North American Pharmacist Licensure
Examination(NAPLEX)
NAPLEX 2025 MORE THAN 1000 QUESTIONS
AND CORRECT ANSWERS LATEST UPLOAD
2024/2025 BEST EXAM SOLUTION RATED A+
FOR SUCCESS
North American Pharmacist Licensure Examination
Key drugs that can cause hypothyroidism - CORRECT ANSWERS "I TALC"
Interferons
Tyrosine Kinase Inhibitors
Amiodarone
Lithium
Carbamazepine
Conditions: Hashimoto's disease
Levothyroxine IV:PO - CORRECT ANSWERS 0.75:1 (IV:PO)
Full replacement dose levothyroxine - CORRECT ANSWERS 1.6 mcg/kg/day (IBW)
If known CAD: start with 12.5-25 mcg daily
Levothyroxine tablet colors - CORRECT ANSWERS Orangutans Will Vomit On You
Right Before They Become Large Proud Giants
25 Orange
50 White (no dye)
75 Violet
88 Olive
100 Yellow
112 Rose
125 Brown
137 Turquoise
150 Blue
,North American Pharmacist Licensure
Examination(NAPLEX)
175 Lilac
200 Pink
300 Green
Drug induced causes of hyperthyroidism - CORRECT ANSWERS Iodine
Amiodarone
Interferons
Radiographic contrast media
treatment for thyroid storm - CORRECT ANSWERS Antithyroid (PTU preferred- give 1
hour before iodide)
Inorganic iodide therapy (SSKI or Lugol's)
Beta Blocker (Propranolol)
Systemic steroid (dexamethasone)
Aggressive cooling (APAP, cooling blankets, supportive treatments)
Hyperthyroid in pregnancy - CORRECT ANSWERS Hyperthyroidism during
pregnancy should be treated with propylthiouracil (PTU) during the first trimester then
methimazole during the second and third trimesters. Although methimazole is a
teratogen, the teratogenic effects are less during the second and third trimesters, and
PTU can cause liver failure, which is why it is substituted out.
Cushing's syndrome - CORRECT ANSWERS Adrenal gland produces too much
cortisol or exogenous steroids are taken in doses higher than normal amounts of
endogenous cortisol
Addison's disease - CORRECT ANSWERS a condition that occurs when the adrenal
glands do not produce enough cortisol; Addisonian crisis (volume depletion and
hypotension, which can be fatal)
Steroids: least to most potent - CORRECT ANSWERS (Cute Hot Pharmacists and
Physicians Marry Together & Deliver Babies)
o Cortisone (25 mg): short acting
o Hydrocortisone (20 mg): short acting
o Prednisone (5 mg): intermediate acting
,North American Pharmacist Licensure
Examination(NAPLEX)
o Prednisolone (5 mg): intermediate acting
o Methylprednisolone (4 mg): intermediate acting
o Triamcinolone (4 mg): intermediate acting
o Dexamethasone (0.75 mg): long acting, highest potency
o Betamethasone (0.6 mg): long acting, highest potency
Immunosuppression from steroids - CORRECT ANSWERS A patient is
immunosuppressed when using >/= 2mg/kg/day or >/= 20mg/day of prednisone or
prednisone equivalent for >2 weeks
Immunosuppressed patients cannot receive live vaccines and have a high risk of
infection
steroid will need to be slowly tapered off: reduce 10-20% every few days (tapers can
last 7-14 days, longer or shorter)
Traditional DMARDs (disease modifying anti-rheumatic drugs) - CORRECT ANSWERS
MTX (Trexall): first line in RA
Hydroxychloroquine (Plaquenil)
Sulfasalazine
Leflunomide (Arava)
Traditional DMARDs (disease modifying anti-rheumatic drugs): MTX - CORRECT
ANSWERS MTX (Trexall): first line in RA
- irreversibly binds and inhibit dihydrofolate reductase, inhibiting folate
- 7.5 to 20 mg once weekly
- hepatotoxicity (avoid alcohol), myelosuppression, mucosistis/stomatitis, teratogenic
- monitor: CBC, LFTs, chest X-ray, hep B/C
- folate replacement
- renal elimination is decreased by aspirin/NSAIDs
Traditional DMARDs (disease modifying anti-rheumatic drugs): hydroxychloroquine -
CORRECT ANSWERS Hydroxychloroquine (Plaquenil)
- Irreversible retinopathy
, North American Pharmacist Licensure
Examination(NAPLEX)
- take with food or milk
- alternative to MTX in liver disease
Traditional DMARDs (disease modifying anti-rheumatic drugs): Sulfasalazine -
CORRECT ANSWERS Sulfasalazine
- CI in sulfa/salicylate allergy
- can cause yellow-orange coloration of skin/urine
- caution in patients with G6PD deficiency
Traditional DMARDs (disease modifying anti-rheumatic drugs): Leflunomide -
CORRECT ANSWERS Leflunomide (Arava)
- inhibits pyrimidine synthesis
- teratogenic - must wait 2 years after use to become pregnant or use accelerated
drug elimination (cholestyramine + activated charcoal)
- hepatotoxic
JAK inhibitors - CORRECT ANSWERS Tofacitinib (Xeljanz)
Baracitinib (Olumiant)
Upadacitinib (Rinvoq)
Boxed warnings: serious infections, malignancy, thrombosis
Do not use with biologic DMARDs or potent immunosuppressants
Anti-TNF Biologic DMARDs - CORRECT ANSWERS Etanercept: Enbrel
Adalimumab: Humira
Infliximab: Remicade
Certolizumab: Cimzia
Golimumab: Simponi
Used for a variety of diseases including RA (typically add on therapy to MTX)
Needles are provided
Each has a pregnancy registry
Boxed warnings: serious infections, malignancies
