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Which of the following is the first combination pill approved to treat chronic HCV genotype 1 infection?
 
a. Vitekta
b. Tybost
c. Movantik
d. Harvoni
e. Contrave


Which of the following is the first combination pill approved to treat chronic HCV genotype 1 infection?
 
a. Vitekta
b. Tybost
c. Movantik
d. Harvoni
e. Contrave

Answer: (d). Ledipasvir and Sofosbuvir (Harvoni) . Ledipasvir and Sofosbuvir (Harvoni) is the first combination pill approved to treat chronic HCV genotype 1 infection.

Harvoni is a fixed-dose combination of ledipasvir, a hepatitis C virus (HCV) NS5A inhibitor, and sofosbuvir, an HCV nucleotide analog NS5B polymerase inhibitor, and is indicated for the treatment of chronic hepatitis C virus (HCV) in adults and pediatric patients 3 years of age and older:

1. Genotype 1, 4, 5, or 6 infection without cirrhosis or with compensated cirrhosis.
2. Genotype 1 infection with decompensated cirrhosis, in combination with ribavirin.
3. Genotype 1 or 4 infection who are liver transplant recipients without cirrhosis or with compensated cirrhosis, in combination with ribavirin.
 
It is available as tablets (90mg Ledipasvir/400 mg Sofosbuvir, 45mg Ledipasvir/200 mg Sofosbuvir)  and oral pellets (45 mg of Ledipasvir and 200 mg of Sofosbuvir, 33.75 mg of Ledipasvir and 150 mg of Sofosbuvir).
 
The recommended dose in an adult patient is  one tablet (90 mg of Ledipasvir and 400 mg of Sofosbuvir) taken orally once daily with or without food.
 
The most common side effects reported in clinical trial participants were fatigue and headache.
 
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Which of the following Oxybutynin formulations is indicated for the symptoms of detrusor overactivity associated with a condition called Spina bifida?
 
I. Ditropan
II. Oxytrol
III. Ditropan XL
 
a. I only
b. III only
c. I and II only
d. II and III only
e. All


Which of the following Oxybutynin formulations is indicated for the symptoms of detrusor overactivity associated with a condition called Spina bifida?
 
I. Ditropan
II. Oxytrol
III. Ditropan XL
 
a. I only
b. III only
c. I and II only
d. II and III only
e. All
 
Answer: (b). Oxybutynin (Ditropan XL) is an antispasmodic, anticholinergic agent. Each Oxybutynin (Ditropan XL) Extended Release Tablet contains 5 mg, 10 mg, or 15 mg of Oxybutynin chloride USP, formulated as a once-a-day controlled-release tablet for oral administration. Oxybutynin (Ditropan XL) uses osmotic pressure to deliver oxybutynin chloride at a controlled rate over approximately 24 hours.
 
Oxybutynin (Ditropan XL) is indicated for the treatment of overactive bladder with symptoms of urge urinary incontinence, urgency, and frequency. It is also indicated in the treatment of pediatric patients aged 6 years and older with symptoms of detrusor overactivity associated with a neurological condition (e.g., spina bifida).
 
Oxybutynin (Ditropan XL) must be swallowed whole with the aid of liquids, and must not be chewed, divided, or crushed. It may be administered with or without food. The recommended starting dose of Oxybutynin (Ditropan XL) in adult is 5 or 10 mg once daily at approximately the same time each day. Dosage may be adjusted in 5-mg increments to achieve a balance of efficacy and tolerability (up to a maximum of 30 mg/day).
 
For pediatric patients aged 6 years of age and older, the recommended starting dose of Oxybutynin (Ditropan XL) is 5 mg once daily at approximately the same time each day. Dosage may be adjusted in 5-mg increments to achieve a balance of efficacy and tolerability (up to a maximum of 20 mg/day).
 
Dry mouth, constipation, blurred vision and vasodilation are commonly reported side effects of Oxybutynin (Ditropan XL).
 
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Cordarone shall be carefully prescribed to patients suffering from:
 
a. Hypertension
b. Arrhythmia
c. Depression
d. Hyperthyroidism
e. Seizure
 


Cordarone shall be carefully prescribed to patients suffering from:
 
a. Hypertension
b. Arrhythmia
c. Depression
d. Hyperthyroidism
e. Seizure
 
Answer: (d). Amiodarone (Cordarone) is a member of a class of antiarrhythmic drugs with predominantly Class III (Vaughan Williams' classification) effects, available for oral administration as pink, scored tablets containing 200 mg of Amiodarone hydrochloride.
 
