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2024 NAPLEX EXAM WITH CORRECT ANSWERS
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2024 NAPLEX EXAM WITH CORRECT ANSWERS
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2024 NAPLEX EXAM WITHCORRECT ANSWERS
Key drugs that can cause hypothyroidism - CORRECT-ANSWERS"I TALC"
Interferons
Tyrosine Kinase Inhibitors
Amiodarone
Lithium
Carbamazepine
Conditions: Hashimoto's disease
Levothyroxine IV:PO - CORRECT-ANSWERS0.75:1 (IV:PO)
Full replacement dose levothyroxine - CORRECT-ANSWERS1.6 mcg/kg/day
(IBW)
If known CAD: start with 12.5-25 mcg daily
Schizophrenia - CORRECT-ANSWERSNegative s/sx: loss of interest, lack of
emotion (apathy), inability to plan/carry out activities, social withdrawal,
poor hygiene, loss of motivation (avolition), lack of speech (alogia)
Positive s/sx:
Hallucinations
Delusions
Disorganized thinking/behavior
Difficulty paying attention
Primarily involved DA, 5-HT, glutamine
Medication/recreational drugs that can cause psychotic sx - CORRECT-
ANSWERSAnticholinergics
Dextromethorphan
DA/DA-agonists
Interferons
Stimulants
Systemic steroids
Illicit/recreational substances: bath salts, cannabis, cocaine,
LSD/hallucinogenics, methamphetamine/ice/crystal, PCP
,first generation antipsychotics - CORRECT-ANSWERSLow-potency:
chlorpromazine, thioridazine
- inc sedation, dec EPS
Mid-potency: loxapine, perphenazine
High-potency: haloperidol (haldol), fluphenazine, thiothixene, trifluoperazine
- dec sedation, inc EPS
BBW: inc risk of death in elderly patients with dementia-related psychosis
- thioridazine: QT prolongation
Warnings: QT prolongation, orthostasis/falls, anticholinergic effects, CNS
depression, EPS, hyperprolactinemia, neuroleptic malignant syndrome
(NMS), blood dycrasias
AEs: sedation, dizziness, anticholinergic effects, EPS
- can give anticholinergic to limit/avoid painful dystonic rxns
Second generation antipsychotics (SGAs) - CORRECT-ANSWERSAripiprazole
(Abilify)
Clozapine (Clozaril)
Lurasidone (Latuda)
Olanzapine (zyprexa)
Paliperidone (Invega)
Quetiapine (Seroquel)
Risperidone (Risperdal)
Ziprasidone (Geodon)
Asenapine (Saphris, Secuado)
Brexpiprazole (Rexulti)
Cariprazine (Vraylar)
Aripiprazole (Abilify) - CORRECT-ANSWERSAbilify maintena - IM suspension,
monthly
Aristada- IM suspension, give every 4-8 weeks
Akathisia, activating
Lower risk of weight gain, some QT prolongation, EPS (in children)
*also approved for irritability with autism and Tourette disorder
Clozapine (Clozaril) - CORRECT-ANSWERSNo sooner than 3rd line due to
severe side effect potential: REMS
,BBW: neutropenia/agranulocytosis (REMS), myocarditis/cardiomyopathy,
seizures
AEs: Agranulocytosis, seizures, constipation, metabolic syndrome,
hypersalivation
*to start tx, baseline ANC must be >/= 1500/mm3; check ANC weekly x6
months, then every 2 weeks x6 months, then monthly; stop if ANC <
1000/mm3
Lurasidone (Latuda) - CORRECT-ANSWERSCI: use with strong CYP3A4
inducers/inhibitors
AE: somnolence, EPS, nausea
Risk of metabolic syndrome, but lower risk than other SGAs
Olanzapine (Zyprexa) - CORRECT-ANSWERSIM injection: acute agitation
BBW: Relprevv suspension lasts 2-4 weeks, restricted use; REMS - monitor
for 3 hours post injection
AEs: somnolence, metabolic syndrome
Paliperidone (Invega) - CORRECT-ANSWERSInvega Sustenna: IM injection,
monthly
Invega Trinza: IM injection, every 3 months
Invega Hafyera: IM injection, every 6 months
AEs: inc prolactin, EPS (esp at higher doses), metabolic syndrome
*active metabolite of risperidone
Quetiapine (Seroquel) - CORRECT-ANSWERSAEs: somnolence, metabolic
syndrome
Low EPS risk, often used for psychosis in parkinson disease
Take XR at night, without food or with a light meal
Risperidone (Risperdal) - CORRECT-ANSWERSRisperdal consta: IM injection,
give every 2 weeks
*also approved for irritability associated with autism
AEs: inc prolactin, EPS (esp at higher doses), metabolic syndrome
, Ziprasodone (Geodon) - CORRECT-ANSWERSTake with food
Geodon IM: acute injection
CI: QT prolongation - do not use with QT risk
Asenapine (Saphris) - CORRECT-ANSWERSNo food/drink for 10 minutes after
dose (SL tab)
AEs: somnolence, tongue numbness
AP if cardiac/QT risk - CORRECT-ANSWERSDO NOT choose QT-prolonging
drug like ziprasidone, haloperidol, thioridazine, or chlorpromazine
BBW: thioridazine, ziprasidone
AP if hx of movement disorder - CORRECT-ANSWERSQuetiapine preferred
AP if overweight/metabolic risk - CORRECT-ANSWERSlower metabolic risk
with aripiprazole, ziprasidone, lurasidone, and asenapine
Psychosis in parkinson disease - CORRECT-ANSWERSCommonly, quetiapine
used; less EPS
Pimavanserin (Nuplazid): does not affect DA receptors
Treatment for tardive dyskinesia - CORRECT-ANSWERSValbenazine:
Somnolence
Deutetrabenazine
- CI: hepatic impairment
- warnings: somnolence
Neuroleptic Malignant Syndrome (NMS) - CORRECT-ANSWERSDue to D2
blockade
Signs: hyperthermia, extreme muscle rigidity, mental status changes,
tachycardia/tachypnea/BP changes
- inc CPK/WBCs
STOP antipsychotic and provide supportive care
- cooled IV fluids
- relax muscles: benzos, dantrolene, DA agonist
Bipolar 1 disorder - CORRECT-ANSWERSAt least one episode of mania, and
usually bouts of intense depression
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