Pharmacy Practice and NAPLEX Review Flashcards

Collection of flashcards for pharmacy students based on nonsterile compounding, toxicology, ethics, cardiology, oncology, and pharmacotherapy notes.

Master Formulation Record

A document for a specific preparation, such as the Lidocaine, Benzocaine & Tetracaine Gel used as a topical anesthetic for superficial surgical procedures and laser therapy.

Comminution

The technique used in step 1 of the compounding instructions to grind lidocaine, benzocaine, and tetracaine powders.

Trituration

The method described in step 4 to prepare PLO gel by mixing the organic and aqueous phases.

Geometric dilution

The technique used in step 3 to incorporate powders into a mixture to ensure uniform distribution.

NAPQI

The toxic metabolite produced in the metabolic pathway of acetaminophen.

CYP450 2E1

The specific metabolic pathway/enzyme responsible for the production of the toxic metabolite NAPQI.

Autonomy

The medical ethics principle that addresses informed consent by respecting an individual's right to make decisions that align with their values.

Beneficence

The ethical principle of intending to do good and maximize benefit for the patient.

Justice

The ethical principle that refers to treating people fairly and without discrimination, often focused on distribution of healthcare resources.

Nonmaleficence

The ethical principle of choosing actions that do not cause harm, such as avoiding an unnecessary procedure.

Informed Consent

The process of fully educating a patient on the nature, alternatives, risks, and benefits of a medical intervention.

HIPAA

The Health Insurance Portability and Accountability Act, a federal law that aims to protect patient privacy and confidentiality.

Koplik spots

Small, white spots located on the inside of a daughter's cheeks, which are a characteristic sign of Measles.

Measles

A childhood disease presenting with a temperature of $102.4^{\circ}F$, a rash covering the entire body, and Koplik spots.

Inhaled SABAs

Short-acting beta-2 agonists, such as Albuterol and Levalbuterol, used for as-needed symptom relief in asthma.

Albuterol MOA

Binding to and stimulating beta-2 adrenergic receptors in the lungs, resulting in bronchial smooth muscle relaxation and bronchodilation.

Levalbuterol

The R-isomer of albuterol that may be considered in patients who are unable to tolerate albuterol due to adverse effects like palpitations.

SABA Adverse Effects

Nervousness, tremor, tachycardia, palpitations, cough, and hypokalemia.

Hyperkalemia treatment

Albuterol is used to treat this condition because it shifts potassium into cells by increasing $Na^+/K^+-ATPase$ activity.

Vaccine Information Statements (VIS)

CDC-developed documents required to be given to patients prior to every dose of a vaccine, listing benefits, risks, and alternatives.

Flolan

A prostacyclin analogue whose primary indication is the treatment of pulmonary arterial hypertension ($PAH$).

CHA2DS2-VASc

A scoring system used for stroke risk in nonvalvular atrial fibrillation to determine the need for antithrombotic therapy.

DOACs

Direct-acting oral anticoagulants such as apixaban, edoxaban, rivaroxaban, and dabigatran, which are preferred over warfarin.

S2 (CHA2DS2-VASc)

A component of the stroke risk score referring to prior stroke, $TIA$, or thromboembolism, weighted with $2$ points.

A2 (CHA2DS2-VASc)

A component of the stroke risk score referring to Age $\ge 75$, weighted with $2$ points.

ISMP

The Institute for Safe Medication Practices, which maintains a list of look-alike and sound-alike ($LASA$) drug names.

Tall man lettering

The use of bolded, uppercase letters to draw attention to differences in drug names, such as $DOBUTamine$ and $DOPamine$.

Barcode scanning

A method to prevent medication errors by scanning the patient identification bracelet and medication barcode before administration.

Alkylating agents

A class of chemotherapy represented by Cyclophosphamide, which inhibits DNA and protein synthesis and is cell cycle nonspecific.

