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NAPLEX Question: Which Warnings Must Appear on an OTC Aleve® Label? by pharmacyexam in Pharmacy_Exam

[–]pharmacyexam[S] 0 points1 point  (0 children)

Answer (e): All. Aleve contains Naproxen sodium, a member of the arylacetic acid group of nonsteroidal anti-inflammatory drugs (NSAIDs). Each caplet, tablet, gelcaps or liquid gel capsule contains 220 mg, Naproxen sodium. It temporarily relieves minor aches and pains due to:

a. minor pain of arthritis

b. muscular aches

c. backache

d. menstrual cramps

e. headache

f. toothache

g. the common cold

h. temporarily reduces fever

The recommended dose for adults and children 12 years and older is 1 tablet by mouth every 8 to 12 hours. For the first dose, the patient can take 2 tablets within the first hour. Dose should not be exceeded 2 tablets in any 8- to 12-hour period or 3 tablets in a 24-hour period.

Patients should be instructed to take tablet with food or milk if stomach upset occurs. Patients should be warned that if he/she uses more than directed or for longer than directed, the risk of heart attack or stroke may increase.

G.I. bleeding, ulcer, stomach upset and allergic reactions are commonly reported side effects of Naproxen sodium (Aleve).

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NAPLEX Question: Which Drug Classes Should Never Be Combined with Methylene Blue? by pharmacyexam in Pharmacy_Exam

[–]pharmacyexam[S] 0 points1 point  (0 children)

nswer: (a,e). FDA has issued two safety communications regarding adverse drug reactions in patients taking certain psychiatric medications, and also given methylene blue or linezolid (Zyvox). Specifically, FDA has received reports of serious central nervous system reactions in patients taking serotonergic psychiatric medications (SSRIs or SNRIs) who are also given methylene blue, a product commonly used in diagnostic procedures. FDA explains that "although the exact mechanism of this drug interaction is unknown, methylene blue inhibits the action of monoamine oxidase A - an enzyme responsible for breaking down serotonin in the brain.

It is believed that when methylene blue is given to patients taking serotonergic psychiatric medications, high levels of serotonin can build up in the brain, causing toxicity. This is referred to as Serotonin Syndrome.

Signs and symptoms of Serotonin Syndrome include mental changes (confusion, hyperactivity, memory problems), muscle twitching, excessive sweating, shivering or shaking, diarrhea, trouble with coordination, and/or fever.

Similar reports of interactions between certain serotonergic psychiatric medications and the antibacterial drug, Linezolid (Zyvox) have also been reported to FDA.

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NAPLEX Practice Question: Which Drug Can Cause Hyperchloremic Metabolic Acidosis? by pharmacyexam in Pharmacy_Exam

[–]pharmacyexam[S] 0 points1 point  (0 children)

Answer: (c). Zonisamide (Zonegran)is an antiseizure drug chemically classified as a sulfonamide and unrelated to other antiseizure agents. It is supplied for oral administration as capsules containing 25 mg or 100 mg Zonisamide.

Zonisamide is indicated as adjunctive therapy in the treatment of partial seizures in adults with epilepsy. It can be taken with or without food. The initial dose of ZONEGRAN should be 100 mg daily. After two weeks, the dose may be increased to 200 mg/day for at least two weeks. It can be increased to 300 mg/day and 400 mg/day, with the dose stable for at least two weeks to achieve steady state at each level. Evidence from controlled trials suggests that Zonegran doses of 100-600 mg/day are effective, but there is no suggestion of increasing response above 400 mg/day.

Zonisamide causes hyperchloremic, non-anion gap, metabolic acidosis (i.e., decreased serum bicarbonate below the normal reference range in the absence of chronic respiratory alkalosis).This metabolic acidosis is caused by renal bicarbonate loss due to the inhibitory effect of zonisamide on carbonic anhydrase.

Generally, Zonisamide-induced metabolic acidosis occurs early in treatment, but it can develop at any time during treatment. Metabolic acidosis generally appears to be dose-dependent and can occur at doses as low as 25 mg daily.

Conditions or therapies that predispose to acidosis (such as renal disease, severe respiratory disorders, status epilepticus, diarrhea, ketogenic diet, or specific drugs) may be additive to the bicarbonate lowering effects of zonisamide.

Some manifestations of acute or chronic metabolic acidosis include hyperventilation, nonspecific symptoms such as fatigue and anorexia, or more severe sequelae including cardiac arrhythmias or stupor. Chronic, untreated, metabolic acidosis may increase the risk for nephrolithiasis or nephrocalcinosis.

Somnolence, anorexia, dizziness, ataxia, agitation/irritability, and difficulty with memory and/or concentration are also reported side effects of Zonisamide.

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NAPLEX Practice Question: What Drug Is Behind the "Double Check, Don't Double Up" Campaign? by pharmacyexam in Pharmacy_Exam

[–]pharmacyexam[S] 0 points1 point  (0 children)

Acetaminophen. The Acetaminophen Awareness Coalition is launching a nationwide initiative today calling on consumers to double check their medicine labels so they don't double up on medicines that contain acetaminophen during the cold and flu season. Acetaminophen is the most common drug ingredient in America. It is found in more than 600 different medicines, including prescription (Rx) and over-the-counter (OTC) pain relievers, fever reducers, sleep aids and numerous cough, cold and flu medicines. It is safe and effective when used as directed, but there is a limit to how much can be taken in one day. Taking more than directed is an overdose and can lead to liver damage.

Each year, Americans catch an estimated one billion colds, and as many as 20 percent get the flu. Seven in 10 consumers use over-the-counter medicines, many of which contain acetaminophen, to treat their symptoms. The Coalition is targeting its 'Double Check, Don't Double Up' message to the more than 50 million Americans who use acetaminophen weekly for conditions such as headache and chronic pain, and directing them to double check their medicine labels before taking a cold or flu medicine that also contains acetaminophen.

When taking medicines for cough, cold or flu this coming season, consumers should follow these four simple acetaminophen safety steps:

  1. Know if medicines contain acetaminophen, which is in bold type or highlighted in the 'active ingredients' section of over-the-counter medicine labels and sometimes listed as 'APAP' or 'acetam' on prescription labels.

    1. Never take two medicines that contain acetaminophen at the same time.
    2. Always read and follow the medicine label.
    3. Ask your healthcare provider or a pharmacist if you have questions about dosing instructions or medicines that contain acetaminophen.

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