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Which of the following information is/are TRUE ABOUT Lyme disease tests? [Select ALL That Apply].

a. Most Lyme disease tests are designed to detect antibodies made by the body in response to infection.
b. Antibodies can take several weeks to develop, so patients may test negative if infected only recently.
c. Antibodies normally persist in the blood for months or even years after the infection is gone; therefore, the test cannot be used to determine cure.
d. Infection with other diseases, including some tickborne diseases, or some viral, bacterial, or autoimmune diseases, can result in false positive test results.
e. Some tests give results for two types of antibody, IgM and IgG.  Positive IgM results should be disregarded if the patient has been ill for more than 30 days.


Which of the following information is/are TRUE ABOUT Lyme disease tests? [Select ALL That Apply].

a. Most Lyme disease tests are designed to detect antibodies made by the body in response to infection.
b. Antibodies can take several weeks to develop, so patients may test negative if infected only recently.
c. Antibodies normally persist in the blood for months or even years after the infection is gone; therefore, the test cannot be used to determine cure.
d. Infection with other diseases, including some tickborne diseases, or some viral, bacterial, or autoimmune diseases, can result in false positive test results.
e. Some tests give results for two types of antibody, IgM and IgG.  Positive IgM results should be disregarded if the patient has been ill for more than 30 days.

Answer: (a,b,c,d,e)

Lyme disease is caused by bacteria. In the United States, this is usually a bacterium called Borrelia burgdorferi. It spreads to humans through the bite of an infected tick. The ticks that spread it are blacklegged ticks (or deer ticks).
 
CDC currently recommends a two-step testing process for Lyme disease. Both steps are required and can be done using the same blood sample. If this first step is negative, no further testing is recommended. If the first step is positive or indeterminate (sometimes called “equivocal”), the second step should be performed. The overall result is positive only when the first test is positive (or equivocal) and the second test is positive (or for some tests equivocal).
 
Key points to remember:
 
1. Most Lyme disease tests are designed to detect antibodies made by the body in response to infection.
2. Antibodies can take several weeks to develop, so patients may test negative if infected only recently.
3. Antibodies normally persist in the blood for months or even years after the infection is gone; therefore, the test cannot be used to determine cure.
4. Infection with other diseases, including some tickborne diseases, or some viral, bacterial, or autoimmune diseases, can result in false positive test results.
5. Some tests give results for two types of antibody, IgM and IgG.  Positive IgM results should be disregarded if the patient has been ill for more than 30 days. 
 
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MenQuadfi is a vaccine given to people 2 years of age and older to help prevent invasive meningococcal disease (including meningitis) caused by serogroups ___________ of the bacterium N meningitidis. [Select ALL That Apply].

a. A
b. B
c. C
d. W
e. Y


MenQuadfi is a vaccine given to people 2 years of age and older to help prevent invasive meningococcal disease (including meningitis) caused by serogroups ___________ of the bacterium N meningitidis. [Select ALL That Apply].

a. A
b. B
c. C
d. W
e. Y

Answer: (a,c,d,e)

MenQuadfi is a vaccine given to people 2 years of age and older to help prevent invasive meningococcal disease (including meningitis) caused by serogroups A, C, W, and Y of the bacterium N meningitidis.

MenQuadfi does not prevent serogroup B disease.

In the U.S., the Centers for Disease Control and Prevention recommends vaccination against meningococcal disease at 11-12 years of age and a second dose at 16 years of age.
Despite strong public health recommendations, about half of teens have not received the recommended second dose of MenACWY vaccine by 17 years of age, leaving them vulnerable when they are at increased risk for the disease.

Hundreds of cases of vaccine-preventable meningococcal disease (caused by serogroups B, C, W, Y) still occur annually in the U.S. and, despite treatment, one in five survivors suffer from permanent complications such as hearing loss, organ damage, and limb amputations.

The most common side effects following a first dose of MenQuadfi included injection site pain, muscle ache, headache, and tiredness. In adolescents and adults receiving a MenQuadfi booster, similar rates of these reactions were observed. 
 
