NAPLEX Practice Actual Questions with 100%
Correct Answers
what type of metabolism do tacrolimus and cyclosporine undergo?
these are both CYP3A4 & PgP SUBSTRATES
susceptible to many drug interactions by GPACMAN & PS PORCS
can erythopoetin / erythropoietin stimulating agents increase BP?
yes! must monitor BP w/ ESA
also, remember these can worsen cancer growth
also, Hg must be <10 to use them
used in anemias... ESRD and cancer anemia
what are the class effects of SSRI's?
- sexual dysfunction
- dry mouth
- tremor and insomnia AND dizziness/somnolence
- hyponatremia/SIADH
- sertraline, citalopram, escilatopram, etc
what are the class effects of NSAIDS? must be able to list them all and quickly identify
- cause fluid retention which INCREASES BP
- RENAL IMPAIRMENT; hurt the kidneys!
- INCREASE RISK OF STROKE (especially those that are COX2 selective like nabumetone, Mobic,
Celecoxib)
- increase POTASSIUM
- intestinal PERFORATION and BLEEDING and stomach ULCERS
- rash
they DO NOT increase BG!
what are the class effects of BB?
which BB are non-selective?
non-selective = BAM; bisoprolol, atenolol, metropolol
what are the class effects of CCB?
- peripheral edema
- amlodipine, felodipine
what are the class effects of atypical/second generation antipsychotics?
what are the class effects of steroids acutely vs long term?
acute - insomnia, agitation/mood changes,
long term - osteoporosis (need to supplement), cushing's syndrome,
, what are the 1st line induction and then maintenance drugs of transplant? what do these drugs do?
1st line for maintenance is basiliximab (Simulect), however, antithymocyte globulin can be used in
high risk patients
1st line for maintenance is tacrolimus AND mycophenolate PLUS/MINUS prednisone
these drugs WEAKEN the immune system so that it doesn't find back against the newly transplanted
organ; termed immunosuppressants
What are the contraindications to estrogen?
- current or past history of VTE
- liver disease
- current or past history of estrogen dependent cancer
- abnormal bleeding
- pregnancy
NEED TO ADD THE REST!
are the triptans used in migraines serotonin receptor agonists or antagonists?
agonists! agonist of 5HT = vasoconstriction which reduces the vasodilation that causes the migraine
when you see these drug names, you should automatically think of a drug interaction problem
- phenytoin, smoker, phenobarbital, oxcarbazepine, rifampin, CARBAMAZEPINE, st. john's wort (PS
PORCS = inducers) = PS PORCS
- grapefruit, protease inhibitors (-navir), itraconazole/ketoconazole (azole antifungals),
cimetidine/cyclosporine/cipro, macrolides (azithromycin, erythromycin), amiodarone, non DHP CCB
(verapamil, diltiazem) = G PACMAN
- warfarin (2C9);
- cyclosporine, CYP3A4 and Pgp substrate
- tacrolimus, CYP3A4 and Pgp substrate
which beta blockers are approved to be used in heart failure
metoprolol SUCCINATE, carvedilol, and bisoprolol
which electrolyte disturbance can potentiate toxicity with digoxin?
LOW potassium
what dose FAST stand for in the acronym for a stroke?
Face; look for drooping
Arms; downward drift
Speech; slurred
Time; call 911 now
whats given with cisplatin to reduce nephrotoxicity?
Amifostine (Ethyol) prophylactically to reduce nephrotoxicity with cisplatin
what is the max lifetime dose of doxorubicin?
Correct Answers
what type of metabolism do tacrolimus and cyclosporine undergo?
these are both CYP3A4 & PgP SUBSTRATES
susceptible to many drug interactions by GPACMAN & PS PORCS
can erythopoetin / erythropoietin stimulating agents increase BP?
yes! must monitor BP w/ ESA
also, remember these can worsen cancer growth
also, Hg must be <10 to use them
used in anemias... ESRD and cancer anemia
what are the class effects of SSRI's?
- sexual dysfunction
- dry mouth
- tremor and insomnia AND dizziness/somnolence
- hyponatremia/SIADH
- sertraline, citalopram, escilatopram, etc
what are the class effects of NSAIDS? must be able to list them all and quickly identify
- cause fluid retention which INCREASES BP
- RENAL IMPAIRMENT; hurt the kidneys!
- INCREASE RISK OF STROKE (especially those that are COX2 selective like nabumetone, Mobic,
Celecoxib)
- increase POTASSIUM
- intestinal PERFORATION and BLEEDING and stomach ULCERS
- rash
they DO NOT increase BG!
what are the class effects of BB?
which BB are non-selective?
non-selective = BAM; bisoprolol, atenolol, metropolol
what are the class effects of CCB?
- peripheral edema
- amlodipine, felodipine
what are the class effects of atypical/second generation antipsychotics?
what are the class effects of steroids acutely vs long term?
acute - insomnia, agitation/mood changes,
long term - osteoporosis (need to supplement), cushing's syndrome,
, what are the 1st line induction and then maintenance drugs of transplant? what do these drugs do?
1st line for maintenance is basiliximab (Simulect), however, antithymocyte globulin can be used in
high risk patients
1st line for maintenance is tacrolimus AND mycophenolate PLUS/MINUS prednisone
these drugs WEAKEN the immune system so that it doesn't find back against the newly transplanted
organ; termed immunosuppressants
What are the contraindications to estrogen?
- current or past history of VTE
- liver disease
- current or past history of estrogen dependent cancer
- abnormal bleeding
- pregnancy
NEED TO ADD THE REST!
are the triptans used in migraines serotonin receptor agonists or antagonists?
agonists! agonist of 5HT = vasoconstriction which reduces the vasodilation that causes the migraine
when you see these drug names, you should automatically think of a drug interaction problem
- phenytoin, smoker, phenobarbital, oxcarbazepine, rifampin, CARBAMAZEPINE, st. john's wort (PS
PORCS = inducers) = PS PORCS
- grapefruit, protease inhibitors (-navir), itraconazole/ketoconazole (azole antifungals),
cimetidine/cyclosporine/cipro, macrolides (azithromycin, erythromycin), amiodarone, non DHP CCB
(verapamil, diltiazem) = G PACMAN
- warfarin (2C9);
- cyclosporine, CYP3A4 and Pgp substrate
- tacrolimus, CYP3A4 and Pgp substrate
which beta blockers are approved to be used in heart failure
metoprolol SUCCINATE, carvedilol, and bisoprolol
which electrolyte disturbance can potentiate toxicity with digoxin?
LOW potassium
what dose FAST stand for in the acronym for a stroke?
Face; look for drooping
Arms; downward drift
Speech; slurred
Time; call 911 now
whats given with cisplatin to reduce nephrotoxicity?
Amifostine (Ethyol) prophylactically to reduce nephrotoxicity with cisplatin
what is the max lifetime dose of doxorubicin?
