2025 NAPLEX Key Drug Guy

Carbamazepine therapeutic level

4-12 mcg/mL

Digoxin therapeutic level

AF: 0.5-2 ng/mL

HF: 0.5-0.9 ng/mL

Gentamicin levels

trough: <2 mcg/mL

peak" 5-10 mcg/mL

Lithium trough

0.6-1.2 mEq/L

phenytoin/fosphenytoin therapeutic range and free level

therapeutic: 10-20 mcg/mL

free phenytoin: 1-2 mcg/mL

procainamide level

4-10 mcg/mL

NAPA (procainamide metabolite) level

15-25 mcg/mL

combined NAPA and procainamide level

10-30 mcg/mL

theophylline therapeutic level

5-15 mcg/mL

tobramycin peak and trough

peak: 5-10 mcg/mL

trough: <2 mcg/mL

valproic acid level

50-100 mcg/mL

vancomycin trough

serious infection: 15-20 mcg/mL

other infections: 10-15 mcg/mL

warfarin INR goal

2-3 unless mechanical valve then 2.5-3.5

Drugs requiring non-PVC Containers

LATTIN (Leach Absorbs To Take In Nutrients)

Lorazepam

Amiodarone

Tacrolimus

Taxanes

Insulin

Nitroglycerin

Drugs to mix in saline only

ACID-APE

Ampicillin

Caspofungin (Cancidas)

Infliximab

Daptomycin

Ampicillin/sulbactam (Unasyn)

Phenytoin (Dilantin)

Ertapenem (Invanz)

Drugs to mix in dextrose only

Only Sugar Always

Oxaliplatin

Sulfamethoxazole/trimethoprim

Amphotericin B

Drugs with filtration requirements

GAL IS PAT MAP

Golimumab

Amphotericin B (lipid form)

Lipids (1.2 micron)

ISavuconazonium

Phenytoin

Amiodarone

Taxanes

MAnnitol

Parenteral nutrition

Do not refrigerate

Dear Sweet Pharmacist, Freezing Makes Me Edgy

Dexmedetomidine

SMX/TMP

Phenytoin

Furosemide

Moxifloxacin

Metronidazole

Enoxaparin

Protect from light

Protect Every Necessary Med from Daylight

Phytonadione

Epoprostenol

Nitroprusside

Micafungin

Doxycyline

Drugs that cause nephropathy

Aminoglycosides

Ampho B

Cisplatin

Cyclosporine

Loop diuretics

NSAIDs

Polymixin

Contrast dye

Tacrolimus

Vancomycin

Drugs that require increased dose in CKD

Aminoglycosides

Beta-lactams

Fluconazole

Quinolones

Vancomycin

LMWH

Rivaroxaban

Apixaban

Dabigatran

H2RAs

Metoclopramide

Bisphosphonates

Lithium

Drugs that are contraindicated in CKD

CrCl <60

- nitrofurantoin

CrCl <50

- tenofovir disproxil fumarate containing products (Viread, Complera, Delstrigo, Srtibild, Symfi)

- voriconazole IV

CrCl <30

- tenofovir alafenamide containing products (Vemlidy, Biktarvy, Descovy, Genvoya, Odefsy, Symtuza)

- NSAIDs

-Dabigatran (DVT/PE)

eGFR <30

- metformin

other

- meperidine

SGLT2i

rivaroxaban

Drugs that raise potassium levels

ACE inhibitors

Aliskiren

ARBS

Canagliflozin

Drosperinone-containing COCs

K+ containing IV fluids

Potassium-sparing diuretics

Potassium supplements

Bactrim

Transplant drugs (cyclosporine, everolimus, tacrolimus)

Drugs with a boxed warning for liver damage

APAP

amiodarone

isoniazid

Ketoconazole

MTX

nefazodone

Nevirapine

propylthiouracil

valproic acid

common live vaccines

MMR

Intranasal Influenza

Cholera

Rotavirus

Oral Typhoid

Varicella

Yellow Fever

MICRO-VY

Travel vaccines

Inactivated: Hep A, Hep B, Japanese encephalitis, meningococcus, polio, typhoid

-Live: Cholera, Typhoid, yellow fever

Antibiotics not needing renal dose adjustments

Antistaph penicillins

Azithromycin and erithyromycin

Ceftriaxone

Clindamycin

Doxycycline

Metronidazole

Moxifloxacin

Linezolid

Drugs that increase LDL and TG

Diuretics

Efavirenz

Steroids

Immunosuppressants

Atypical antipsychotics

Protease inhibitors

Drugs that increase LDL only

Fibrates

SGLT2 inhibitors

Drugs that increase TGs only

IV lipid emulsions

clevidipine

propofol

bile acid sequestrants

Conditions that alter cholesterol levels

obesity

poor diet

alcohol use disorder

hypothyroidism

smoking

diabetes

renal/liver disease

nephrotic syndrome

Drugs that increase blood pressure

Amphetamines, ADHD drugs

cocaine

Decongestants

ESAs

Immunosuppressants

NSAIDs

Systemic steroids

oral contraceptives

VEGF inhibitors

IV medications for hypertensive crisis

clevidipine

enalaprit

esmolol

hydralazine

labetolol

nifedipine

nitroglycerin

nitroprusside

Drugs that worsen HF

DI Nation

DPP4-I (alogliptan, saxagliptin)

Immunosuppressants (adalimumab, etanercept & interferons)

Non-DHP CCBs

Anti-Arrhythmics (Class I and dronedarone(

TZDs

Itraconazole

Oncology agents (doxorubicin, daunorubicin)

NSAIDs (including celecoxib)

Drugs that prolong QTc Interval

Antiarrythmics

Antimalerials

Azoles

Macrolides

Quinolones

Lefamulin

SSRIs

TCAs

Mirtazapine, trazodone, venlafaxine

Ondansetron

Droperidol, metoclopramide, promethazine

Antipsychotics

Leuprolide

Tyrosine kinase inhibitors

Arsenic trioxide

Drugs causing (+) Coombs test

Penicillins

Cephalosporins

Isoniazid

Levodopa

Methyldopa

Rifampin

Quinidine

Quinine

Sulfonamides

G6PD Deficiency

Dapsone

Methylene blue

Nitrofurantoin

Pegloticase

Rasburicase

Primaquine

Quinidine

Quinine

Sulfonamides

Vaccines in sickle cell

Routine childhood

Haemophilus influenzae (Hib)

Pneumonia (PCV15 or PCV20)

Additional for functional asplenia

Meningococcal quadravalent and serogroup B

Pneumococcal if not given as a child

Drugs that can increase IOP

-anticholinergics (oxybutynin, tolteridone, trihexphenidyl, TCA's, benztropine)

-cough, cold, motion sickness meds (antihistamines, Benadryl, scopolamine)

-chronic steroids, esp eye drops like prednisolone PredForte

-topiramate (Topamax)

Common drugs known to cause vision changes or damage

retinal changes/retinopathy

- chloroquine

-hydroxychloroquine

optic neuropathy

- amiodarone

-ethambutol

- linezolid

IFIS

- alpha-blockers

color discrimination

- digoxin

- PDE-5i

- voriconazole

vision loss

- digoxin

-PDE-5i

- isotretinoin

- topiramate

- vigabatrin

-voriconazole

select drugs that cause PAH

cocaine

fenfluramine

methamphetamine/amphetamine

SSRIs during pregnancy

phentermine

Drugs that can cause pulmonary fibrosis

Amiodarone/dronedarone

Bleomycin

Busulfan

Carmustine