Amiodarone (Cordarone) contains 37.3% iodine by weight. Therefore, it shall be carefully prescribed to patients suffering from hypo-hyper-thyroidism.
 
Because of its life-threatening side effects and the substantial management difficulties associated with its use, Amiodarone (Cordarone) is indicated only for the treatment of the following documented, life-threatening recurrent ventricular arrhythmias when these have not responded to documented adequate doses of other available antiarrhythmics or when alternative agents could not be tolerated.
 
1. Recurrent ventricular fibrillation.
 
2. Recurrent hemodynamically unstable ventricular tachycardia.
 
Loading doses of 800 to 1,600 mg/day are required for 1 to 3 weeks (occasionally longer) until initial therapeutic response occurs. Administration of Amiodarone (Cordarone) in divided doses with meals is suggested for total daily doses of 1,000 mg or higher, or when gastrointestinal intolerance occurs. If side effects become excessive, the dose should be reduced.
 
When adequate arrhythmia control is achieved, or if side effects become prominent, Amiodarone (Cordarone) dose should be reduced to 600 to 800 mg/day for one month and then to the maintenance dose, usually 400 mg/day.
 
Since grapefruit juice is known to inhibit CYP3A4-mediated metabolism of oral amiodarone in the intestinal mucosa, resulting in increased plasma levels of Amiodarone, grapefruit juice should not be taken during treatment with oral Amiodarone.
 
Since amiodarone is a substrate for CYP3A4 and CYP2C8, drugs/substances that inhibit CYP3A4 may decrease the metabolism and increase serum concentrations of Amiodarone.
 
Hepatic injury, hypothyroidism, hyperthyroidism, tremor, poor coordination and pulmonary fibrosis are commonly reported side effects of Amiodarone (Cordarone).
 
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Which of the following shall be measured before initiating Inspra therapy?
 
a. blood glucose level
b. amino acid (alanine) level
c. serum potassium level
d. INR ratio
e. LDL level


Which of the following shall be measured before initiating Inspra therapy?
 
a. blood glucose level
b. amino acid (alanine) level
c. serum potassium level
d. INR ratio
e. LDL level
 
Answer: Serum potassium level. Eplerenone (Inspra) is a blocker of aldosterone binding at the mineralocorticoid receptor. It is available for oral administration contains 25 mg or 50 mg of Eplerenone (Inspra). It is indicated for the treatment of Congestive Heart Failure Post-Myocardial Infarction and Hypertension.
 
Treatment should be initiated at 25 mg once daily and titrated to the recommended dose of 50 mg once daily, preferably within 4 weeks as tolerated by the patient. Eplerenone (Inspra) may be administered with or without food.
 
Serum potassium should be measured before initiating Eplerenone (Inspra) therapy, within the first week, and at one month after the start of treatment or dose adjustment. Serum potassium should be assessed periodically thereafter.
 
For hypertensive patients receiving moderate CYP3A4 inhibitors (e.g., erythromycin, saquinavir, verapamil, and fluconazole), the starting dose of Eplerenone (Inspra) should be reduced to 25 mg once daily. In all patients taking Eplerenone (Inspra) who start taking a moderate CYP3A4 inhibitor, check serum potassium and serum creatinine in 3-7 days.
 
Hyperkalemia, dizziness, diarrhea and abdominal pain are reported side effects of Eplerenone (Inspra).
 
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Zetia is indicated for the treatment of:
 
I. Hyperlipidemia
II. Homozygous Familial Hypercholesterolemia
III. Sitosterolemia
 
a. I only
b. III only
c. I and II only
d. II and III only
e. All


Zetia is indicated for the treatment of:
 
I. Hyperlipidemia
II. Homozygous Familial Hypercholesterolemia
III. Sitosterolemia
 
a. I only
b. III only
c. I and II only
d. II and III only
e. All
 
Answer (e), All. Ezetimibe (Zetia), administered alone, is indicated as adjunctive therapy to diet for the reduction of elevated total cholesterol (total-C), low-density lipoprotein cholesterol (LDL-C), apolipoprotein B (Apo B), and nonhigh- density lipoprotein cholesterol (non-HDL-C) in patients with primary (heterozygous familial and nonfamilial) hyperlipidemia.
 