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Keytruda is indicated for the treatment of: [Select ALL That Apply].
 
a. Non-Small Cell Lung Cancer
b. Head and Neck Squamous Cell Cancer
c. Gastric Cancer
d. Esophageal Cancer
e. Cervical Cancer



Keytruda is indicated for the treatment of: [Select ALL That Apply].
 
a. Non-Small Cell Lung Cancer
b. Head and Neck Squamous Cell Cancer
c. Gastric Cancer
d. Esophageal Cancer
e. Cervical Cancer

Answer: (a,b,c,d,e)

The active ingredient found in Keytruda is Pembrolizumab. It is available in injection (100 mg/4 mL) form.
 
Binding of the PD-1 ligands, PD-L1 and PD-L2, to the PD-1 receptor found on T cells, inhibits T cell proliferation and cytokine production. Upregulation of PD-1 ligands occurs in some tumors and signaling through this pathway can contribute to inhibition of active T-cell immune surveillance of tumors.

Pembrolizumab is a monoclonal antibody that binds to the PD-1 receptor and blocks its interaction with PD-L1 and PD-L2, releasing PD-1 pathway-mediated inhibition of the immune response, including the anti-tumor immune response. In syngeneic mouse tumor models, blocking PD-1 activity resulted in decreased tumor growth.

Keytruda is indicated for the treatment of:

a. Melanoma
b. Non-Small Cell Lung Cancer (NSCLC)
c. Small Cell Lung Cancer (SCLC)
d. Head and Neck Squamous Cell Cancer (HNSCC)
e. Classical Hodgkin Lymphoma (cHL)
f. Primary Mediastinal Large B-Cell Lymphoma (PMBCL)
g. Urothelial Carcinoma
h. Microsatellite Instability-High Cancer
i. Gastric Cancer
k. Esophageal Cancer
l. Cervical Cancer
m. Hepatocellular Carcinoma (HCC)
n. Merkel Cell Carcinoma (MCC)
o. Renal Cell Carcinoma (RCC)
p. Endometrial Carcinoma
 
The usual recommended dose of Keytruda is 200 mg every 3 weeks or 400 mg every 6 weeks.  
 
Immune-Mediated pneumonitis, colitis, hepatitis, endocrinopathies, hypophysitis, nephritis and renal dysfunction are commonly reported side effects of the drug.
 
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What are the possible side effects of Farxiga? [Select All That Apply]:
 
a. Dehydration
b. Ketoacidosis
c. Urinary tract infections
d. Vaginal yeast infections
e. Balanitis


What are the possible side effects of Farxiga? [Select All That Apply]:
 
a. Dehydration
b. Ketoacidosis
c. Urinary tract infections
d. Vaginal yeast infections
e. Balanitis

Answer: (a,b,c,d,e)
 
The active ingredient found in Farxiga is Dapagliflozin (Farxiga).  
 
Farxiga may cause serious side effects including:
1. Dehydration
2. Ketoacidosis
3. Serious urinary tract infections (UTI)
4. Low blood sugar (hypoglycemia)
5. Bacterial infections under the skin of the genitals and areas around them
6. Vaginal yeast infections
7. Yeast infection of skin around the penis (balanitis) in men.

The most common side effects of Dapagliflozin (Farxiga) include yeast infections of the vagina or penis, and changes in urination, including urgent need to urinate more often, in larger amounts, or at night.


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Farxiga is indicated to [Select All That Apply]:
 
a. improve blood sugar control along with diet and exercise in adults with type 2 diabetes.
b. reduce the risk of hospitalization for heart failure in adults with type 2 diabetes.
c. reduce the risk of cardiovascular death and hospitalization for heart failure in adults with heart failure.
d. reduce the risk of diabetic ketoacidosis in adults with type 1 diabetes.


