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%).

Try our Naplex QBank. www.pharmacyexam.com **Please note: This type of question will not show up in an MPJE. We are just posting to MPJE group for knowledge.

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.

Try our Naplex QBank. www.pharmacyexam.com **Please note: This type of question will not show up in an MPJE. We are just posting to MPJE group for knowledge.

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.

In which aspect, Salicylate is different from NSAIDs? [Select ALL THAT APPLY]

a. Provide greater pain control with equivalent doses.
b. May cause GI side effects more frequently than NSAIDs.
c. May inhibit prostaglandin synthesis irreversibly; whereas NSAIDs do reversibly.
d. May cause more renal damage than NSAIDs.
e. Risk of bleeding is more with Salicylate compared to NSAIDs.

In which aspect, Salicylate is different from NSAIDs? [Select ALL THAT APPLY]

a. May provide greater pain control with equivalent doses.
b. May cause more GI side effects than NSAIDs.
c. Inhibits prostaglandin synthesis irreversibly; where NSAIDs do reversibly.
d. May cause more renal damage than NSAIDs.
e. May increase the risk of bleeding more compared to NSAIDs.

Answer (b,c): Salicylates, like NSAIDs, work by inhibiting prostaglandin synthesis by inhibiting both COX-1 and COX-2 enzymes; however, salicylates do so in an irreversible manner, while NSAIDs do so reversibly.

Absorption in the gut is affected by the dosage form, gastric pH, gastric emptying time, dissolution rate, and food/antacids.

Aspirin is widely bioavailable with an onset of analgesia within 30 minutes and lasting 4 to 6 hours.

FDA-approved uses for salicylates include treatment of symptoms for osteoarthritis, rheumatoid arthritis, and other rheumatologic diseases, as well as temporary relief of minor aches and pains associated with backache or muscle aches.

High-dose aspirin (900-1000 mg) has been established as an effective treatment option for acute migraine.

Aspirin causes dyspepsia and GI irritation even more frequently than OTC NSAIDs.

Try our Naplex QBank. www.pharmacyexam.com **Please note: This type of question will not show up in an MPJE. We are just posting to MPJE group for knowledge.

At 1000 mg dose, Acetaminophen is usually effective treating which of the following Migraine related symptoms? [Select ALL THAT APPLY]

a. Nausea
b. Vomiting
c. Blurry vision
d. Photophobia
e. Phonophobia

At 1000 mg dose, Acetaminophen is usually effective treating which of the following Migraine related symptoms?[Select ALL THAT APPLY]

a. Nausea
b. Vomiting
c. Blurry vision
d. Photophobia
e. Phonophobia

Answer: (d,e). Acetaminophen has been shown in studies to reduce pain, as well as improve photophobia and phonophobia in individuals with migraine and tension-type headache. They have not been shown to improve symptoms of nausea, vomiting, or blurry vision with migraine.

Try our Naplex QBank. www.pharmacyexam.com **Please note: This type of question will not show up in an MPJE. We are just posting to MPJE group for knowledge.

Which of the following statements is NOT TRUE about the tension-type headaches? [Select ALL THAT APPLY]

a. Pain associated with this type of headache is unilateral
b. Mild photophobia or phonophobia is reported with the headache
c. Routine physical activity usually aggravates the headache
d. Headache has fast onset of action and last for few hours.
e. It is also known as stress headache.

Which of the following statements is NOT TRUE about the tension-type headaches? [Select ALL THAT APPLY]

a. Pain associated with this type of headache is unilateral
b. Mild photophobia or phonophobia is reported with the headache
c. Routine physical activity usually aggravates the headache
d. Headache has fast onset of action and last for few hours.
e. It is also known as stress headache.

Answer: (a,c,d)

1. Tension-type headaches often are caused by stress, depression, anxiety, emotional conflicts, or other stimuli.

2. They are sometimes called stress headaches and may result from pericranial muscle contraction.

3. Patients experience bilateral symptoms that may be over the top of the head to the neck and vary from diffuse ache to tight, pressing, and constricting pain.

4. They have gradual onset and may last minutes to days.

5. They are not accompanied by nausea or vomiting but may have either mild photophobia or phonophobia.

6. Routine physical activity such as walking or climbing stairs does not aggravate the headache.

7. Tension-type headaches may be episodic or chronic. Episodic headaches occur less than 15 days per month. Chronic headaches occur 15 or more days per month for at least 3 months.

Medication-overuse headache is generally classified as a:

a. Primary-headache
b. Secondary-headache
c. Tertiary-headache
d. Category II-headache
e. Category V-headache

Medication-overuse headache is generally classified as a:

a. Primary-headache
b. Secondary-headache
c. Tertiary-headache
d. Category II-headache
e. Category V-headache

Answer (b): Headaches are classified as primary or secondary according to the International Classification of Headache Disorders (ICHD) 2018.

Primary headaches are not caused by underlying illness. ICHD further classifies primary headaches as tension-type headache, migraine, trigeminal autonomic cephalalgias, or other primary headache disorders.

Secondary headaches are associated with an underlying condition (e.g., head injury or trauma, infection, stroke, substance withdrawal, or facial or cranial disorders).

Medication-overuse headaches are considered secondary by ICHD although they are not caused by an underlying disease (but are attributed to the withdrawal effect of analgesic medication).

Try our Naplex QBank. www.pharmacyexam.com **Please note: This type of question will not show up in an MPJE. We are just posting to MPJE group for knowledge.

The simultaneous administration of which of the following with Qdolo is considered as a duplication of therapy?

a. Lopressor
b. Humira
c. Ultram
d. Ritalin
e. Levaquin

The simultaneous administration of which of the following with Qdolo is considered as a duplication of therapy?

a. Lopressor
b. Humira
c. Ultram
d. Ritalin
e. Levaquin

Answer: (c).

The active ingredient found in Qdolo is Tramadol hydrochloride. It is available as an oral solution. It is a schedule IV controlled substance. The simultaneous administration of Ultram (Tramadol) with Qdolo (Tramadol) is considered duplication of therapy; concurrent use should be avoided.

Qdolo is an opioid agonist indicated in adults for the management of pain severe enough to require an opioid analgesic and for which alternative treatments are inadequate.
Start at 25 mg/day and titrate in 25 mg increments as separate doses every 3 days to reach 100 mg/day (25 mg four times a day). Thereafter the total daily dose may be increased by 50 mg as tolerated every 3 days to reach 200 mg /day (50 mg four times a day). After titration, Qdolo 50 mg to 100 mg can be administered as needed for pain relief every 4 to 6 hours not to exceed 400 mg/day.

Concomitant use of opioids with benzodiazepines or other central nervous system (CNS) depressants, including alcohol, may result in profound sedation, respiratory depression, coma, and death. Reserve concomitant prescribing for use in patients for whom alternative treatment options are inadequate; limit dosages and durations to the minimum required; and follow patients for signs and symptoms of respiratory depression and sedation.

Monitor patients closely for respiratory depression, especially within the first 24-72 hours of initiating therapy and following dosage increases with Qdolo and adjust the dosage accordingly.

The most common incidence of treatment-emergent adverse events in patients from clinical trials were dizziness/vertigo, nausea, constipation, headache, somnolence, vomiting and pruritus.