% for actinic keratosis (scaly patch of
skin) where 0.5g is used
Comes as solution 1.5 (Klofensaid II) - 2% (Pennsaid), patch 1.3% (Flecor, Licart)
COX-2 selectivity (CV events)
SE: anemia, skin rash, asthma exacerbation, renal (NSAID + diuretic + ACE/ARB) /
hepatic tox (least risk with ibuprofen / celecoxib)
**FDA safety alert: Caution with use in pregnancy after 20 weeks, can cause fetal renal
tox / oligohydroaminos, avoid use after 30 weeks due to risk of premature closure of
fetal ductus arteriosus
CI: for use in patients w/ CABG surgery
requires med guide to be dispensed
/.Cataflam, Cambia, Zipsor, Zorvolex (I,D, BBW, SE) - Answer-Diclofenac oral
I: Gout, dysmenorrhea, ankylosing spondylitis, migraine, arthritis, pain
D: 100 - 150mg per day in divided doses (50-75mg BID)
COX-2 selectivity (CV events)
SE: edema, constipation, nausea, rash, HTN, anemia
**FDA safety alert: Caution with use in pregnancy after 20 weeks, can cause fetal renal
tox / oligohydroaminos, avoid use after 30 weeks due to risk of premature closure of
fetal ductus arteriosus
CI: for use in patients w/ CABG surgery
Requires med guide to be dispensed
/.Flector / Licart - Answer-diclofenac patch 1.3%
Flector: 1 patch (180mg) placed to most painful area BID
Licart: 1 patch daily
COX-2 selectivity (CV events)