The combination of Ezetimibe (Zetia) and Atorvastatin or Simvastatin is indicated for the reduction of elevated total-C and LDL-C levels in patients with Homozygous Familial Hypercholesterolemia (HoFH).
 
It is also indicated as adjunctive therapy to diet for the reduction of elevated sitosterol and campesterol levels in patients with homozygous familial sitosterolemia.
 
The recommended dose of Ezetimibe (Zetia) is 10 mg once daily with or without food. Liver enzyme abnormalities, rhabdomyolysis and myopathy are commonly reported side effects of Zetia.


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What is an elemental calcium amount in Actonel With Calcium?
 
a. 1250 mg
b. 500 mg
c. 650 mg
d. 1000 mg
e. 1250 mg


What is an elemental calcium amount in Actonel With Calcium?
 
a. 1250 mg
b. 500 mg
c. 650 mg
d. 1000 mg
e. 1250 mg
 
500 mg. Risedronate (Actonel) With Calcium is a co-package product containing Risedronate sodium tablets, 35 mg for once weekly dosing and calcium carbonate tablets, USP (1250 mg, equivalent to 500 mg elemental calcium) for daily dosing for the remaining 6 days of the week. Each package contains a 28-day course of therapy.
 
Risedronate (Actonel) is a pyridinyl bisphosphonate that inhibits osteoclast-mediated bone resorption and modulates bone metabolism. It is indicated for the treatment and prevention of osteoporosis in postmenopausal women.
 
Risedronate (Actonel) should be taken at least 30 minutes before the first food or drink of the day other than water. Risedronate (Actonel) should not be taken at the same time as other medications, including calcium.
 
To facilitate delivery to the stomach, Risedronate (Actonel) should be swallowed while the patient is in an upright position and with a full glass of plain water (6 to 8 oz). Patients should not lie down for 30 minutes after taking the medication.
 
Risedronate (Actonel) is not recommended for use in patients with severe renal impairment (creatinine clearance < 30 mL/min). No dosage adjustment is necessary in patients with a creatinine clearance ≥ 30 mL/min or in the elderly.
 
One 1250 mg calcium carbonate tablet (500 mg elemental calcium) orally, taken with food daily on each of the remaining six days (Days 2 through 7 of the 7-day treatment cycle).
 
Arthralgia, myalgia and nausea are commonly reported side effects of Risedronate (Actonel).

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Which of the following active ingredients found in Fosamax Plus D?
 
a. Vitamin D1
b. Vitamin D2
c. Vitamin D3
d. Vitamin D4
e. Vitamin D5


Which of the following active ingredients found in Fosamax Plus D?
 
a. Vitamin D1
b. Vitamin D2
c. Vitamin D3
d. Vitamin D4
e. Vitamin D5

Answer: (c) Alendronate sodium is a bisphosphonate that acts as a specific inhibitor of osteoclast mediated bone resorption. Bisphosphonates are synthetic analogs of pyrophosphate that bind to the hydroxyapatite found in bone.
 
Fosamax Plus D contains Alendronate sodium, a bisphosphonate, and Cholecalciferol (vitamin D3). Cholecalciferol (vitamin D3) is a secosterol that is the natural precursor of the calcium-regulating hormone calcitriol (1,25 dihydroxyvitamin D3).
 
It is indicated for the treatment of osteoporosis in postmenopausal women and to increase bone mass in men with osteoporosis.
 
The recommended dosage is one 70 mg Alendronate/2800 international units vitamin D3 or one 70 mg Alendronate/5600 international units vitamin D3 tablet once weekly.

Important Administration Instructions:

1. Take the drug at least one-half hour before the first food, beverage, or medication of the day with plain water only. Other beverages (including mineral water), food, and some medications are likely to reduce the absorption of Alendronate. Waiting less than 30 minutes, or taking Fosamax Plus D with food, beverages (other than plain water) or other medications will lessen the effect of Alendronate by decreasing its absorption into the body.

2. Take Fosamax Plus D upon arising for the day. To facilitate delivery to the stomach and thus reduce the potential for esophageal irritation, a Fosamax Plus D tablet should be swallowed with a full glass of water (6-8 ounces).

