It's Giving Infection
Which medication used as part of the TB regimen has the side effect of orange-red discoloration of body secretions?
A. Isonazid
B. Rifampin
C. Ethambutol
D. All of the above
What is B. Rifampin?
What is a possible result of aggressive diuresis with loop diuretics?
A. Alkalosis
B. Hyperkalemia
C. Acidosis
D. Hypercalcemia
What is A. Alkalosis?
A pharmacy student is performing a med rec at bedside for an admitted patient in the hospital. The patient states “I take a little yellow pill for my thyroid.” What is the strength of this yellow pill?
A. 75 mcg
B. 88 mcg
C. 100 mcg
D. 125 mcg
What is C. 100 mcg?
A 78 YO male reports heartburn and occasional regurgitation 3-4 times weekly for the past 4 months, especially after large meals. He wants a safe option that he can purchase today without seeing a doctor.
A. Omeprazole
B. Famotidine
C. Calcium carbonate
D. Pantoprazole
What is B. Famotidine?
A physician orders 1,000 mg of vancomycin to be infused over 60 minutes. The vial is reconstituted and further diluted to a total volume of 250 mL. The nurse calls to ask how quickly they should run the line. What should be the infusion rate in mL/hr?
A. 200 mL/hr
B. 250 mL/hr
C. 300 mL/hr
D. 350 mL/hr
What is B. 250 mL/hr?
Which of the following is NOT one of the 2016 IDSA Antimicrobial Stewardship Guideline suggested interventions?
A. Use of rapid viral testing for respiratory pathogens to reduce inappropriate antibiotic use
B. Use of clinical practice guidelines within antibiotic stewardship programs to reduce antibiotic therapy to the shortest duration of treatment
C. Concurrent administration of probiotics with all antibiotic therapy
D. Hospital implementation of pharmacokinetic monitoring and adjustment for aminoglycosides
What is C. Concurrent administration of probiotics with all antibiotic therapy?
This drug is known to cause blueish-gray skin discoloration and thyroid hormone dysregulation?
A. Levothyroxine
B. Amiodarone
C. Dronedarone
D. Methimazole
What is B. Amiodarone?
Which steroid is used for aldosterone replacement?
A. Dexamethasone
B. Triamcinolone
C. Betamethasone
D. Fludrocortisone
What is D. Fludrocortisone?
Which of these GLP-1 receptor agonists has the greatest efficacy in terms of amount of weight loss?
A. Dulaglutide
B. Liraglutide
C. Semaglutide
D. Exenatide
What is C. Semaglutide?
An order calls for 750 mg ceftriaxone in 100 mL NS. The ceftriaxone vial contains 1 g of powder and the final solution volume is 10 mL after reconstitution, giving a final concentration of 100 mg/mL. How many milliliters of ceftriaxone should the technician withdraw from the reconstituted vial to prepare the correct dose?
A. 2.5 mL
B. 5.5 mL
C. 7.5 mL
D. 12.5 mL
What is C. 7.5 mL?
Which lab values do we monitor with amphotericin B? (Select all that apply).
A. Mg
B. SCr
C. K
D. Glucose
What is
A. Mg
B. SCr
C. K?
Which of the following medications should be avoided with lovastatin? (Select ALL that apply.)
A. Lopid
B. Voriconazole
C. Theophylline
D. Plavix
E. Clarithromycin
What is A. Lopid, B. Voriconazole and E. Clarithromycin?
Which medications lower blood glucose independent of glucose presence, posing a higher risk for hypoglycemia?
A. Semaglutide
B. Glimepiride
C. Metformin
D. Dapagliflozin
What is B. Glimepiride?
Which medication used in variceal bleeding is selective for vasoconstriction of splanchinc vasculature?
A. Vasopression
B. Midodrine
C. Octreotide
D. Norepinephrine
What is C. Octreotide?
PG a 45 YO, 63 inch tall, 70 kg insulin-naive female patient with type 2 diabetes is starting basal-bolus therapy. The provider would like to trial a starting total daily dose (TDD) of insulin at 0.4 units/kg/day. What is the starting basal insulin dose?
A. 14 units
B. 28 units
C. 35 units
D. 70 units
What is A. 14 units?
A patient has developed VAP 3 days after being intubated. Cultures revealed Pseudomonas aeruginosa growing in respiratory cultures. Which antimicrobial covers this bug?
A. Cefazolin
B. Amoxicillin-clavulanate
C. Vancomycin
D. Piperacillin/tazobactam
What is D. Piperacillin/tazobactam?
What is the heparin VTE treatment dose?
A. 60 units/kg IV bolus; 12 units/kg/hr infusion
B. 5000 units SQ Q8H
C. 80 units/kg IV bolus; 18 units/kg/hr infusion
D. 180 mcg/kg IV bolus; 2 mcg/kg/min infusion
What is C. 80 units/kg IV bolus; 18 units/kg/hr infusion?
