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NPLEX 2 Pharm Questions and Correct
Answers | Latest Update
5-fluorouracil
✓ -:- ANTI-NEOPLASTIC/ ANTI-METABOLITE
✓ IND:
✓ - Carcinoma of the breast, colon, head and neck, pancreas, rectum or
stomach
✓ - TOPICAL for management of actinic (solar) keratosis, superficial basal
cell carcinomas
✓ ACT:
✓ - Pyrimidine antimetabolite, blocks methylation of deoxyuridylic acid and
interferes with DNA synthesis
✓ - Stops thymidilate synthase.
✓ A/E:
✓ - Dermatitis, vomiting, diarrhea, alopecia, heartburn, nausea, anorexia,
stomatitis, esophagitis, leukopenia, GI ulceration, myelosuppression
✓ C/I:
✓ - Poor nutritional status, depressed bone marrow fcn, thrombocytopenia,
major surgery w/in the previous month, PREGNANCY, enzyme deficiency
✓ INT:
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✓ - Decreased effect from methotrexate
✓ - Cimetidine, leucovorin increase levels
✓ - Avoid ethanol
✓ MONITOR: CBC w/ differential, platelet count, renal and LV fcn tests
✓ Rx: IV or topical
Acetaminophen
✓ -:- NON-NARCOTIC ANALGESIC/ ANTIPYRETIC (Tylenol)
IND:
- Mild pain, acute MSK pain, OA, RA, fever
ACT:
- Inhibits CNS prostaglandin synthesis, analgesic, anti-pyretic, NOT anti-inflammatory, Does
not affect platelet agg or uric acid metabolism
A/E:
- MAY INHIBIT CARTILAGE FORMATION, HEPATITIS (BLACK BOX WARNING FOR
HEPATOTOXICITY)
- Preg B
- OD can cause potentially lethal hepatotoxicity (overwhelms glutathione detox system in
LV), or nephrotoxicity
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- ANTIDOTE; Charcoal, N-Acetylcysteine (glutathione precursor).
C/I:
- LV dz, LV failure, alcoholism
INT:
- Barbituates, carbamazepine, phenytoin, isoniazid OBCP, and rifampin all activate LV
breakdown of acetaminophen and cause it to be more hepatotoxic and less active.
- Acetamin. may decrease activity of lamotrigine, zidovudine and loop diuretics,
- May interfere w/ home glucose monitors.
**Monitor for HEPATOTOXICITY W/ INGESTION > 4g/DAY
Acyclovir
✓ -:- ANTIVIRAL (Inhibits DNA polymerase)
IND:
- HSV ixn and prevention, VZV, EBV, disseminated neonatal herpes, CMV ixn
ACT:
- Nucleoside analog inhibiting viral replication, NON-CURATIVE
A/E:
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- HA, diarrhea, nausea, delirium, tremor, Htn, transent renal dysfunction w/ high doses,
encephalopathy (IV), CAN PROMOTE EMERGENCE OF RESISTANT STRAINS
C/I:
- Preg C
INT:
- Synergistic toxicity w/ ZIDOVUDINE (AZT).
MONITOR: urinalysis, BUN, serum creatinine, LV enz, CBC
Rx: Oral, topical, IV
Adalimumab
✓ -:- DMARD (Antirheumatic, TNF-alpha inhib)
IND:
- RA, psoriatic arthritis, ankylosing spondylitis, Crohn's dz, severe psoriasis, JRA
ACT:
- Fully-humanized anti TNF-alpha IgG; anti-inflammatory and immunosuppressive
A/E:
- injection site rxn's, increased risk of dangerous ixn's (TB), herpes zoster re-activation,
cancers (ESP LYMPHOMA IN CHILDREN)
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