3. Patients should not lie down for at least 30 minutes and until after their first food of the day.

4. Fosamax Plus D should not be taken at bedtime or before arising for the day. Failure to follow these instructions may increase the risk of esophageal adverse experiences. 
 
Asthenia, diarrhea, abdominal pain, edema, leg cramps and rash are commonly reported side effects of Fosamax Plus D.

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Which of the following information is/are TRUE about Ebola Hemorrhagic Fever?
 
I. It is a viral hemorrhagic fevers.
II. It is a severe, often fatal disease in humans and nonhuman primates.
III. It is caused by infection with a virus of the family Filoviridae.
 
a. I only
b. I and II only
c. III only
d. II and III only
e. All


Which of the following information is/are TRUE about Ebola Hemorrhagic Fever?
 
I. It is a viral hemorrhagic fevers.
II. It is a severe, often fatal disease in humans and nonhuman primates.
III. It is caused by infection with a virus of the family Filoviridae.
 
a. I only
b. I and II only
c. III only
d. II and III only
e. All

Answer:(d), All. Ebola hemorrhagic fever (Ebola HF) is one of numerous Viral Hemorrhagic Fevers. It is a severe, often fatal disease in humans and nonhuman primates (such as monkeys, gorillas, and chimpanzees).
 
Ebola HF is caused by infection with a virus of the family Filoviridae, genus Ebolavirus. When infection occurs, symptoms usually begin abruptly. The first Ebolavirus species was discovered in 1976 in what the Democratic Republic of the Congo near the Ebola River is now. Since then, outbreaks have appeared sporadically.
 
There are five identified subspecies of Ebolavirus. Four of the five have caused disease in humans: Ebola virus (Zaire ebolavirus); Sudan virus (Sudan ebolavirus); Taï Forest virus (Taï Forest ebolavirus, formerly Côte d'Ivoire ebolavirus); and Bundibugyo virus (Bundibugyo ebolavirus). The fifth, Reston virus (Reston ebolavirus), has caused disease in nonhuman primates, but not in humans.

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Which of the following information about Cardioviva is/are TRUE?
 
I. It is a natural, over-the-counter probiotic supplement.
II. It is clinically proven to support healthy knee cartilage in adults.
III. The probiotic strain in Cardioviva is Lactobacillus acidophilus.
 
a. I only
b. I and II only
c. III only
d. II and III only
e. All


Which of the following information about Cardioviva is/are TRUE?
 
I. It is a natural, over-the-counter probiotic supplement.
II. It is clinically proven to support healthy knee cartilage in adults.
III. The probiotic strain in Cardioviva is Lactobacillus acidophilus.
 
a. I only
b. I and II only
c. III only
d. II and III only
e. All
 
Answer: (a), I is true. Cardioviva is a natural, over-the-counter probiotic supplement. The probiotic strain in Cardioviva is Lactobacillus reuteri. It is clinically proven to support healthy Cholesterol levels in adults. The suggested dose is one 100 mg capsule twice daily with meals. Gas and bloating are commonly reported side effects of Cardioviva.
 
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Which of the following nasal corticosteroids is/are available OTC? [Select ALL THAT APPLY].
 
a. Nasacort
b. Nasonex
c. Omnaris
d. Flonase
e. Vancenase


Which of the following nasal corticosteroids is/are available OTC? [Select ALL THAT APPLY].
 
a. Nasacort
b. Nasonex
c. Omnaris
d. Flonase
e. Vancenase
 
Answer: (a,d),
 
The U.S. Food and Drug Administration (FDA) has approved Flonase Allergy Relief (fluticasone propionate 50 mcg spray)as an over-the-counter (OTC) treatment for temporary relief of the symptoms of hay fever or upper respiratory allergies.
 
Flonase Allergy Relief is the first over-the-counter nasal spray indicated for relief of all nasal and eye-related allergy symptoms including runny nose, sneezing, itchy nose, nasal congestion and itchy and watery eyes. Flonase Allergy Relief will be available at full prescription strength and to provide 24-hour non-drowsy allergy relief.
 
Nasacort Allergy 24HR and Children's Nasacort Allergy 24HR, an active ingredient Triamcinolone, are available as OTC for temporary relief of the symptoms of hay fever or upper respiratory allergies. The recommended dose is spray 2 (Triamcinolone acetonide 55 mcg spray) times into each nostril while sniffing gently daily. Once the allergy symptoms improve, reduce to 1 spray in  each nostril per day.

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