A patient female 24 year old came to you with cough, fever and sore throat

A patient female 24 year old came to you with cough, fever and sore throat. She has 4 days with these symptoms when she was to the grandmother'village. We see the tympanic membrane that is inflamated with some lessions on it. We see even a little conjunctivitis.
Laboratory exams are :
Hct: 33
WBC: 11,000/μL
Reticulocytes: 4%
Chest x-ray shows bilateral infiltrates

What will you choose to take the better infection control?

a. Erythromycin
b. Trimethoprim-sulfamethoxazole
c. Cefuroxime
d. Ciprofloxacine
e. Amoxicillin/clavulanate

A patient suffer of chronic obstructive lung disease for about 10 years

A patient 53 year old suffer of chronic obstructive lung disease for about 10 years. He recently develops an episode of aching in the distal extremities in both wrists.There is a 10-lb weight loss. The skin over the wrists is warm and erythematous. Plain film is shows periosteal thickening.

What should you do?

a. Start ciprofloxacin
b. Chest x-ray
c. Aspirate both wrists
d. Begin gold therapy

CCF is on treatment with digoxin and a loop diuretic

Question:
A fifty-five year old with chronic cardiac failure is on treatment with digoxin and a loop diuretic.
This combination is likely to cause digoxin toxicity by the following mechanism:


a) this combination increases the half-life of digoxin
b) diuretics decrease potassium levels
c) frusemide and digoxin interact to form a poisonous compound
d) digoxin is a competitive inhibitor of frusemide
e) the above statement is wrong, loop diuretics are not a recognised cause of increased digoxin toxicity

The NAPLEX - What Is It Exactly?

The North American Pharmacist Licensure Examination is the Naplex - in a nutshell.

Okay - let's what exactly NAPLEX is, shall we??

The Naplex exam is an examination created by the NABP (National Association of Boards of Pharmacy) that tests just how good someone looking to get into a pharmacy career knows their stuff. It is a content driven exam, devised and run to test your ability and knowledge of Pharmacist issues as well as general pharmacy related medical issues.

Pharmacology Practice Questions-NAPLEX

1. In a zero order elimination process, which of the following is true?

A. The removal of drug is independent of drug concentration
B. Cl = Elimination rate/Cp
C. t1/2 = .7VD/Cl
D. All are true 

2. For highly polar drugs (e.g. mannitol) what primarily determines elimination rate?

A. Excretion rate
B. Metabolism rate
C. Absorption rate
D. Distribution rate
E. All of the above 

3. Bioavailability is related to which of the following parameters, according to the equation F = 1 - E

A. Excretion
B. Elimination
C. Extraction Ratio
D. Enterohepatic Recycling 

4. For the majority of drugs, which of the following equations correctly defines clearance?

A. Cl = Elimination rate/Cp
B. Cl = QxE
C. Cl = .7VD/t1/2
D. All are correct 

5. How much of a 10 mg dose of morphine reaches the systemic circulation given F = .24?

A. 24mg
B. 0.24 mg
C. 2.4 mg
D. 4.1 mg 

6. Given that the VD = 230 L/70Kg and Cl = 60 L/hr/70 Kg for morphine, approximately how much of a 10 mg IV dose remains after 8 hr, given to a normal 70 Kg patient?

A. 5 mg
B. 2.5 mg
C. 1.25 mg
D. 625 mg 

7. Given F = .24, what is the overall hepatic clearance of morphine if the above patient has portal hypertension such that their hepatic blood flow is reduced by ½? Assume the clearance value given in the previous question is entirely hepatic clearance.

A. 30 L/hr/70 Kg
B. 60 L/hr/70 Kg
C. 120 L/hr/70 Kg
D. 250 L/hr/70 Kg 

8. Which of the following enzymes could directly act on codeine?

A. Glucuronyl transferase
B. Sulfotransferase
C. Glutathione transferase
D. a & b
E. All of the above 

9. Which Cytochrome P450 isozyme does not participate appreciably in drug metabolism?

A. CYP1A2
B. CYP2C9
C. CYP3A4
D. CYP51
E. All are drug metabolizing isoforms 

10. Which of the following Cytochrome P450 isozymes is responsible for the bulk of phase I metabolism?

A. CYP1A2
B. CYP2C9
C. CYP2D6
D. CYP3A4
E. CYP51 

11. Which of the following enzymes could metabolize ethanol?

A. Cytochrome P450
B. Alcohol Dehydrogenase
C. Glucuronyl Transferase
D. Sulfotransferase
E. All of the above 

12. Which of the following are similarities between Cytochrome P450 and MAO?

A. Both add oxygen from O2 to substrates and also form water
B. Both carry out direct heteroatom oxidations
C. Both carry out oxidative deaminations
D. Both carry out N-dealkylations
E. All of the above 

13. What would be the preferred route of metabolism of succinyl choline?

A. Ester hydrolysis
B. N-oxidation
C. Glucuronide conjugation
D. a & b
E. All of the above 

14. Which of the following causes the smallest change in solubility?

A. Hydroxylation
B. Glucuronidation
C. Sulfation
D. Glutathione conjugation 

15. Cigarette smoke causes an increase in levels of CYP1A isozymes. Theophylline is primarily metabolized by the CYP1A system. What would happen to theophylline clearance for an asthmatic patient in hospital who could not smoke?

A. No change
B. Increase
C. Decrease 

Answer Key
1. A
2. A
3. C
4. D
5. C
6. C
7. A
8. D
9. D
10. E
11. E
12. C
13. C
14. A
15. C

NAPLEX-PHARMD

A patient with diabetes, hypertension and dyslipidemia has been using metformin 1000 mg BID for 5 months. Her A1C is currently 8.2%. Which of the following

A 48 year-old female patient comes into the pharmacy. She states she usually doesn’t have headaches, but since she got stuck on a computer at work today, she developed eye strain and a headache. She asks if it is safe to take anything for the headache. Her only other chronic medication is lisinopril 20 mg once daily. You check her blood pressure, which is 144/78. Which is the best OTC recommendation?

A.	Ibuprofen 600 mg as-needed, not to exceed twice daily.
B.	Ibuprofen 600 mg as-needed, not to exceed three times daily.
C.	Ibuprofen 800 mg as-needed, not to exceed twice daily.
D.	Ibuprofen 800 mg as-needed, not to exceed three times daily.
E.	Ibuprofen is not the best medication for this patient.

NAPLEX

An elderly gentleman has coronary heart disease. He uses the following medicines: clopidogrel, aspirin, lisinopril, Toprol XL and vardenafil. A physician called and asked if it is appropriate to begin Flomax therapy. Choose the appropriate response.

A.	The use of Flomax is contraindicated.
B.	Flomax can be used, but the patient will require careful monitoring for orthostasis and dizziness.
C.	A safer option would be Cardura.
D.	This drug is not appropriate; Sanctura should be used instead.
E.	Flomax is not available in the U.S.

NAPLEX QUESTIONS

A 53 y/o patient in the hospital is getting Solu Medrol 40mg IV Q12h. The physician wants to send the patient home on an equivalent daily dose of prednisone. Which of the following would you recommend?

A.	100mg
B.	80mg
C.	400mg
D.	120mg
E.	140mg

NAPLEX-QUESTIONS

Lipitor is the #1 branded cholesterol drug. Which of the following statements concerning Lipitor is correct?

A.	There are no significant drug interactions.
B.	The generic name is rosuvastatin.
C.	The maximum dose is 80 mg daily.
D.	It must be taken with the evening meal.
E.	It is safe to use in pregnancy.