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73 listings in all posts with a title or author like "RxExam"




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The FDA has recently approved Xywav for the treatment of cataplexy or excessive daytime sleepiness (EDS) in patients 7 years of age and older with narcolepsy. Another drug Xyrem is available for the same indication in the US. What is a principal advantage of using Xywav over Xyrem?

a. Less side effects
b. Less potential for abuse
c. Low sodium contents
d. More potency
e. Cheaper


The FDA has recently approved Xywav for the treatment of cataplexy or excessive daytime sleepiness (EDS) in patients 7 years of age and older with narcolepsy. Another drug Xyrem is available for the same indication in the US. What is a principal advantage of using Xywav over Xyrem?

a. Less side effects
b. Less potential for abuse
c. Low sodium contents
d. More potency
e. Cheaper

Answer: C

The active ingredients found in Xywav is (calcium, magnesium, potassium, and sodium oxybates) oral solution. It is for the treatment of cataplexy or excessive daytime sleepiness (EDS) in patients 7 years of age and older with narcolepsy.

Xywav is an oxybate product with a unique composition of cations resulting in 92 percent less sodium - or approximately 1,000 to 1,500 mg/night - than sodium oxybate at the recommended dosage range of 6 to 9 grams.

Multiple Xywav dosing options are available for adult and pediatric patients. Prescribers can titrate Xywav into unequal doses taken over the course of the night. When patients start Xywav after sodium oxybate, Xywav treatment is initiated at the same dose and regimen as sodium oxybate (gram for gram) and titrated as needed based on efficacy and tolerability.

Xywav makes it possible for patients to have a lower-sodium oxybate treatment option. This may help patients taking sodium oxybate better align with daily sodium intake recommendations including those by the American Heart Association. Excess sodium intake has been linked with increases in blood pressure, hypertension, stroke, and other cardiovascular disease.

Xyrem (Sodium oxybate) carries warnings about its high sodium content,10 and was previously the only product approved to treat both cataplexy and EDS in patients with narcolepsy 7 years of age and older and designated as a standard of care for the treatment of cataplexy and EDS by the American Academy of Sleep Medicine.
Xywav has a Boxed Warning as a central nervous system depressant, and for its potential for abuse and misuse. Because of the risks of CNS depression and abuse and misuse, Xywav is available only through a restricted program under a REMS called the Xywav and Xyrem REMS Program.

Most common adverse reactions in adults are headache, nausea, dizziness, decreased appetite, parasomnia, diarrhea, hyperhidrosis, anxiety and vomiting.

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


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Entresto is indicated for the treatment of:

a. Hypertension
b. Heart failure
c. Depression
d. Type II diabetes mellitus
e. Panic disorder


Entresto is indicated for the treatment of:

a. Hypertension
b. Heart failure
c. Depression
d. Type II diabetes mellitus
e. Panic disorder

Answer: b. The active ingredients found in Entresto are Sacubitril and Valsartan. Sacubitril is a neprilysin inhibitor whereas Valsartan is an angiotensin II receptor blocker.

It is available as tablets (24/26 mg, 49/51 mg and 97/103 mg).

It is indicated:

1. to reduce the risk of cardiovascular death and hospitalization for heart failure in patients with chronic heart failure (NYHA Class II-IV) and reduced ejection fraction. It is usually administered in conjunction with other heart failure therapies, in place of an ACE inhibitor or other ARB.

2. for the treatment of symptomatic heart failure with systemic left ventricular systolic dysfunction in pediatric patients aged one year and older.



Hypotension, hyperkalemia, cough, dizziness and renal failure are reported side effects of the drug.

