Which of the following statements is/are TRUE ABOUT Palforzia? [Select ALL THAT APPLY]

a. The active ingredient found in Palforzia is Arachis hypogaea.
b. It is indicated to prevent peanut hypersensitivity.
c. It indicated for the emergency treatment of allergic reactions, including anaphylaxis.
d. It should not be administered in patients with uncontrolled asthma.
e. It is available only through a restricted program Palforzia REMS.

Which of the following statements is/are TRUE ABOUT Palforzia? [Select ALL THAT APPLY]

a. The active ingredient found in Palforzia is Arachis hypogaea.
b. It is indicated to prevent peanut hypersensitivity.
c. It indicated for the emergency treatment of allergic reactions, including anaphylaxis.
d. It should not be administered in patients with uncontrolled asthma.
e. It is available only through a restricted program Palforzia REMS.

Answer: (a,b,d,e). The active ingredient found in Palforzia is (Peanut (Arachis hypogaea) Allergen Powder-dnfp). It is an oral immunotherapy indicated for the mitigation of allergic reactions, including anaphylaxis, that may occur with accidental exposure to peanut. Palforzia is approved for use in patients with a confirmed diagnosis of peanut allergy.

Palforzia can cause anaphylaxis, which may be life-threatening and can occur at any time during Palforzia therapy. It is NOT indicated for the emergency treatment of allergic reactions, including anaphylaxis.

Prescribe injectable epinephrine, instruct and train patients on its appropriate use, and instruct patients to seek immediate medical care upon its use.

Do not administer Palforzia to patients with uncontrolled asthma. Observe patients during and after administration of the Initial Dose Escalation and the first dose of each Up-Dosing level, for at least 60 minutes.

Palforzia is available only through a restricted program called the Palforzia REMS.

Patients should be advised to report immediately which of the following signs or symptoms when on Clozapine therapy? [Select ALL THAT APPLY].

a. Lethargy
b. Fever
c. Sore throat
d. Weakness
e. Severe nausea and vomiting

Patients should be advised to report immediately which of the following signs or symptoms when on Clozapine therapy? [Select ALL THAT APPLY].

a. Lethargy
b. Fever
c. Sore throat
d. Weakness
e. Severe nausea and vomiting

Answer: (a,b,c,d). Clozaril (Clozapine), an atypical antipsychotic drug, is indicated for:

1. Treatment-Resistant Schizophrenia
2. Reduction in the Risk of Recurrent Suicidal Behavior in Schizophrenia or Schizoaffective Disorders

Because of a significant risk of agranulocytosis, a potentially Life-threatening adverse event, Clozaril (Clozapine) should be Reserved for use in

(1). the treatment of severely ill patients with Schizophrenia who fail to show an acceptable response to Adequate courses of standard antipsychotic drug treatment,

Or

(2). for reducing the risk of recurrent suicidal behavior in patients With schizophrenia or schizoaffective disorder who are judged to Be at risk of reexperiencing suicidal behavior.
Patients being treated with Clozapine must have a baseline white Blood cell (WBC) count and absolute neutrophil count (ANC) before initiation of treatment as well as regular WBC counts and ANCs during treatment and for at least 4 weeks after Discontinuation of treatment.

Clozapine is available only through a distribution system that Ensures monitoring of WBC count and ANC according to the Schedule described below prior to delivery of the next supply of Medication.

Agranulocytosis, defined as an ANC of less than 500/mm³, has been reported with Clozaril (Clozapine). Patients should be advised to report immediately the appearance of lethargy, weakness, fever, sore throat or any other signs of infection occurring at any time during Clozaril (Clozapine) therapy. Such patients should have a WBC count and ANC performed promptly.

Based on the genetic make-up of SARS-CoV-2, which of the following drug classes is most likely to prove effective?

a. Angiotensin converting enzyme inhibitors
b. Protease inhibitors
c. Nucleoside analogues
d. Neuraminidase inhibitors
e. Calcium channel blockers

Based on the genetic make-up of SARS-CoV-2, which of the following drug classes is most likely to prove effective?

a. Angiotensin converting enzyme inhibitors
b. Protease inhibitors
c. Nucleoside analogues
d. Neuraminidase inhibitors
e. Calcium channel blockers

Answer: (b). The SARS-CoV-2 RNA codes for a pair of protease enzymes that are essential to production of viable virions upon release. Since protease inhibitors have been highly effective for treating patients with infections of human immunodeficiency virus and hepatitis C virus, that is the best choice.