Anthracyclines

A class of chemotherapy represented by Doxorubicin, which binds DNA to inhibit synthesis and repair via topoisomerase II inhibition.

Folate antimetabolites

A class of chemotherapy represented by Methotrexate, which prevents purine and pyrimidine production in the S phase.

Vinca alkaloids

A class of chemotherapy represented by Vincristine, which inhibits microtubule formation in the M phase.

Live vaccine separation

The requirement that $MMR$ and varicella vaccines be administered at least $3-11$ months after an antibody-containing product.

Oxytrol patch

A transdermal formulation for urinary incontinence that should be changed twice weekly.

Parkinson disease psychosis

Psychotic symptoms such as delusions and visual hallucinations triggered by medications that increase dopamine activity.

Levodopa

A component of Sinemet that acts as a prodrug of dopamine and carries a risk of medication-induced psychosis.

Methotrexate Adverse Effects

Hepatotoxicity, myelosuppression, and mucositis.

Mile's Solution

A magic mouthwash compounded preparation containing lidocaine, diphenhydramine, hydrocortisone, tetracycline, and nystatin.

 Mile's Solution BUD

The beyond-use date for this water-containing oral preparation is $14$ days.

Enoxaparin

The preferred treatment for a pregnant female diagnosed with a right lower extremity venous thromboembolism.

Mucinex D

An OTC cough and cold product that contains a decongestant (pseudoephedrine).

Relative Risk (RR)

The ratio of the risk in the treated group compared to the risk in the control group.

Absolute Risk Reduction (ARR)

The absolute difference in risk between groups, calculated as $\text{Risk}_{control} - \text{Risk}_{treatment}$.

Alpha ($\alpha$)

The predetermined significance level for endpoints, which in the provided biostatistics study was set at $0.03$.

Student t-test

An appropriate statistical test used to evaluate between-group differences for continuous variables like Age.

Acute ischemic stroke

A condition managed with reperfusion therapy using IV alteplase if the patient presents within $4.5$ hours of symptom onset.

Intravenous alteplase

A fibrinolytic indicated for ischemic stroke that must be preceded by a CT scan to rule out intracranial hemorrhage.

Oral nimodipine

A calcium channel blocker indicated only to improve outcomes associated with subarachnoid hemorrhage by preventing vasospasm.

Graves' disease

An autoimmune condition that causes overproduction of thyroid hormones ($T3$, $T4$).

Propylthiouracil (PTU)

The preferred treatment for hyperthyroidism during the first trimester of pregnancy.

Methimazole

The preferred treatment for Graves' disease except during the first trimester of pregnancy or thyroid storm.

Motion sickness treatment

Adult options include Transderm-Scop, Dimenhydrinate, and Meclizine.

Nonsevere inpatient CAP

Community-acquired pneumonia treated with a beta-lactam plus a macrolide or doxycycline.

Prolonged QTc in CAP

A condition (where $QTc > 440\,msec$) that makes ceftriaxone plus doxycycline the safest treatment option to avoid macrolides and fluoroquinolones.

Extended-interval dosing

Aminoglycoside dosing using higher doses (e.g., $7\,mg/kg$) less often, monitored by a random level compared to a nomogram.

Hartford dosing nomogram

A graph plotted using a random gentamicin level drawn $6-14$ hours after the start of infusion to determine dosing frequency.

Traditional aminoglycoside dosing

Dosing involving smaller doses ($1.5-2.5\,mg/kg$) monitored with peaks and troughs.

Statin-associated muscle symptoms

Adverse effects that may require discontinuing statin therapy and starting ezetimibe.

Nitroglycerin SL counseling

One tablet should be allowed to dissolve under the tongue every $5$ minutes at the onset of chest pain, up to $3$ doses.

Nitroglycerin SL storage

Must be stored at room temperature in the original amber glass vial with the lid closed tightly.