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Rexulti (Brexpiprazole) is indicated for: [Select ALL THAT APPLY].

a. OCD
b. Schizophrenia
c. Hypertension
d. Arrhythmia
e. Depression


Rexulti (Brexpiprazole) is indicated for: [Select ALL THAT APPLY].

a. OCD
b. Schizophrenia
c. Hypertension
d. Arrhythmia
e. Depression

Answer: b, e
 
The active ingredient found in Rexulti is Brexpiprazole. It is available as tablets (0.25 mg, 0.5 mg, 1 mg, 2 mg, 3 mg, and 4 mg).

The recommended dose is 0.5 to 3 mg per day once daily with or without food.

The mechanism of action of Brexpiprazole in the treatment of major depressive disorder or schizophrenia is unknown. However, the efficacy of Brexpiprazole may be mediated through a combination of partial agonist activity at serotonin 5-HT1A and dopamine D2 receptors, and antagonist activity at serotonin 5-HT2A receptors.

Rexulti (Brexpiprazole)  is an atypical antipsychotic indicated for:

1. Use as an adjunctive therapy to antidepressants for the treatment of major depressive disorder (MDD).

2. Treatment of schizophrenia

Dosing adjustments:

1. Moderate to Severe Hepatic Impairment (Child-Pugh score ≥7): Maximum recommended dosage is 2 mg once daily for patients with MDD and 3 mg once daily for patients with schizophrenia.

2. Moderate, Severe or End-Stage Renal Impairment (ClCr<60 mL/minute): Maximum recommended dosage is 2 mg once daily for patients with MDD and 3 mg once daily for patients with schizophrenia.

3. Known CYP2D6 Poor Metabolizers: Reduce the usual dosage by half.
 
Weight gain and akathisia are commonly reported side effects of the drug.



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What is the probable mechanism of action of Sirturo (Bedaquiline)?

a. Inhibits 5-alpha azo reductase
b. Inhibits DNA gyrase
c. Inhibits mycobacterial ATP synthase
d. Inhibits RNA polymerase
e. Inhibits CGAP ligase


What is the probable mechanism of action of Sirturo (Bedaquiline)?

a. Inhibits 5-alpha azo reductase
b. Inhibits DNA gyrase
c. Inhibits mycobacterial ATP synthase
d. Inhibits RNA polymerase
e. Inhibits CGAP ligase

Answer: c

The active ingredient found in Sirturo is Bedaquiline. is the first anti-TB drug to interfere with bacterial energy metabolism.

Sirturo (Bedaquiline)® specifically inhibits mycobacterial ATP (adenosine 5'-triphosphate) synthase, by binding to subunit c of the enzyme that is essential for the generation of energy in Mycobacterium tuberculosis.

Sirturo (Bedaquiline)® is a diarylquinoline antimycobacterial drug indicated as part of combination therapy in the treatment of adult and pediatric patients (12 to less than 18 years of age and weighing at least 30 kg) with pulmonary multi-drug resistant tuberculosis (MDR-TB).

Reserve Sirturo (Bedaquiline)® for use when an effective treatment regimen cannot otherwise be provided.
 
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Recently FDA approved pediatric suspension of VESIcare for used in pediatric patients aged 2 years and older for the treatment of:

a. Overactive bladder
b. Neurogenic detrusor overactivity
c. Nausea and vomiting
d. Preventing excessive gastrin secretion
e. Diarrhea associated with C. difficile


Recently FDA approved pediatric suspension of VESIcare for used in pediatric patients aged 2 years and older for the treatment of:

a. Overactive bladder
b. Neurogenic detrusor overactivity
c. Nausea and vomiting
d. Preventing excessive gastrin secretion
e. Diarrhea associated with C. difficile

Answer: b

The active ingredient found in VESIcare is Solifenacin succinate. It is a muscarinic antagonist. It is available in tablet and pediatric oral suspension dosage forms.

VESIcare LS oral suspension will come in a 5 mg/5 mL (1 mg/mL) oral suspension and will be available in the United States in late 2020.

The tablet dosage form is indicated for the treatment of adults with overactive bladder with symptoms of urge urinary incontinence, urgency, and urinary frequency.
The recommended dose is 5 to 10 mg orally once daily.

