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NAPLEX Exam 86 Questions with Verified Answers
If a patient is taking aspirin and ibuprofen (cardio and pain), how should they separate them? - CORRECT ANSWER Take aspirin 1 hour before or 8 hours after ibuprofen How do NSAIDs effect blood pressure? - CORRECT ANSWER Can raise it Max dose of diclofenac gel? - CORRECT ANSWER 32 grams daily Diclofenac gel dose for feet, ankles, and knee? - CORRECT ANSWER 4 grams QID Pediatric dosage of acetaminophen - CORRECT ANSWER 10-15 mg/kg/dose q4- 6hours Max 5 doses/day Pediatric dosage of ibuprofen - CORRECT ANSWER 5-10 mg/kg/dose q6-8h Max 40 mg/kg/day REMs exist for all opioids of this type - CORRECT ANSWER ER and LA Patients who are rapid 2D6 metabolizers should avoid what pain medication? - CORRECT ANSWER Codeine Dosage for Duragesic - CORRECT ANSWER 1 patch q72h Boxed warning on fentanyl - CORRECT ANSWER Use with strong or moderate CYP3A4 inhibitors may increase effect Fentanyl can only be used for this type of pain - CORRECT ANSWER Chronic What are the requirements for a patient to be converted to fentanyl - CORRECT ANSWER 60 morphine milligram equivelents (MME)/day for at least 7 days
What type of opioid should be removed prior to MRI - CORRECT ANSWER Patches (dispose in toilet) Boxed warning on hydrocodone ER (Vantrela ER) - CORRECT ANSWER Initiation of strong 3A4 inhibitors or stopping induces can cause overdose Methadone Boxed warning - CORRECT ANSWER QT prolongation Describe methadones half-life - CORRECT ANSWER Variable Risk of using methadone or Meperidine with SSRIs - CORRECT ANSWER Serotonin syndrome Warning on Meperidine - CORRECT ANSWER Renal impairment (can accumulate and cause seizures) Avoid for pain management Side effects of morphine - CORRECT ANSWER N/V Dizziness Pruritis (may need antihistimine) Boxed warning on oxycodone - CORRECT ANSWER Initiation of strong 3A inhibitors or stopping induces can cause overdose How should oxymorphone (Opana) be taken? - CORRECT ANSWER On an empty stomach Boxed warning for Tramadol - CORRECT ANSWER Seizure Risk Serotonin Syndrome Do not use in breastfeeding mothers Tramadol is contraindicated in this population - CORRECT ANSWER Younger than 12, or 18 years following tonsillectomy/adenoidectomy Tapentadol contraindications (Nucynta) - CORRECT ANSWER MAOi use
These two opioids contain morphine + naltrexone and the capsules can be opened to release beads, however should not be crushed - CORRECT ANSWER Kadian Embeda Boxed warning on Amphotericin B - CORRECT ANSWER Verify what formulation you have. Conventionaldoses should not exceed 1.5 mg/kg/day Cardiopulmonary arrest Side effects of Amphotericin B - CORRECT ANSWER Infusion-related fevers, chills, HA, Malaise, Rigors Nephrotoxicity Potassium and Magnesium wasting Medications that patients receiving Amphotericin B deoxycholate should be pre- medicated with. - CORRECT ANSWER Acetaminophen or NSAID Diphenhydramine or Hydrocortisone Meperidine NS bolus Flucytosine should always be used with what medication to prevent resistance - CORRECT ANSWER Amphotericin B Flucytosine side effects - CORRECT ANSWER Myelosuppression Hepatitis Only this azole requires renal dosing - CORRECT ANSWER Fluconazole Drug of choice for Aspergillis - CORRECT ANSWER Voriconazole This azole oral suspension and tablets/capsules are not bioequivalent - CORRECT ANSWER Posaconazole Itraconazole Boxed Warning for Ketoconazole - CORRECT ANSWER Hepatotoxicity
Contraindicated with cisapride, dofetilide, pimozide, quinidine (arrhythmias) Should only be used as last resort (oral) Boxed warning for itraconazole - CORRECT ANSWER CI for treatment of anychomycosis in patients with ventricular dysfunction or history of HF QT prolongation All azoles have this side effect - CORRECT ANSWER Increased LFT Voriconazole side effects - CORRECT ANSWER Visual changes Increased LFT Increase SCr CNS toxicity QT prolongation Avoid direct sunlight Should Voriconazole Suspension be refrigerated? - CORRECT ANSWER No Side effects of Posaconazole - CORRECT ANSWER QT prolongation Increased LFG Potassium and Magnesium wasting What antifungal requires a 0.2-1.2 micron filter during administration - CORRECT ANSWER Isavuconazonium Sulfate (Cresemba) What three azoles have pH dependent absorption - CORRECT ANSWER Itraconazole Ketoconazole Posaconazole Echinocandins mechanism of action - CORRECT ANSWER Inhibit synthesis of beta (1,3)-D-glucan, a component of the cell wall Side effects for echinocandins - CORRECT ANSWER Increased LFT Hypotension Decreased potassium and Magnesium
T/F: Itraconazole solutions and tablets should be taken with food - CORRECT ANSWER Fales: Tablets: food Solution: empty stomach How quickly should neuraminidase inhibitors be started? - CORRECT ANSWER 48 hours Dosing of oseltamivir if over 12 and for tx - CORRECT ANSWER 75 mg BID x 5 days Dosing of oseltamivir if over 12 and used for ppx - CORRECT ANSWER 75 mg x 10 days Side effects for oseltamivir - CORRECT ANSWER Headache and vomitings. Neuropsychiatriv events Side effects of Zanamivir (NA inhibit) - CORRECT ANSWER Neuropsychiatric events Bronchospasms Side effects of acyclovir (zovirax), Valacyclyovir (valtrex) and Famciclovir (famvir) for Herpes - CORRECT ANSWER Malase headache NVD Increase SCr and crystal nephropathy with IV acyclovir How is the dose of acyclovir calculated - CORRECT ANSWER IBW in obese patients Treatment for genital herpes should start how quickly - CORRECT ANSWER Within 1 day of lesion onse Treatment for invasive HSV encephalitis infections - CORRECT ANSWER IV acyclovir What time frame is shingles therapy most effective? - CORRECT ANSWER Started within 72 hours of symptoms Zostavax - CORRECT ANSWER Prevents shingles
approved for 50+ Recommeneded for 60+ Can be given to people who have had shingles outbreaks Treatment of choice for cytomegalovirus (CMV) - CORRECT ANSWER Ganciclovir Valganciclovir Side effects and boxed warnings for ganciclovir and valganciclovir - CORRECT ANSWER Boxed warning: myelosuppression SE: thrombocytopenia, neutropenia, leukopenia, anemia Should valganciclovir suspension be refrigerated? - CORRECT ANSWER Yes Cidofovir is approved for the treatment of CMV infections in what patient population - CORRECT ANSWER HIV only Boxed warning for foscarnet (foscavir) - CORRECT ANSWER renal impairment Seizures Electrolyte imbalanceq What is the treatment for the Epstein-Barr Virus - CORRECT ANSWER No treatment Treatment for first episode of HSV2 gnatil lesions - CORRECT ANSWER Acyclovir Valtrex Famvir for 7-10 days amphotericin B is only capatible with what solution? - CORRECT ANSWER D5W