Nitroglycerin SL tablet

A short-acting nitrate used for acute chest pain relief by vasodilating coronary arteries and peripheral veins.

Nitrate-free interval

A period of at least $10-12$ hours required daily to decrease tolerance to long-acting nitrates.

Allopurinol

A xanthine oxidase inhibitor used for urate-lowering therapy that can cause hypersensitivity reactions like severe rash ($SJS/TEN$).

HLA-B*5801

A genetic marker that should be tested in high-risk patients before starting allopurinol to avoid severe cutaneous reactions.

Pegloticase

A recombinant uricase urate-lowering therapy that can cause anaphylaxis and requires premedication with antihistamines and steroids.

Xarelto in AFib

Rivaroxaban dosed at $20\,mg$ daily with the evening meal for patients with $CrCl > 50\,mL/min$ to maximize bioavailability.

Secondary hyperparathyroidism

A CKD complication triggered by hyperphosphatemia and vitamin D deficiency leading to hypocalcemia and increased $PTH$.

Doxercalciferol

An active vitamin D analog used in $ESRD$ when the kidneys are unable to activate vitamin D.

CYP3A4 inhibitors

Substances that can increase drug levels, including Ritonavir, Diflucan, and Grapefruit.

Parenteral Nutrition Osmolarity Formula

$mOsmol/L = [\frac{\text{Weight (g/L)}}{\text{MW (g/mole)}}] \times \text{particles} \times 1,000$.

D5/NS Osmolarity

The calculated value for an IV fluid containing $5\%\text{ dextrose}$ and $0.9\%\text{ sodium chloride}$ is $560\,mOsmol/L$.

Loop diuretic equivalence

$40\,mg$ of oral furosemide provides an equivalent diuretic effect to $20\,mg$ of torsemide.

Norepinephrine MOA

A vasopressor used to maintain blood pressure in septic shock primarily through alpha-1 receptor agonism.

Phentolamine

An alpha-blocker administered to treat the extravasation of vasopressors.

Complera

A combination antiretroviral product containing Emtricitabine, Tenofovir disoproxil fumarate, and Rilpivirine.

Nasacort Allergy 24-HR

An intranasal allergy spray containing the active ingredient triamcinolone.

Valganciclovir

An antiviral for cytomegalovirus colitis that requires dose adjustments if $CrCl$ is below $60\,mL/min$.

Cetuximab

An $EGFR$ inhibitor monoclonal antibody used for metastatic colorectal adenocarcinoma.

KRAS wild-type

The laboratory result required to confirm that cetuximab will be effective in treating metastatic colorectal cancer.

HLA-B*1502

A genetic allele that should be negative to reduce the risk of serious skin reactions with the use of carbamazepine.

IV Iron Boxed Warning

Fatal anaphylaxis warnings associated specifically with iron dextran and ferumoxytol ($Feraheme$).

Feraheme Monitoring

Monitoring patients for signs of hypersensitivity reactions for at least $30$ minutes after the iron infusion.

p-value significance

A result is statistically significant if the p-value calculated by a statistical test is less than the predetermined alpha.

Confidence Interval ratio significance

A result for an Odds Ratio ($OR$) is statistically significant if the interval does not include $1$.

Ezetimibe MOA

Decreases low-density lipoprotein cholesterol by inhibiting the absorption of cholesterol in the small intestine.

PCSK9 inhibitors

Monoclonal antibodies like alirocumab that prevent the degradation of $LDL$ receptors.

Statins MOA

Inhibition of HMG-CoA reductase at the rate-limiting step of cholesterol synthesis.

Cyclophosphamide oral liquid BUD

A beyond-use date of $56$ days is appropriate when stored in a refrigerator.

Hypothyroidism Characteristics

Elevated $TSH$ level, low free $T4$, and symptoms such as weight gain and fatigue.

Levothyroxine

The treatment of choice for overt primary hypothyroidism that provides synthetic $T4$ replacement.