Recently, Food and Drug Administration (FDA) has approved VESIcare LS (Solifenacin succinate) oral suspension for the treatment of neurogenic detrusor overactivity (NDO) in pediatric patients aged 2 years and older. 

Patients with NDO may experience involuntary bladder contractions, which can lead to symptoms of urinary urgency, frequency and incontinence. Spina bifida, a congenital spinal cord defect, is a common cause of NDO in children.

The most common adverse reactions (more than 4% in VESIcare-treated patients and placebo-treated patients) were dry mouth and constipation at both 5 mg and 10 mg doses; and urinary tract infection and blurred vision at the 10 mg dose.

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Dupixent (Dupilumab) is a fully-human monoclonal antibody that inhibits the signaling of the: [Select ALL THAT APPLY].
 
a. IL-4
b. IL-8
c. IL-13
d. IL-20
e. IL-23


Dupixent (Dupilumab) is a fully-human monoclonal antibody that inhibits the signaling of the: [Select ALL THAT APPLY].
 
a. IL-4
b. IL-8
c. IL-13
d. IL-20
e. IL-23

Answer: a, c

Atopic dermatitis usually develops in early childhood and is more common in people who have a family history of the condition.

The main symptom is a rash that typically appears on the arms and behind the knees, but can also appear anywhere.

The active ingredient found in Dupixent (Dupilumab) is Dupilumab. It is the first biologic medicine for children aged 6 to 11 Years with Moderate-to-Severe Atopic Dermatitis.
Dupixent (Dupilumab) is a fully-human monoclonal antibody that inhibits the signaling of the interleukin-4 (IL-4) and interleukin-13 (IL-13) proteins, and is not an immunosuppressant.

IL-4 and IL-13 are key drivers of the type 2 inflammation that plays a major role in atopic dermatitis, asthma and chronic rhinosinusitis with nasal polyposis (CRSwNP).
Dupixent (Dupilumab) is an interleukin-4 receptor alpha antagonist indicated:

1. for the treatment of patients aged 6 years and older with moderate-to-severe atopic dermatitis whose disease is not adequately controlled with topical prescription therapies or when those therapies are not advisable.

2. as an add-on maintenance treatment in patients with moderate-to-severe asthma aged 12 years and older with an eosinophilic phenotype or with oral corticosteroid dependent asthma.

3. as an add-on maintenance treatment in adult patients with inadequately controlled chronic rhinosinusitis with nasal polyposis (CRSwNP).

The recommended dose is an initial dose of 600 mg (two 300 mg injections in different injection sites), followed by 300 mg given every other week.
 
Most common adverse reactions (incidence ≥1%) are injection site reactions, conjunctivitis, blepharitis, oral herpes, keratitis, eye pruritus, other herpes simplex virus infection, and dry eye.

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Which of the following information is the primary gene associated with an increased risk for Ankylosing Spondylitis?
 
a. HLA-B27
b. PRC-201
c. HLB-A27
d. CEA
e. RTP-PY3


Which of the following information is the primary gene associated with an increased risk for Ankylosing Spondylitis?
 
a. HLA-B27
b. PRC-201
c. HLB-A27
d. CEA
e. RTP-PY3

Answer: a

Ankylosing Spondylitis is best known as an arthritis of the joints of the spine, but it frequently affects other joints (e.g, shoulders, hips) and occasionally affects other organs such as the eyes, skin, and intestines (ie, uveitis, psoriasis, and inflammatory bowel disease, respectively).

The etiology of Ankylosing Spondylitis is unknown; however, environmental and genetic factors may play a role in its occurrence.
 
1. Human leukocyte antigen-B27 (HLA-B27) is the primary gene associated with an increased risk for Ankylosing Spondylitis;

2. The presence of interleukin 23R (IL23R) and endoplasmic reticulum aminopeptidase 1 (ERAP1) may also increase risk.

Symptom onset commonly occurs in late adolescence or early adulthood (17-45 years of age) with unilateral or alternating low back and buttock pain or stiffness that improves with activity and worsens with rest.
 
