Pharmacy Practice Exam Review Flashcards

Practice flashcards covering nonsterile compounding, ethical principles, internal medicine, biostatistics, and oncology based on NAPLEX review material.

Comminution

The process of reducing particle size using techniques such as grinding, crushing, jointing, or vibrating.

Trituration

The act of grinding a powder to reduce particle size or the process of mixing two or more powders together.

Geometric dilution

A compounding technique used when mixing two ingredients of unequal quantities to ensure the even distribution of the smaller quantity throughout the mixture.

NAPQI

The toxic metabolite of acetaminophen characteristically produced through the $CYP450\,2E1$ metabolic pathway.

Autonomy

The ethical principle of respecting an individual's right to make informed decisions about their healthcare that align with their values and preferences.

Beneficence

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

Justice

The ethical principle of treating people fairly and without discrimination, often focused on in public health and drug distribution policies.

Nonmaleficence

The ethical principle that a provider should choose actions that do not cause harm, such as avoiding unnecessary procedures.

Informed consent

The process of fully educating a patient on the nature, alternatives, risks, and benefits of a medical intervention to ensure an educated decision.

Confidentiality

The principle of protecting patient information from unauthorized disclosure, foundational to laws like the Health Insurance Portability and Accountability Act (HIPAA).

Koplik spots

Small, white spots located on the inside of a patient's cheeks that are a clinical characteristic of the childhood disease Measles.

SABAs

Inhaled short-acting beta-2 agonists (e.g., albuterol) used for as-needed symptom relief (reliever therapy) in asthma.

Levalbuterol (Xopenex HFA)

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

Palpitations

An adverse effect of SABAs resulting from the stimulation of beta-2 receptors in vascular smooth muscle causing peripheral vasodilation and reflex tachycardia.

Tremors

An adverse effect of SABAs resulting from the stimulation of beta-2 receptors in skeletal muscle, which increases neuromuscular excitability.

Hypokalemia

An electrolyte abnormality caused by SABAs which increase $Na^{+}/K^{+}-ATPase$ activity, shifting potassium into cells.

Vaccine Information Statement (VIS)

A document developed by the CDC for each vaccine that describes the benefits and risks of vaccination and must be given to patients prior to every dose.

Flolan

A prostacyclin analogue medication primarily indicated for the treatment of pulmonary arterial hypertension.

Atrial fibrillation

An arrhythmia that impairs the atria's ability to move blood effectively, potentially causing blood to pool and form a left atrial thrombus.

Left atrial thrombus

A blood clot that can form in the heart due to atrial fibrillation and potentially travel to the brain, causing a cardioembolic stroke.

CHA2DS2-VASc

A scoring tool used to estimate the annual percent risk of stroke in patients with nonvalvular atrial fibrillation based on specific risk factors.

DOAC

Direct-acting oral anticoagulants such as apixaban, edoxaban, rivaroxaban, and dabigatran, which are often preferred over warfarin for stroke prevention in AF.

ISMP

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

Tall man lettering

The use of bolded, uppercase letters to draw attention to differences in similar drug names (e.g., DOBUTamine and DOPamine) to reduce confusion.

Alkylating agents

A class of chemotherapy drugs, such as cyclophosphamide, that inhibits DNA and protein synthesis and is cell cycle nonspecific.

Anthracyclines

A class of chemotherapy drugs (e.g., doxorubicin) that binds DNA to inhibit synthesis and repair via topoisomerase II inhibition; notable for causing cardiotoxicity.

Folate antimetabolites

A chemotherapy class (e.g., methotrexate) that interferes with enzymes in folic acid synthesis, preventing purine and pyrimidine production in the S phase.

Vinca alkaloids

A chemotherapy class, such as vincristine, that inhibits microtubule formation in the M phase of the cell cycle.

Measles, mumps, and rubella (MMR) vaccine

A live vaccine that must be administered at least $3\text{-}11\,months$ after products containing immune globulins.

Oxytrol patch

A transdermal formulation of oxybutynin used for urinary incontinence that is changed twice weekly.

Parkinson disease psychosis

A condition characterized by paranoid delusions and visual hallucinations, often triggered by medications that increase dopamine activity.

Levodopa

The component of Sinemet that acts as a prodrug of dopamine to treat the motor symptoms of Parkinson disease.

Absolute Risk Reduction (ARR)

The difference in risk between a control group and a treatment group, calculated as $\text{Control Group Event Rate} - \text{Treatment Group Event Rate}$.

Alpha level ($\alpha$)

A prespecified accepted risk of committing a type I error (false positive conclusion) in a clinical study.

p-value

The probability of observing a result due to chance; it must be less than the alpha level ($\alpha$) for a result to be statistically significant.

