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The questions for NAPLEX were last updated on Nov 21, 2024.
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Which of the following medication should be avoided in patients with heart failure?
Patients with heart failure should avoid taking NSAIDs (which includes naproxen), COX-2 inhibitors, nondihydropyridine calcium channel blockers (for reduced EF), thiazolidinediones (which includes pioglitazone), cilostazol, and dronedarone (for severe or recently decompensated heart failure).
A patient with multibacillary leprosy is on dapsone, clofazimine, and rifampin. Which of the following is true regarding the mechanism of action of the medications listed?
A, B -- false -- dapsone inhibits bacterial synthesis of dihydrofolic acid, via competition with para- aminobenzoate for the active site of dihydropteroate synthetase. Dapsone is both bacteriostatic and weakly bactericidal against M. leprae. Neither of the listed mechanisms are the cause of these effects. C -- False -- A substance with both anti-leprosy and anti-inflammatory activity, clofazimine is weakly bactericidal against M. leprae by binding to the guanine bases of bacterial DNA, not DNA polymerase directly. D -- False -- See below. E -- True -- Rifampin is bactericidal by inhibiting RNA synthesis by blocking DNA-dependent RNA polymerase.
LN is 84 YOM who is in hospital for a back surgery. His height is 5 feet and 4 inches, weight 85 kg and NKDA.
His past medical history includes hypertension, diabetes mellitus, major depression, hypothyroidism and chronic back pain. Post-op day 1, LN's medication includes Dexamethasone 8mg iv q6h with taper dosing, Ondansetron 4mg iv q6h prn for N/V, Levothyroxine 0.075mg po daily, Lisinopril 10mg po daily, Citalopram 20mg po daily, Docusate sodium / Senna 1 tab po twice a day, Bisacodyl 10mg suppository daily prn for constipation, Famotidine 20mg iv q12hr, Metoclopramide 10mg iv q6h, Metformin 500mg po bid, D51/2NS with 20K at 125mls/hour and Hydromorphone PCA at 0.2mg/hour of basal rate, demand dose 0.1mg. lock-out
every 6min, one hour limit 2.2mg/hour. Pertinent morning labs includes serum creatinine 1.4mg/dl, Mg 1.5mg/ dl, K 5.0mmol/L, Na 135mmol/L. The bioavailability of levothyroxine is roughly 50%.
The physician requests you for a dose recommendation to convert her home dose of 75mcg po daily to intravenous.
What would be the appropriate intravenous dose?
Since the bioavailability of levothyroxine is roughly 50% (given in the Question:). To convert
the home dose to intravenous, it would be 50% of the oral dose. So 50% of oral 75 mcg would be 37.5 mcg intravenously.
If you mix 30 gm 5% lidocaine cream and 90gm of 0.5% hydrocortisone cream, what percent of lidocaine and hydrocortisone do you have as the end product?
Lidocaine: 30g 0.05 = 1.5g. Hydrocortisone: 90g 0.005 = 0.45g. 90g + 30g = 120g. 1.5g/120g = 0.0125 100 = 1.25% Lidocaine. 0.45g/120g = 0.00375 100 = 0.375% Hydrocortisone.
What is the standard loading dose for clopidogrel in the treatment of ACS?
300mg is the standard loading dose of clopidogrel -- an antiplatelet drug -- in the treatment of acute coronary syndrome (ACS).
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