Page 37 - Naplex Q&A 2025 Version

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1.(a). A patient is allergic to sulfa drugs. He should 5.(b) Dryness of mouth, increased thirst, irregular
avoid a drug that has a sulfa moiety in its molecule. heartbeats, muscle and leg cramps are signs of
The thiazide diuretics are structurally related to Hydrochlorothiazide induced hypokalemia.
sulfa drugs. Therefore, the patient should avoid
Hydrochlorothiazide. 6. (c) Orapred ODT (Prednisolone sodium
phosphate disintegrating tablets) is a sodium salt of
2. (e). The active ingredient found in Geodon is the phospho ester of the glucocorticoid
Ziprasidone. It is classified as an antipsychotic prednisolone.
agent. It is indicated for the treatment of
schizophrenia, acute treatment of agitation in It is indicated in the treatment of the atopic
schizophrenia and treatment of Bipolar I disorder dermatitis, Crohn’s disease, ulcerative colitis and
(acute mixed or manic episodes and maintenance acute exacerbations of chronic obstructive
treatment as an adjunct to lithium or valproate). pulmonary disease (COPD).

It is available as capsule and injection. The Dosage of Orapred ODT should be individualized
recommended therapeutic dose of Geodon is 20 to according to the severity of the disease and the
80 mg twice daily. NMS, tardive dyskinesia, response of the patient. The initial dose of Orapred
extrapyramidal symptoms and agitation are ODT may vary from 10 to 60 mg (prednisolone base)
reported side effects of the drug. per day, depending on the specific disease entity
being treated.
3.(c). Thiazide diuretics may cause hypokalemia and
hyponatremia by enhancing a urinary excretion of Fluid retention, alteration in glucose tolerance,
sodium and potassium ions. It raises the serum elevation in blood pressure, behavioral and mood
concentration of uric acid, calcium ions and glucose changes, increased appetite and weight gain are
by stimulating their reabsorption from the renal commonly reported side effects of Orapred.
tubules. Thus, it causes hyperuricemia rather than
hypouricemia. 7.(c) A normal therapeutic serum concentration of
potassium lies between 3.5 and 5 mEqs/L. The
4.(e) Hydrochlorothiazide induced hypokalemia may serum concentration of potassium less than 3.5
increase the toxic effects of Digoxin. Questran mEqs/L is called hypokalemia and above 5 mEqs/L
(Cholestyramine) and Colestid (Colestipol) may - known as hyperkalemia.
inhibit the G.I. absorption of Digoxin by binding to
its acidic group. 8. (e) Aldactone (Spironolactone) oral tablets
contain 25 mg, 50 mg, or 100 mg of the aldosterone
Concurrent use of Hydrochlorothiazide with lithium antagonist Spironolactone. It is also known as a
or lithium containing products is not recommended potassium sparing diuretic. It is indicated in the
since both sodium and lithium ions compete for management of edema and sodium retention
reabsorption from renal tubules. Since associated with congestive heart failure (CHF),
Hydrochlorothiazide increases the renal excretion cirrhosis of the liver and the nephrotic syndrome. It
of sodium ions, it facilitates the reabsorption of is also useful for the management of essential
lithium ions from the renal tubules. This may result hypertension and hypokalemia.
in increased serum concentration and toxicities of
lithium. Aldactone (spironolactone) is a specific
pharmacologic antagonist of aldosterone, acting
primarily through competitive binding of receptors
at the aldosterone-dependent sodium-potassium

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