Use of neuraminidase inhibitors (e.g., oseltamivir, peramivir, zanamivir) is not logical, since coronaviruses do not have a gene for neuraminidase.

Nucleoside analogues (e.g., acyclovir, ganciclovir, ribavirin) would be expected to exert effects only at high levels since the coronavirus has an exonuclease that would recognize and remove the analogues when incorporated into the viral genome.

It is currently unknown as to whether angiotensin converting enzyme (ACE) inhibitors or angiotensin-2 receptor blockers (ARBs) are beneficial or harmful based on changes in the ACE2 protein involved in viral entry in lung tissue.

The recommended dose of Olumiant in patients taking strong Organic Anion Transporter 3 (OAT3) inhibitors is _____________.

a. 1 mg once daily
b. 2 mg once daily
c. 3 mg once daily
d. 4 mg once daily
e. Cannot be used with OAT3 inhibitors

The recommended dose of Olumiant in patients taking strong Organic Anion Transporter 3 (OAT3) inhibitors is _____________.

a. 1 mg once daily
b. 2 mg once daily
c. 3 mg once daily
d. 4 mg once daily
e. Cannot be used with OAT3 inhibitors

Answer: (a). The active ingredient found in Olumiant is Baricitinib. It is a Janus kinase (JAK) inhibitor indicated for the treatment of adult patients with moderately to severely active rheumatoid arthritis who have had an inadequate response to one or more TNF antagonist therapies.

1. The recommended dose of Olumiant (Baricitinib) in patients taking strong Organic Anion Transporter 3 (OAT3) inhibitors (e.g., probenecid) is 1 mg once daily.

2. The recommended dose of Olumiant (Baricitinib) in patients with moderate renal impairment is 1 mg once daily.

3. Olumiant (Baricitinib) is not recommended in patients with severe renal impairment.

4. Olumiant (Baricitinib) is not recommended in patients with severe hepatic impairment.

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Which of the following statements would indicate that a patient understands why he is taking Olumiant?

a. "I have vasomotor symptoms associated with menopause."
b. "I have rheumatoid arthritis."
c. "I have hypercalcemia."
d. "I have Paget's disease of bone."
e. "I have migraine headaches associated with menopause."

Which of the following statements would indicate that a patient understands why he is taking Olumiant?

a. "I have vasomotor symptoms associated with menopause."
b. "I have rheumatoid arthritis."
c. "I have hypercalcemia."
d. "I have Paget's disease of bone."
e. "I have migraine headaches associated with menopause."

Answer: b

The active ingredient found in Olumiant is Baricitinib. It is a Janus kinase (JAK) inhibitor indicated for the treatment of adult patients with moderately to severely active rheumatoid arthritis who have had an inadequate response to one or more TNF antagonist therapies.

The recommended dose of Olumiant is 2 mg once daily.

Upper respiratory tract infections, nausea, herpes simplex, and herpes zoster are commonly reported side effects of the drug.

The drug also has shown promising result for the treatment of Covid-19 infection when administered simultaneously with Remdesivir.Olumiant (Baricitinib) in combination with Veklury (Remdesivir) cuts the median recovery time by about a day, compared to patients treated with Remdesivir alone.

Which of the following statements is/are TRUR ABOUT Covid-19? [Select ALL THAT APPLY]

a. COVID-19 infection often begins with malaise, dry cough, dyspnea, fatigue, and feeling of fever.
b. Covid-19 infection has incubation period of 2- to 14-day.
c. In contrast to the sudden onset people report with influenza, progression of symptoms with Covid-19 virus have a slower onset.
d. During early phases of viral spread, symptoms began an average of 7 days before patients sought medical or emergent care.
e. Fever occurs in 89% Covid-19 symptomatic patients.

Which of the following statements is/are TRUR ABOUT Covid-19? [Select ALL THAT APPLY]

a. COVID-19 infection often begins with malaise, dry cough, dyspnea, fatigue, and feeling of fever.
b. Covid-19 infection has incubation period of 2- to 14-day.
c. In contrast to the sudden onset people report with influenza, progression of symptoms with Covid-19 virus have a slower onset.
d. During early phases of viral spread, symptoms began an average of 7 days before patients sought medical or emergent care.
e. Fever occurs in 89% Covid-19 symptomatic patients.