Farxiga is indicated to [Select All That Apply]:
 
a. improve blood sugar control along with diet and exercise in adults with type 2 diabetes.
b. reduce the risk of hospitalization for heart failure in adults with type 2 diabetes.
c. reduce the risk of cardiovascular death and hospitalization for heart failure in adults with heart failure.
d. reduce the risk of diabetic ketoacidosis in adults with type 1 diabetes.

Answer: (a,b,c)
 
The active ingredient found in Farxiga is Dapagliflozin (Farxiga).  Farxiga is indicated to:
 
1. improve blood sugar control along with diet and exercise in adults with type 2 diabetes.
2. reduce the risk of hospitalization for heart failure in adults with type 2 diabetes.
3. reduce the risk of cardiovascular death and hospitalization for heart failure in adults with heart failure.
 
Farxiga should not be used to treat people with type 1 diabetes or diabetic ketoacidosis (increased ketones in your blood or urine).
 
To improve glycemic control, the recommended starting dose of Farxiga is 5 mg orally once daily, taken in the morning, with or without food. In patients tolerating Farxiga 5 mg once daily who require additional glycemic control, the dose can be increased to 10 mg once daily.


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Farxiga is:

a. 5HT-1 receptor Antagonist
b. Alpha-2 inhibitor
c. Renin inhibitor
d. SGLT2 inhibitor
e. SSRI


Farxiga is:

a. 5HT-1 receptor Antagonist
b. Alpha-2 inhibitor
c. Renin inhibitor
d. SGLT2 inhibitor
e. SSRI

The active ingredient found in Farxiga is Dapagliflozin (Farxiga). It is the first sodium glucose co-transporter 2 (SGLT2) inhibitor approved by the US FDA. It is available as tablets (5mg and 10mg).

Sodium-glucose co-transporter 2 (SGLT2) is the predominant transporter responsible for reabsorption of glucose from the glomerular filtrate back into the circulation. Dapagliflozin (Farxiga) is an inhibitor of SGLT2. By inhibiting SGLT2, Dapagliflozin (Farxiga) reduces renal reabsorption of filtered glucose and lowers the renal threshold for glucose, and thereby increases urinary glucose excretion.

Dapagliflozin (Farxiga) also reduces sodium reabsorption and increase the delivery of sodium to distal tubule. This may influence several physiological functions including, but not limited to, lowering both pre-and afterload of the heart and downregulation of sympathetic activity.

Dapagliflozin (Farxiga) is a prescription medicine used to:

1. improve blood sugar control along with diet and exercise in adults with type 2 diabetes

2. reduce the risk of hospitalization for heart failure in adults with type 2 diabetes and known cardiovascular disease or multiple cardiovascular risk factors

3. reduce the risk of cardiovascular death and hospitalization for heart failure in adults with heart failure (when the heart is weak and cannot pump enough blood to the rest of your body)

Dapagliflozin (Farxiga) should not be used to treat people with type 1 diabetes or diabetic ketoacidosis (increased ketones in your blood or urine).

Usual Adult Dose for Diabetes Type 2:

a. To improve glycemic control (can be taken with or without food):

1. Initial dose: 5 mg orally once a day
2. May increase to 10 mg orally once a day for additional glycemic control if lower dose has been tolerated
3. Maximum dose: 10 mg/day

b. To reduce the risk of hospitalization for heart failure: 10 mg orally once a day.

Dehydration, ketoacidosis, UTI infection, hypoglycemia and vaginal yeast infection are reported side effects of the drug.

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Which of the following is the first FDA-approved intravenous (IV) treatment for migraine prevention?
 
a. Imitrex
b. Relpax
c. Zomig
d. Cambia
e. Vyepti


Which of the following is the first FDA-approved intravenous (IV) treatment for migraine prevention?
 
a. Imitrex
b. Relpax
c. Zomig
d. Cambia
e. Vyepti
 
Answer: (e). 

The active ingredient found in Vyepti is Eptinezumab-jjmr. It is the first FDA-approved intravenous (IV) treatment for migraine prevention.
 