The pain is usually dull and diffuses and progresses gradually over weeks to months. Up to 35% of patients have hip arthritis.
 
 The pain eventually becomes chronic and bilateral in nature and advances to neck pain and stiffness months to years after initial presentation.
 
Of note, symptoms of Ankylosing Spondylitis may initially manifest in a peripheral joint in a minority of patients, more commonly in children, which may lead to the potential for an incorrect diagnosis. 
 
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Which of the following information IS NOT reported symptom of pediatric multisystem inflammatory syndrome?
 
a. fever
b. rash
c. persistent cough
d. swollen lymph nodes
e. belly pain


Which of the following information IS NOT reported symptom of pediatric multisystem inflammatory syndrome?
 
a. fever
b. rash
c. persistent cough
d. swollen lymph nodes
e. belly pain

Answer: c

Though the coronavirus doesn't infect as many children as adults, doctors are alarmed that a growing number of children are becoming sick with a condition called pediatric multisystem inflammatory syndrome, which may be related to the coronavirus.

Symptoms of pediatric multisystem inflammatory syndrome include a fever, rash, swollen lymph nodes, and belly pain, the Health Department said in its advisory.

A persistent cough and breathing troubles, two of the main symptoms of COVID-19, are not listed as symptoms of the condition.

The state Health Department said the condition has similarities to toxic shock syndrome and Kawasaki disease, a childhood illness.

Treatments include steroids, intravenous immunoglobulin, aspirin, antibiotics, and oxygen, sometimes use of a ventilator in the most serious cases.

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Nurtec is indicated for which of the following?

a. Hypertension
b. Gout
c. Migraine
d. Diabetes
e. Rheumatoid arthritis


Nurtec is indicated for which of the following?

a. Hypertension
b. Gout
c. Migraine
d. Diabetes
e. Rheumatoid arthritis

Answer: c

The active ingredient found in Nurtec is Rimegepant. It  is a calcitonin gene-related peptide receptor antagonist indicated for the acute treatment of migraine with or without aura in adults.
 
The recommended dose is 75 mg taken orally, as needed. The maximum dose in a 24-hour period is 75 mg. The safety of treating more than 15 migraines in a 30-day period has not been established.
 
Nausea is the most commonly reported side effect of Nurtec (Rimegepant). 
 
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Phexxi is indicated for the treatment of:
 
a. Hypertension
b. Diabetes
c. Prevention of pregnancy
d. Nausea and vomiting associated with emetogenic cancer therapy
e. Parkinsonism


Phexxi is indicated for the treatment of:
 
a. Hypertension
b. Diabetes
c. Prevention of pregnancy
d. Nausea and vomiting associated with emetogenic cancer therapy
e. Parkinsonism
 
Answer: C

Phexxi is the first non-hormonal, on-demand, vaginal pH regulator contraceptive designed to maintain vaginal pH within the normal range of 3.5 to 4.5 – an acidic environment that is inhospitable to sperm.
 
The active ingredients found in Phexxi are lactic acid, citric acid and potassium bitartrate. It is available as vaginal gel.
 
It is indicated for the prevention of pregnancy in females of reproductive potential for use as an on-demand method of contraception. Phexxi is not effective for the prevention of pregnancy when administered after intercourse.
 
Avoid use of Phexxi in females of reproductive potential with history of recurrent urinary tract infection or urinary tract abnormalities.
 
Vulvovaginal burning sensation, vulvovaginal pruritus, vulvovaginal mycotic infection, urinary tract infection, vulvovaginal discomfort, bacterial vaginosis, vaginal discharge, genital discomfort, dysuria, and vulvovaginal pain are commonly reported side effects of Phexxi.
 
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