Page 55 - Naplex Q&A 2025 Version

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Daraprim (Pyrimethamine) is indicated for the It is indicated for the short-term treatment (4 to 8
treatment of malaria and other protozoal weeks) in the healing and symptomatic resolution
infections, while Trimpex (Trimethoprim) is of diagnostically confirmed erosive esophagitis. It is
generally combined with Sulfamethoxazole for the also indicated for short-term treatment (4 to 8
treatment of bacterial infections. weeks) of heartburn and other symptoms
associated with GERD in adults and children 1 year
86.(c) The normal blood uric acid concentrations or older.
should lie between 6 and 7mg/dL. The patient’s
blood report indicates an elevated level of blood Nexium, in combination with amoxicillin and
uric acid (12 mg/dL). An elevated uric acid level may clarithromycin, is indicated for the treatment of
exaggerate the patient’s current gout condition. patients with H. pylori infection and duodenal ulcer
Methotrexate generally has a tendency to elevate disease.
the blood uric acid concentration and therefore
should be carefully used in above patient. Nexium I.V. for Injection is indicated for the short-
term treatment (up to 10 days) of GERD patients
A normal creatinine clearance should generally lie with a history of erosive esophagitis as an
between 80 and 120 ml/min. A decrease in renal alternative to oral therapy in patients when therapy
creatinine clearance (25ml/min) may indicate with Nexium delayed-release capsules is not
severe renal function impairment. Methotrexate possible or appropriate.
therapy should be carefully initiated in patients with
an impaired renal function. Headache, abdominal pain, nausea and diarrhea are
reported side effects of the drug.
87.(e) Rheumatrex, a brand name of Methotrexate,
is available in dose packs. It is available in 5 mg, 7.5 89. (d) Wellcovorin (Leucovorin calcium) is a
mg, 10 mg, 12.5 mg, 15 mg, 17.5 mg and 20 mg of derivative of tetrahydrofolic acid. It is indicated as
dose pack strengths. an antidote for folic acid antagonists such as
Methotrexate. It is also indicated for the treatment
Dose packs are generally indicated for the of megaloblastic anemia due to folic acid deficiency.
treatment of rheumatoid arthritis. The recommend It is available in 5 mg and 25 mg of oral strengths.
starting dose for rheumatoid arthritis is 7.5 mg,
once a week. Leucovorin calcium tablets are intended for oral
administration. Because absorption is saturable,
The dose packs are generally not recommended for oral administration of doses greater than 25 mg is
the administration of weekly doses of the drug not recommended.
greater than 20 mg.
Leucovorin rescue should begin as soon as possible
88.(e) Nexium (Esomeprazole) is classified as a after an inadvertent overdosage and within 24
Proton Pump Inhibitor (PPI). It is supplied in hours of methotrexate administration when there is
2
delayed-release capsules and in packets for a delayed excretion. Leucovorin 15 mg (10 mg/m )
delayed-release oral suspension. Each delayed- should be administered IM, IV, or PO every 6 hours
release capsule contains 20 mg, or 40 mg of until serum methotrexate level is return to normal.
esomeprazole in the form of enteric-coated
granules and each packet of Nexium for delayed- Leucovorin should be carefully prescribed with 5-FU
release oral suspension contains 10 mg, 20 mg, or (Fluorouracil) since it may enhance the toxic effect
40 mg of Esomeprazole, in the form of the same of 5-FU. Patients should be watched for diarrhea
enteric-coated granules used in Nexium Delayed- when these two drugs are simultaneously used.
Release Capsules. It is also available as an injection
for intravenous administration.

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