Answer: (a,b,c,e) The COVID-19 often begins with malaise, dry cough, dyspnea, fatigue, and feeling of fever. It progresses over an 11- to 14-day period. It has incubation period of 2- to 14-day. Some patients have had nausea, vomiting, and diarrhea. In contrast to the sudden onset people report with influenza, progression of symptoms with SARS-CoV-2 have a slower onset. During early phases of viral spread, symptoms began an average of 3.5 days (not 7 days) before patients sought medical or emergent care. Fever occurs in almost all symptomatic patients (89%), cough is very common (68%), and some patients have fatigue (38%), sputum production (33%), shortness of breath (19%), sore throat (14%), and headache (14%).

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The transition from mild/moderate symptoms to more severe stages of COVID-19 is marked by the onset of:

a. Loss of or reductions in smell or taste
b. Multi organ failures
c. Severe seizure
d. Acute respiratory distress syndrome
e. Refractory, nonproductive cough

The transition from mild/moderate symptoms to more severe stages of COVID-19 is marked by the onset of:

a. Loss of or reductions in smell or taste
b. Multi organ failures
c. Severe seizure
d. Acute respiratory distress syndrome
e. Refractory, nonproductive cough

Answer:(d). About 5% of patients with COVID-19 (one-fourth of those needing hospitalization) present with advanced symptoms or become critically ill as viral damage in the lungs results in acute respiratory distress syndrome. Multi-organ failure occurs later in the disease course; changes in smell and taste and nonproductive cough are early symptoms of COVID-19.

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Liver toxicity with acetaminophen may occur and is a serious, dose-dependent effect. The maximum recommended dosage is:

a. 15mg/kg/day
b. 30mg/kg/day
c. 45mg/kg/day
d. 75mg/kg/day
e. 100mg/kg/day

Liver toxicity with acetaminophen may occur and is a serious, dose-dependent effect. The maximum recommended dosage is:

a. 15mg/kg/day
b. 30mg/kg/day
c. 45mg/kg/day
d. 75mg/kg/day
e. 100mg/kg/day

Answer: (d). Liver toxicity with acetaminophen may occur and is a serious, dose-dependent effect. The maximum recommended dosage is 75 mg/kg/day (adults not to exceed 4 g/d), and products carry warnings about exceeding this dose.

Signs associated with acetaminophen toxicity can mimic influenza symptoms and may include nausea, vomiting, diarrhea, and excessive sweating.

This may lead parents and caregivers to administer more medication to the child. Care should be taken not to exceed this threshold by administering higher doses more frequently than recommended.

In 2011 and 2012, the manufacturer of brand-name Tylenol products voluntarily reduced the maximum daily dosage to 3000 mg (6 tablets), with the dosing interval changed from 2 tablets every 4 to 6 hours to 2 tablets every 6 hours; the maximum daily dosage for Regular Strength Tylenol has been reduced to 3250 mg.

However, generic manufacturers may still have a maximum dose of 4000 mg on the product label.

The probable mechanism of action of Baloxavir Marboxil?

a. HMG-CoA inhibitor
b. Neuraminidase inhibitor
c. Cap-dependent endonuclease inhibitor
d. DNA dependent RNA polymerase inhibitor
e. PABA inhibitor

The probable mechanism of action of Baloxavir Marboxil?

a. HMG-CoA inhibitor
b. Neuraminidase inhibitor
c. Cap-dependent endonuclease inhibitor
d. DNA dependent RNA polymerase inhibitor
e. PABA inhibitor

Answer: (c) The active ingredient found in Xofluza (Baloxavir marboxil) is Baloxavir marboxil. Xofluza (Baloxavir marboxil) is a polymerase acidic (PA) endonuclease inhibitor.

Baloxavir marboxil is a prodrug that is converted by hydrolysis to baloxavir, the active form that exerts anti-influenza virus activity. Baloxavir inhibits the endonuclease activity of the polymerase acidic (PA) protein, an influenza virus-specific enzyme in the viral RNA polymerase complex required for viral gene transcription, resulting in inhibition of influenza virus replication.

Prescription antiviral medications with influenza virus activity may be useful adjuncts in influenza prevention and treatment and are most effective when administered within _______ of symptom onset.

a. 24 hours
b. 48 hours
c. 72 hours
d. 4 days
e. 12 hours

Prescription antiviral medications with influenza virus activity may be useful adjuncts in influenza prevention and treatment and are most effective when administered within _______ of symptom onset.

a. 24 hours
b. 48 hours
c. 72 hours
d. 4 days
e. 12 hours

Answer: (b). Prescription antiviral medications with influenza virus activity may be useful adjuncts in influenza prevention and treatment and are most effective when administered within 48 hours of symptom onset.