NAPLEX STUDY SET (EVERYTHING)
QUESTIONS WITH CORRECT ANSWERS
Hypercalcemia is caused by the following medications - ANSWER -Vitamin D,
Thiazide Diuretics
Hypocalcemia caused by the following medications - ANSWER -Long term Heparin
Loop Dirtuetics
Bisphosphonates
Cinacalcet, calcitonin, Foscamet
Topiramate
Hyper-magnesium caused by the following medications - ANSWER -Antacids (Makes
sense because contain mg)
Laxatives (Phillips milk of magnesia)
Hypo-magnesium caused by the following medications - ANSWER -PPIs
Diruetics
Amphotericin
Hyper phosphatemia caused by - ANSWER -Renal Failure
Hypo-phosphatemia caused by - ANSWER -Phosphate binders
Hyper-Natremia caused by - ANSWER -Hypertonic Saline
Hypo-Natremia caused by - ANSWER -Diruetics
SSRI
Carbamazepine
Oxcarbamazepine
Increase Bicarbonate caused by - ANSWER -Loop Diuretics
Systemic steroids
What are some medications that decrease bicarb levels - ANSWER -Topiramate
Zonisamide
Salicylate Overdose (make sense because its an acid)
What is the use of Blood Urea Nitrogen (BUN) - ANSWER -Used to asses fluid status
Increase in renal impairment and dehydration
ABX that cause QT Prolongation - ANSWER -Quinolones and Macrolides
,Anti Fungals that cause QT Prolongation - ANSWER -Azole Antifungal except
Isavuconazonium
Anti emetic drugs that cause QT prolongation - ANSWER -5HT3 Receptor Antagonist
Drosperidol and phenothiazines
Anti psychotics that cause QT prolongation - ANSWER -Most of them do (Less common
ones include thioraridazine,)
Anti Arrhythmic drug class that cause QT prolonagtion - ANSWER -Class Ia and Ic and
Class III
Anti depressants that cause QT prolonagtion (most of the classes) - ANSWER -Tri-
cyclics, SSRIs, SNRI
Mirtazepine and trazadone
Setraline is preffered in patients with Heart conditons
Class Ia Anti-arrhythmics MOA - ANSWER -Negative ionotrophs
Disopyramide, Quinidine, Procainamide
(Double , Quater Pounder)
Class II Anti-arrhythmics MOA - ANSWER -Block Sympathetic Activity which decrease
HR
Beta Blockers
Because
Class Ib Anti-arrhythmics MOA - ANSWER -Same MOA as Class Ia
Lidocaine, Mexiletine
Lettuce, Mayo
Class Ic Anti arrhythmic Drugs - ANSWER -Flecainide, Propafenone
Fries, Please
Class III Anti-arrhythmics MOA - ANSWER -Block K+ channels, alpha and beta
adrenergic receptors, Ca2+ and Na+ Channels (Block every channel)
Dronedarone, Dofetilide, Sotalol, Isbutilide, Amiodarone (Bolded = Preferred in HF)
*Dieting During Stress Is Always*
Class IV Anti-arrhythmics MOA - ANSWER -Slow rate in V-tach, Negative Ionotropic
,Verapimil, Diltiazem,
(Very Difficult)
**Donot use in HF*
Characteristics of Amiodarone - ANSWER -- BBW: Pulmonary, Liver, Eye toxicity
- Hypothyrodism and hypethyrodism
- Avoid in Iodine sensitivty
- Correct Electrolyes (HYPO- Kalemia, Magnesemia, Calcemia)
- Monitor LFT and Thyroid Q6 mos
- Decrease Warfarin and digoxin dose by 50%
- No more than Lovastatin or Simvastatin 40mg/dy
- Additive effect with drugs that decrease HR ( BB, NDHP CCB, Digoxin, clonidine,
precedex)
- Use filter 0.22 micron
Characteristics of NDHPs CCB - ANSWER -only CCB to be used in Arrhythmias,
SE: Edema, constipation, Gingival Hyperplasia
Characteristics of Digoxin - ANSWER -Add on in HF and Arrhythmia
Typical dose: 0.125-0.25mg
Decrease dose by 20-25% IV-PO
Toxicity: N/V, appetite loss, bradycardia
Worsening toxicity: Blurred vision, greenish yellow halos
DIGITAB: ANTIDOTE
HYPO (Kalemia, Magnesemia, thyrodism) HYPER (calcemia) increase digoxin levels
Characteristics of Quinidine - ANSWER -Use in arrhythmias
Avoid in GDP6 deficiency (cause hemolysis)
SE: DILE, Diarrhea,
toxicity: Cinchonism (Tinnitus, blurred vision, delirium)
Take with food/ milk to avoid GI upset
Increase in alkaline food and Decrease in Na+ increase drug levels
Characteristics of Dronedarone - ANSWER -BBW: Increase risk of death in HF or
Permanent AFIB
Causes: liver failure and PF
SE: QT prolongation
Does not contain iodine
*Decrease digoxin by 50%*
Clopidogrel - ANSWER -Anti-Platelet and pro-drug that irreversibly binds to P2Y12.
, Stop 5 days prior to surgery
Do not use esomeprazole and omeprazole
Can cause Thrombocytopenia Pupura is d/c prematurely.
*Metabolized by 2C19.*
Gram Positive Bacteria Cocci - ANSWER -Streptococcus Pyogene
Steptococcus Pneumoniae
Enterococcus (VRE)
Staph Aureus
Gram Positive Bacteria Rods - ANSWER -Listeria Monocytes
Gram Positive Anaerobes - ANSWER -Peptostreptococcus
Actinomyces
Clostridium
Gram Negative Bacteria Cocci - ANSWER -Neiseria Gonorhea
Gram Negative Rods that colonize the gut - ANSWER -Proteus Mirabilis
E-coli
Klebsilla Pneumonaie
Serratis
Enterobacter and Citro Bacter
PEK and SEC (Which is part of capes)
Gram Negative Rods that DONOT colonize the gut - ANSWER -Pseudmonas
Aeuruginosa
H-flu
Gram Negative Anaerobes - ANSWER -Bacteroides fragilis
Prevotella species
Gram Negative coccobacilli - ANSWER -Acinetobacter baumannii
Bordetella pertussis
Moraxella catarrhalis
Gram Negative curved and spiral - ANSWER -H-pylori
Treponema species
Common Resistant Pathogens - ANSWER -- K. pnemoniae (ESBL, CRE)
- E. coli (ESBL,CRE)
- Acinetobacter baumannii
- E. faecalis/faecium (VRE)
- S. aureus (MRSA)
