NAPLEX Exam Dumps - North American Pharmacist Licensure Examination

In the management of acute ischemic stroke, alteplase should be administered within 3 hours of symptom onset.

Corrected phenytoin (mg/L) = Observed phenytoin (mg/L) / (0.2 x albumin [g/dL]) + 0.1 = 17.8 / (0.2 x 2.1) +

0.1 = 17.8 / 0.42 + 0.1 = 42.48mg/L ← phenytoin level is high. Normal therapeutic range is: 10-20mg/dL

Lidocaine: 30g × 0.05 = 1.5g. Hydrocortisone: 90g × 0.005 = 0.45g. 90g + 30g = 120g. 1.5g/120g = 0.0125 × 100 = 1.25% Lidocaine. 0.45g/120g = 0.00375 × 100 = 0.375% Hydrocortisone.

Absolute risk reduction: 0.027 = 2.7% (Event rate in enoxaparin group) – (Event rate in rivaroxaban group) = (57/1473) – (17/1513) = 0.02746

The dihydropyridine drug – nifedipine – is the active ingredient found in the medicine Adalat. Nifedipine is used to treat angina, Reynaud’s phenomenon and hypertension. It is also used as a tocolytic agent in premature labor.

Lifelong Vitamin B12 supplementation. Vitamin B12 (cyanocobalamin) deficiency generally presents in patients as fatigue, diarrhea and headaches but can also be the cause of cognitive changes (difficulty concentrating, even mild dementia). Pernicious anemia is a macrocytic anemia, therefore laboratory findings indicate an increased mean corpuscular volume (MCV), with a decreased hemoglobin. A positive Schilling test indicates that the B12 deficiency is due to a lack of intrinsic factor. Lifelong cyanocobalamin supplementation (either orally or via injections) is needed to treat pernicious anemia. A is incorrect. Folic acid deficiency anemia is another common type of macrocytic anemia. However, cognitive deficits are not typically seen with folic acid deficiency. Furthermore, a schilling test would be negative and the methylmalonic acid (MMA) would be normal, rather than elevated. C is incorrect. Iron deficiency anemia causes a microcytic anemia, characterized by a decreased MCV. D is incorrect. A Coomb’s test is used to detect autoimmune hemolysis that may be suspected in patients with normocytic anemia (anemia with an MCV in the normal range). E is incorrect. Corticosteroids and iron supplementation are indicated as treatment in hemolytic anemia.

A, B – false – dapsone inhibits bacterial synthesis of dihydrofolic acid, via competition with para- aminobenzoate for the active site of dihydropteroate synthetase. Dapsone is both bacteriostatic and weakly bactericidal against M. leprae. Neither of the listed mechanisms are the cause of these effects. C – False – A substance with both anti-leprosy and anti-inflammatory activity, clofazimine is weakly bactericidal against M. leprae by binding to the guanine bases of bacterial DNA, not DNA polymerase directly. D – False – See below. E – True – Rifampin is bactericidal by inhibiting RNA synthesis by blocking DNA-dependent RNA polymerase.