A 62-year-old female with Type 2 Diabetes Mellitus presents for follow-up. Her current regimen includes: Insulin glargine 30 units nightly and Insulin aspart 8 units before each meal.
Her home glucose log over the past 4 days shows: FBG: 190–220 mg/dL, Pre-lunch: 120–140 mg/dL, Pre-dinner: 110–130 mg/dL, Bedtime: 100–120 mg/dL No side effects have been reported per the patient.
Which of the following is the most appropriate adjustment to her insulin regimen?
A. Increase insulin glargine to 33 units nightly
B. Increase insulin glargine to 36 units nightly
C. Increase insulin aspart before breakfast to 10 units
D. Increase insulin aspart before dinner to 10 units
E. Add correction-scale insulin at bedtime
What is A. Increase insulin glargine to 33 units nightly?
What is the treatment of choice for COPD?
A. Atrovent
B. Anoro Ellipta
C. Flovent
D. Montelukast
What is B. Anoro Ellipta?
A clinical trial studied a new cholesterol-lowering drug. Among 1,450 patients receiving the drug, 87 experienced a cardiovascular event, while among 1,500 patients on placebo, 142 experienced the same event. What is the NNT?
A. 27
B. 28
C. 29
D. 30
What is C. 29?
NNT, always round UP!
A 52-year-old male kidney transplant recipient presents with fever, malaise, and leukopenia. Laboratory testing confirms Cytomegalovirus (CMV) infection viremia. Which of the following is the treatment of choice for this patient?
a. Acyclovir
b. Valacyclovir
c. Ganciclovir
d. Oseltamivir
What is C. Ganciclovir?
A 64-year-old female with a history of hypertension and atrial fibrillation presents to the emergency department with sudden right-sided weakness and slurred speech. Her husband reports she was last known well at 1:00 PM, and she arrived to the ED at 3:30 PM. A non-contrast CT scan of the head shows no evidence of hemorrhage. Her blood pressure is 168/92 mmHg, and glucose is 110 mg/dL. Neurologic exam confirms a left-sided ischemic stroke. It is now 4:00 PM.
Which of the following is the most appropriate next step in management?
A. Administer IV Aspirin immediately
B. Withhold fibrinolytic therapy because the patient is outside the treatment window
C. Start IV Heparin infusion
D. Administer IV Alteplase
E. Delay treatment for MRI confirmation
What is D. Administer IV Alteplase?
A 23-year-old female with a history of Type 1 Diabetes Mellitus presents to the emergency department with nausea, vomiting, abdominal pain, and confusion. Her roommate reports she has not taken her insulin for 2 days. Her respirations are deep and quick.
Labs: Glucose: 520 mg/dL, Sodium: 130 mEq/L, Potassium: 5.6 mEq/L, Bicarbonate: 10 mEq/L, pH: 7.1, Anion gap: 22, Serum ketones: positive
Which of the following is the most appropriate initial management step?
A. Administer IV regular insulin bolus immediately
B. Start IV fluids with Lactated Ringers
C. Administer sodium bicarbonate IV push
D. Start potassium replacement therapy immediately
What is B. Start IV fluids with Lactated Ringers
MR is a 45 YO female with PMH of DM, HTN and chronic back pain from a motorcycle accident that occurred 5 years ago. The patient had been on hydrocodone/APAP 5-325 mg ever since. One day, MR was up late one night preparing a report for work and fell asleep without setting her alarm. MR woke up late and quickly got ready for work. MR hurried down the stairs of her home not noticing Boots, her cat, at the end of the stairs. As MR reached the end of the stairs, she tripped over Boots and fell. MR was rushed by EMS to the ED where she had x-rays that showed an ankle fracture. MR was discharged from the ED with hydrocodone/APAP 7.5-325mg and advised to stop taking her hydrocodone 5-325mg. MR now presents to the pharmacy stating that she has not had a BM in a week. What product would you recommend for MR?
A. Docusate
B. Senna
C. Methylnaltrexone
D. Linzess
What is B. Senna?
All parts of the patient case are not necessary, but a this is often a distraction used on the NAPLEX. You may not need to read the long passage to answer the question, so common practice is to read the question first before reading the case.
DB is a 2-year-old male with acute otitis media. He is prescribed amoxicillin suspension 400 mg/5 mL at a dose of 90 mg/kg/day. He weighs 26 pounds and is 35 inches tall. How many milligrams of amoxicillin should be administered every 12 hours? (Answer must be numeric; round the final answer to the nearest TEN milligrams.)
A. 540 mg
B. 531.82 mg
C. 530 mg
D. 535 mg
What is C. 530 mg?