Examination(NAPLEX)
NAPLEX 2025 MORE THAN 1000 QUESTIONS
AND CORRECT ANSWERS LATEST UPLOAD
2024/2025 BEST EXAM SOLUTION RATED A+
FOR SUCCESS
North American Pharmacist Licensure Examination
Key drugs that can cause hypothyroidism - CORRECT ANSWERS "I TALC"
Interferons
Tyrosine Kinase Inhibitors
Amiodarone
Lithium
Carbamazepine
Conditions: Hashimoto's disease
Levothyroxine IV:PO - CORRECT ANSWERS 0.75:1 (IV:PO)
Full replacement dose levothyroxine - CORRECT ANSWERS 1.6 mcg/kg/day (IBW)
If known CAD: start with 12.5-25 mcg daily
Levothyroxine tablet colors - CORRECT ANSWERS Orangutans Will Vomit On You
Right Before They Become Large Proud Giants
25 Orange
50 White (no dye)
75 Violet
88 Olive
100 Yellow
112 Rose
125 Brown
137 Turquoise
150 Blue
,North American Pharmacist Licensure
Examination(NAPLEX)
175 Lilac
200 Pink
300 Green
Drug induced causes of hyperthyroidism - CORRECT ANSWERS Iodine
Amiodarone
Interferons
Radiographic contrast media
treatment for thyroid storm - CORRECT ANSWERS Antithyroid (PTU preferred- give 1
hour before iodide)
Inorganic iodide therapy (SSKI or Lugol's)
Beta Blocker (Propranolol)
Systemic steroid (dexamethasone)
Aggressive cooling (APAP, cooling blankets, supportive treatments)
Hyperthyroid in pregnancy - CORRECT ANSWERS Hyperthyroidism during
pregnancy should be treated with propylthiouracil (PTU) during the first trimester then
methimazole during the second and third trimesters. Although methimazole is a
teratogen, the teratogenic effects are less during the second and third trimesters, and
PTU can cause liver failure, which is why it is substituted out.
Cushing's syndrome - CORRECT ANSWERS Adrenal gland produces too much
cortisol or exogenous steroids are taken in doses higher than normal amounts of
endogenous cortisol
Addison's disease - CORRECT ANSWERS a condition that occurs when the adrenal
glands do not produce enough cortisol; Addisonian crisis (volume depletion and
hypotension, which can be fatal)
Steroids: least to most potent - CORRECT ANSWERS (Cute Hot Pharmacists and
Physicians Marry Together & Deliver Babies)
o Cortisone (25 mg): short acting
o Hydrocortisone (20 mg): short acting
o Prednisone (5 mg): intermediate acting
,North American Pharmacist Licensure
Examination(NAPLEX)
o Prednisolone (5 mg): intermediate acting
o Methylprednisolone (4 mg): intermediate acting
o Triamcinolone (4 mg): intermediate acting
o Dexamethasone (0.75 mg): long acting, highest potency
o Betamethasone (0.6 mg): long acting, highest potency
Immunosuppression from steroids - CORRECT ANSWERS A patient is
immunosuppressed when using >/= 2mg/kg/day or >/= 20mg/day of prednisone or
prednisone equivalent for >2 weeks
Immunosuppressed patients cannot receive live vaccines and have a high risk of
infection
steroid will need to be slowly tapered off: reduce 10-20% every few days (tapers can
last 7-14 days, longer or shorter)
Traditional DMARDs (disease modifying anti-rheumatic drugs) - CORRECT ANSWERS
MTX (Trexall): first line in RA
Hydroxychloroquine (Plaquenil)
Sulfasalazine
Leflunomide (Arava)
Traditional DMARDs (disease modifying anti-rheumatic drugs): MTX - CORRECT
ANSWERS MTX (Trexall): first line in RA
- irreversibly binds and inhibit dihydrofolate reductase, inhibiting folate
- 7.5 to 20 mg once weekly
- hepatotoxicity (avoid alcohol), myelosuppression, mucosistis/stomatitis, teratogenic
- monitor: CBC, LFTs, chest X-ray, hep B/C
- folate replacement
- renal elimination is decreased by aspirin/NSAIDs
Traditional DMARDs (disease modifying anti-rheumatic drugs): hydroxychloroquine -
CORRECT ANSWERS Hydroxychloroquine (Plaquenil)
- Irreversible retinopathy
, North American Pharmacist Licensure
Examination(NAPLEX)
- take with food or milk
- alternative to MTX in liver disease
Traditional DMARDs (disease modifying anti-rheumatic drugs): Sulfasalazine -
CORRECT ANSWERS Sulfasalazine
- CI in sulfa/salicylate allergy
- can cause yellow-orange coloration of skin/urine
- caution in patients with G6PD deficiency
Traditional DMARDs (disease modifying anti-rheumatic drugs): Leflunomide -
CORRECT ANSWERS Leflunomide (Arava)
- inhibits pyrimidine synthesis
- teratogenic - must wait 2 years after use to become pregnant or use accelerated
drug elimination (cholestyramine + activated charcoal)
- hepatotoxic
JAK inhibitors - CORRECT ANSWERS Tofacitinib (Xeljanz)
Baracitinib (Olumiant)
Upadacitinib (Rinvoq)
Boxed warnings: serious infections, malignancy, thrombosis
Do not use with biologic DMARDs or potent immunosuppressants
Anti-TNF Biologic DMARDs - CORRECT ANSWERS Etanercept: Enbrel
Adalimumab: Humira
Infliximab: Remicade
Certolizumab: Cimzia
Golimumab: Simponi
Used for a variety of diseases including RA (typically add on therapy to MTX)
Needles are provided
Each has a pregnancy registry
Boxed warnings: serious infections, malignancies