Vyepti (Eptinezumab-jjmr) is a humanized monoclonal antibody that binds to calcitonin gene-related peptide (CGRP) ligand and blocks its binding to the receptor.
 
The recommended dose is 100 mg every 3 months; some patients may benefit from a dose of 300 mg.


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Which of the following information is/are TRUE about Nexletol? [Select All That Apply]
 
a. An active ingredient found in Nexletol is Bempedoic acid.
 
b. It is indicated for reducing the elevated LDL-c level.
 
c. It is an ATP Citrate Lyase (ACL) inhibitor.
 
d. The recommended dose should be taken every 8 hours.
 
e. Hyperuricemia and increased risk of tendon rupture or injury is reported side effect of the drug.


Which of the following information is/are TRUE about Nexletol? [Select All That Apply]
 
a. An active ingredient found in Nexletol is Bempedoic acid.
 
b. It is indicated for reducing the elevated LDL-c level.
 
c. It is an ATP Citrate Lyase (ACL) inhibitor.
 
d. The recommended dose should be taken every 8 hours.
 
e. Hyperuricemia and increased risk of tendon rupture or injury is reported side effect of the drug.
 
Answer: (a, b, c, and e).  
 
The active ingredient found in Nexletol is Bempedoic acid. It is a tablet, an oral, once-daily, non-statin  (LDL-C) lowering medicine.
 
It is indicated as an adjunct to diet and maximally tolerated statin therapy for the treatment of adults with heterozygous familial hypercholesterolemia (HeFH) or established atherosclerotic cardiovascular disease (ASCVD) who require additional lowering of LDL-C.  
 
Nexletol is a first-in-class ATP Citrate Lyase (ACL) inhibitor that lowers LDL-C by inhibition of cholesterol synthesis in the liver.
 
Nexletol was generally well-tolerated in clinical studies. Label warnings and precautions include hyperuricemia, with the development of gout in a small percentage of patients, as well as increased risk of tendon rupture or injury.
 
Overall in Phase 3 studies, the adverse events reported most frequently in patients who received Nexletol were generally reported at similar rates in patients who received placebo.
The most common adverse events reported with Nexletol (incidence ≥ 2% and greater than placebo) were upper respiratory tract infections, muscle spasms, hyperuricemia, back pain, abdominal pain or discomfort, bronchitis, pain in extremity, anemia, and elevated liver enzymes.
 
Avoid concomitant use of Nexletol with Simvastatin greater than 20 mg.


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Which of the following information is/are TRUE about coronavirus? [Select All That Apply]
 
a. 2019-nCoV belongs to a family of single-stranded RNA viruses known as coronaviridae, a common type of virus which affects mammals, birds and reptiles.
 
b. In humans, it commonly causes mild infections, similar to the common cold, and accounts for 10-30% of upper respiratory tract infections in adults
 
c. Although the incubation period of the 2019-nCoV strain is currently unknown, the United States Centre for Disease Control indicates that symptoms may appear in as few as 2 days or as long as 14 days after exposure.
 
d. Similarly to other common respiratory tract infections, MERS and SARS are spread by respiratory droplets produced by an infected person when they sneeze or cough.
 
e. In severe cases, the coronavirus can cause kidney failure.


Which of the following information is/are TRUE about coronavirus? [Select All That Apply]
 
a. 2019-nCoV belongs to a family of single-stranded RNA viruses known as coronaviridae, a common type of virus which affects mammals, birds and reptiles.
 
b. In humans, it commonly causes mild infections, similar to the common cold, and accounts for 10-30% of upper respiratory tract infections in adults
 
c. Although the incubation period of the 2019-nCoV strain is currently unknown, the United States Centre for Disease Control indicates that symptoms may appear in as few as 2 days or as long as 14 days after exposure.
 
d. Similarly to other common respiratory tract infections, MERS and SARS are spread by respiratory droplets produced by an infected person when they sneeze or cough.
 
e. In severe cases, the coronavirus can cause kidney failure.