Alteplase

An intravenous fibrinolytic used for reperfusion therapy in acute ischemic stroke, ideally administered within $4.5\,hours$ of symptom onset.

Nimodipine

A lipophilic dihydropyridine calcium channel blocker only indicated to improve neurological outcomes following subarachnoid hemorrhage.

Graves' disease

An autoimmune condition leading to the overproduction of thyroid hormones ($T3$, $T4$).

Propylthiouracil (PTU)

The preferred treatment for hyperthyroidism during the first trimester of pregnancy due to causing less severe fetal abnormalities than alternatives.

Methimazole

The preferred thionamide for Graves' disease, except during the first trimester of pregnancy or when treating thyroid storm.

Motion sickness treatment options

Pharmacotherapeutic options for adults include Transderm-Scop, dimenhydrinate, and meclizine.

Hartford dosing nomogram

A tool used to determine the administration frequency of aminoglycosides (gentamicin and tobramycin) when using extended-interval dosing.

Extended-interval dosing

An aminoglycoside dosing strategy using higher doses (e.g., $7\,mg/kg$) administered less frequently (every $24$, $36$, or $48\,hours$) based on random levels.

Allopurinol

A xanthine oxidase inhibitor for gout that is associated with severe hypersensitivity reactions (e.g., Stevens-Johnson Syndrome) and requires screening for $HLA\text{-}B^{*}5801$.

HLA-B*5801

A genetic allele that, if present, increases a patient's risk of severe cutaneous adverse reactions to the medication allopurinol.

KRAS mutation wild-type

The genetic status a tumor must have for EGFR inhibitors (e.g., cetuximab) to be effective in metastatic colorectal cancer.

Cetuximab

A monoclonal antibody that inhibits the epidermal growth factor receptor (EGFR); it is only effective in KRAS mutation wild-type tumors.

HLA-B*1502

A genetic marker that increases the risk of serious skin reactions to carbamazepine, oxcarbazepine, and fosphenytoin.

INSTIs

Integrase strand transfer inhibitors (e.g., bictegravir, dolutegravir) which are recommended as part of the initial antiretroviral regimen for most HIV-treatment patients.

Atropine

The treatment administered for the reversal of symptoms in organophosphate poisoning, such as excess salivation and lacrimation.

Triptan sensations

Adverse effects of triptans (e.g., sumatriptan) characterized by transient pressure or heaviness on the chest or neck region.

Sumatriptan (Imitrex) repeat dosing

For oral tablets, a second dose may be administered no sooner than $2\,hours$ after the initial dose if symptoms return.

ISO 7

The required air quality standard for the buffer room where sterile compounded products are prepared.

Aztreonam

A monobactam antibiotic with only gram-negative activity (including Pseudomonas aeruginosa) that is safe for use in patients with a penicillin allergy.

Drospirenone

A progestin in certain oral contraceptives with antimineralocorticoid activity that can decrease potassium excretion and increase the risk of hyperkalemia.

Levothyroxine

A synthetic $T4$ replacement and the treatment of choice for primary hypothyroidism.

Enoxaparin (Lovenox)

The preferred anticoagulant for the treatment of venous thromboembolism in pregnant patients.

Osmolarity

A measure of concentration describing the total number of particles in $1\,liter$ of solution, measured in $mOsmol/L$.

Heparin-Induced Thrombocytopenia (HIT)

An antibody-mediated prothrombotic state suspected when the platelet count drops by $>\,50\%$ from baseline following heparin exposure.

Simvastatin/Cyclosporine interaction

A contraindicated drug combination because cyclosporine (a strong CYP3A4 inhibitor) increases simvastatin concentrations, elevating the risk of rhabdomyolysis.

Secondary hyperparathyroidism

A CKD complication triggered by hyperphosphatemia and vitamin D deficiency, resulting in bone and mineral disorders.

Doxercalciferol

An active vitamin D analog used to treat secondary hyperparathyroidism in patients with advanced chronic kidney disease.

Acrolein

A toxic metabolite produced by cyclophosphamide and ifosfamide that causes urothelial toxicity and hemorrhagic cystitis.

Mesna

An adjunctive treatment that inactivates acrolein in the bladder to prevent hemorrhagic cystitis caused by ifosfamide and high-dose cyclophosphamide.

Cardura XL

An alpha-blocker OROS formulation (doxazosin) that may leave an empty insoluble shell, or 'ghost tablet,' in the patient's stool.

