Page 63 - Naplex Q&A 2025 Version

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mg per day. It is advisable that a total daily dose of This will result in an increase serum concentration
more than 100 mg should be given in two divided and toxicity of such drugs.
doses. If the doses are not equal, the larger dose
should be given at bedtime. 124.(c) Elixir (Benadryl) contains 5 to 40% alcohol.
Diabinese (Chlorpropamide) is an oral sulfonylurea
It acts through inhibition of the serotonin uptake in agent that produces disulfiram-like reactions when
the brain. Dizziness, yawning, impotence, dryness of used with alcohol. The symptoms of disulfiram-like
mouth, nausea and vomiting are reported side reactions are abdominal pain, abdominal cramps,
effects of the drug. nausea, vomiting, throbbing headaches, flushing
and hypoglycemia.
Luvox CR is an extended-release capsule for oral
administration that contains fluvoxamine maleate 125.(a) Ziana (Clindamycin phosphate 1.2% and
as an active ingredient. The recommended starting Tretinoin 0.025%) Gel, is an antibiotic and retinoid
dose for Luvox CR capsules in adult patients is 100 combination gel product with two active
mg once per day. Luvox CR capsules should be ingredients. Clindamycin phosphate is a water-
administered, with or without food, as a single daily soluble ester of the semi-synthetic antibiotic
dose at bedtime. Consequently, the dose should be produced from the parent antibiotic lincomycin. It is
increased in 50 mg increments every week, as indicated for the topical treatment of acne vulgaris
tolerated, until maximum therapeutic benefit is in patients 12 years or older. At bedtime, squeeze a
achieved, not to exceed 300 mg per day. pea-sized amount of medication onto one fingertip,
dot onto the chin, cheeks, nose, and forehead, and
123.(d) The prescription for Micronase can be then gently rub over the entire face.
substituted by selecting DiaBeta, since the active
ingredient found in, both, Micronase and DiaBeta is Systemic absorption of Clindamycin has been
Glyburide. Glyburide is classified as an oral demonstrated following topical use of Ziana.
sulfonylurea agent. It stimulates the release of Diarrhea, bloody diarrhea, and colitis (including
insulin from the functioning beta-cells of the pseudomembranous colitis) have been reported
pancreas. It also increases the sensitivity of insulin with the use of topical Clindamycin. When
to the peripheral site. It inhibits the glycogenolysis significant diarrhea occurs, Ziana gel should be
(breakdown of glycogen into glucose) and discontinued. It is a pregnancy category C drug.
gluconeogenesis (synthesis of glucose from sources
other than glycogen). 126.(b) The active ingredient found in Precose is
Acarbose.
The usual starting dose of DiaBeta as initial therapy
is 2.5 to 5 mg daily, administered with breakfast or 127.(d) Precose (Acarbose) is classified as an alpha-
the first main meal. Those patients who may be glucosidase inhibitor. It is a complex oligosaccharide
more sensitive to hypoglycemic drugs should be which delays the absorption of ingested
started at 1.25 mg daily. carbohydrates by inhibiting alpha-glucosidase
enzymes, and may raise the blood glucose
Hypoglycemia is the principal side effect of the concentration slowly after eating meals. It does not
drug. Disulfiram-like reactions generally occur with increase the secretion of insulin. It inhibits
the use of alcohol with any of the oral sulfonylurea pancreatic -amylase and intestinal a glucosidase
agents. Chlorpropamide is at the highest risk. enzymes.

Sulfonylurea agents have high affinity for protein Pancreatic -amylase helps digesting complex
binding, and may displace the oral anticoagulant, starch to oligosaccharide; while intestinal -
NSAIDs and Digoxin from their protein binding sites. glucosidase helps digesting oligosaccharide to
glucose. Thus by inhibiting both these key enzymes,

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