Answer: (a, b, c, d, e).  
 
A novel strain of coronavirus (temporarily named ‘2019-nCoV’ by the World Health Organization [WHO]) was first detected in December 2019 in Wuhan, a city in China’s Hubei province with a population of 11 million, after an outbreak of pneumonia without an obvious cause. The virus has now spread to countries across the globe.
 
Pharmacists are likely to come across worried patients, and/or those with cold and flu symptoms which may appear similar to those of 2019-nCoV.
 
2019-nCoV belongs to a family of single-stranded RNA viruses known as coronaviridae, a common type of virus which affects mammals, birds and reptiles.
 
In humans, it commonly causes mild infections, similar to the common cold, and accounts for 10-30% of upper respiratory tract infections in adults. More serious infections are rare, although coronaviruses can cause enteric and neurological disease.
 
Previous coronavirus outbreaks include Middle East Respiratory Syndrome (MERS), first reported in Saudi Arabia in September 2012, and severe acute respiratory syndrome (SARS), identified in southern China in 2003. MERS infected around 2,500 people and led to more than 850 deaths while SARS infected more than 8,000 people and resulted in nearly 800 deaths. The case fatality rates for these conditions were 35% and 10%, respectively.
 
2019-nCoV is a new strain of coronavirus that has not been previously identified in humans. Although the incubation period of the 2019-nCoV strain is currently unknown, the United States Centre for Disease Control indicates that symptoms may appear in as few as 2 days or as long as 14 days after exposure.
 
Similarly, to other common respiratory tract infections, MERS and SARS are spread by respiratory droplets produced by an infected person when they sneeze or cough.
 
As this coronavirus affects the respiratory tract, common presenting symptoms include fever and dry cough, with some patients presenting with respiratory symptoms (e.g. sore throat, nasal congestion, malaise, headache and myalgia) or even struggling for breath.
 
In severe cases, the coronavirus can cause pneumonia, severe acute respiratory syndrome, kidney failure and death.


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How one should take Rybelsus? [Select All That Apply]
 
a. Take on an empty stomach when you first wake up.
b. Take with no more than 4 ounces of plain water.
c. Wait at least 30 minutes before eating, drinking, or taking other oral medications.
d. It works best if you take Rybelsus 5 minutes before taking the meal.
e. It should be taken once a weekly.


How one should take Rybelsus? [Select All That Apply]
 
a. Take on an empty stomach when you first wake up.
b. Take with no more than 4 ounces of plain water.
c. Wait at least 30 minutes before eating, drinking, or taking other oral medications.
d. It works best if you take Rybelsus 5 minutes before taking the meal.
e. It should be taken once a weekly.
 
Answer: (a,b,c) The active ingredient found in Rybelsus is Semaglutide. It is a glucagon-like peptide 1 (GLP-1) receptor agonist indicated as:
1. an adjunct to diet and exercise to improve glycemic control in adults with type 2 diabetes mellitus.
 
Rybelsus should be taken:
 
1. Take on an empty stomach when you first wake up.
2. Take with no more than 4 ounces of plain water.
3. Wait at least 30 minutes before eating, drinking, or taking other oral medications.
 
Instruct patients to take Rybelsus (Semaglutide) at least 30 minutes before the first food, beverage, or other oral medications of the day with no more than 4 ounces of plain water only. Waiting less than 30 minutes, or taking with food, beverages (other than plain water) or other oral medications will lessen the effect of Rybelsus (Semaglutide).
Waiting more than 30 minutes to eat may increase the absorption of Rybelsus (Semaglutide). Swallow tablets whole. Do not cut, crush, or chew tablets.
 
Start Rybelsus (Semaglutide) with 3 mg once daily for 30 days. After 30 days on the 3 mg dose, increase the dose to 7 mg once daily. Dose may be increased to 14 mg once daily if additional glycemic control is needed after at least 30 days on the 7 mg dose.

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