Left Shift

A laboratory finding of an elevated band count (immature neutrophils), typically indicating an acute bacterial infection or inflammation.

Sodium zirconium cyclosilicate

A potassium-binding resin used to increase gastrointestinal potassium elimination in the treatment of hyperkalemia.

Humalog

A rapid-acting insulin brand whose 'in use' vials are stable when stored at room temperature for $28\,days$.

Inpatient CAP Antibiotic Selection (Nonsevere)

Preferred regimens include a beta-lactam (e.g., ceftriaxone) combined with either a macrolide or doxycycline.

Doxorubicin lifetime cumulative dose

The maximum lifetime exposure limited to $450\text{-}550\,mg/m^2$ to prevent dose-limiting cardiotoxicity.

Primary outcome

The main endpoint in a clinical trial (e.g., mean change in A1C) that the study is specifically designed to evaluate.

FOLFIRI

A chemotherapy regimen for colorectal cancer consisting of fluorouracil, leucovorin, and irinotecan.

Biktarvy

A single-tablet HIV regimen containing bictegravir, emtricitabine, and tenofovir alafenamide.

Complera

A single-tablet HIV regimen containing emtricitabine, tenofovir disoproxil fumarate, and rilpivirine.

Valganciclovir

An antiviral medication used for CMV colitis that requires dose adjustments based on the patient's creatinine clearance ($CrCl$).

Cockcroft-Gault Equation

The mathematical formula used to estimate creatinine clearance ($CrCl$) for the purposes of drug dosing.

HIPAA

The Health Insurance Portability and Accountability Act, a federal law protecting patient privacy.

Respiratory alkalosis

An acid-base disorder defined by a pH $>\,7.45$ and a low $pCO_2$ ($<\,35\,mmHg$), commonly resulting from hyperventilation.

Metabolic acidosis

An acid-base disorder defined by a low pH and low serum bicarbonate ($HCO_3^{-}$).

Anion gap

A laboratory calculation ($Na^{+} - (Cl^{-} + HCO_3^{-})$) used to identify and evaluate metabolic acidosis.

$D5/NS$ Osmolarity

The total osmolarity of an IV fluid containing 5% dextrose and 0.9% sodium chloride, approximately $560\,mOsmol/L$.

Norepinephrine

A vasopressor that acts primarily as an alpha-1 agonist to increase blood pressure in patients with septic shock.

Phentolamine

An alpha-blocker administered to treat tissue damage caused by the extravasation of vasopressors.

Bacteroides fragilis

An anaerobic gram-negative pathogen covered by the antibiotic Zosyn (piperacillin/tazobactam).

Emtricitabine

A nucleoside reverse transcriptase inhibitor (NRTI) component in HIV products such as Truvada and Descovy.

Tenofovir disoproxil fumarate (TDF)

An NRTI prodrug of tenofovir associated with renal impairment and bone mineral density loss.

Tenofovir alafenamide (TAF)

A newer NRTI prodrug of tenofovir associated with a lower risk of renal and bone toxicities compared to TDF.

Rilpivirine

An NNRTI used in HIV regimens that requires an acidic environment for absorption; its use is contraindicated with PPIs.

Nitrate-free interval

A required period of at least $10\text{-}12\,hours$ daily to prevent the development of tolerance to long-acting nitrate formulations.

T-score

A measurement from a DXA scan where a score $>\,-1$ is considered normal bone mineral density.

Anticipatory nausea and vomiting

A conditioned response occurring before a chemotherapy cycle that can be managed with a benzodiazepine (e.g., lorazepam).

G6PD deficiency

A genetic condition that is a contraindication for rasburicase and pegloticase due to the risk of hemolytic anemia.

Colesevelam

A bile acid sequestrant that binds intestinal bile acids to decrease cholesterol levels.

Fibrates

A class of medications (e.g., fenofibrate) that activates PPAR-alpha to decrease triglyceride levels.

Ora-Plus

An oral suspending vehicle used in the preparation of nonsterile compounded suspensions.

Non-PVC materials

Specialized bags and tubing required for taxanes (e.g., paclitaxel) to prevent leaching of the plasticizer diethylhexyl phthalate (DEHP).

0.22 micron filter

The specific filter size required during the infusion of taxanes like paclitaxel to protect patients from particulate matter.

Spiriva HandiHaler

A dry powder inhaler device where the patient inserts a tiotropium capsule and pierces it before inhalation.

Toujeo SoloStar

A long-acting insulin glargine formulation with a concentration of $300\,units/mL$.

Triptan Contraindications

Use is avoided in patients with cerebrovascular disease, ischemic heart disease, or uncontrolled hypertension due to vascular effects.