NAPLEX flashcards

32 cards. Read the term and the definition here. The deck at the top of this page is optional.

Metformin eGFR thresholds

Metformin should not be started when eGFR is below 45 mL/min/1.73 m²; it is contraindicated below 30 mL/min/1.73 m², where lactic acidosis risk becomes unacceptable.

HFrEF four pillar therapy

Guideline-directed HFrEF therapy combines an ARNI, ACE inhibitor, or ARB with an evidence-based beta-blocker, a mineralocorticoid receptor antagonist, and an SGLT2 inhibitor.

Warfarin INR targets

Most indications, including atrial fibrillation and venous thromboembolism, target an INR of 2.0 to 3.0; mechanical mitral valves and antiphospholipid syndrome require 2.5 to 3.5.

Vancomycin AUC monitoring target

For serious MRSA infection, vancomycin is dosed to an AUC24/MIC of 400 to 600 mg·h/L, which predicts efficacy and nephrotoxicity better than trough-only monitoring.

High-intensity statin definition

Atorvastatin 40 to 80 mg or rosuvastatin 20 to 40 mg daily lowers LDL-C by at least 50 percent and is the standard intensity for patients with clinical ASCVD.

Status epilepticus treatment sequence

Convulsive status epilepticus is treated first with a benzodiazepine such as IV lorazepam or IM midazolam, followed by fosphenytoin, levetiracetam, or valproate.

Bioequivalence confidence interval rule

Two products are bioequivalent when the 90 percent confidence interval of the test-to-reference ratio for both AUC and Cmax falls entirely within 80 to 125 percent.

Volume of distribution meaning

Volume of distribution equals the amount of drug in the body divided by plasma concentration; a very large value indicates tissue sequestration and poor removal by hemodialysis.

Loading dose equation

Loading dose equals the volume of distribution multiplied by the target plasma concentration, divided by bioavailability; it rapidly reaches therapeutic levels without waiting for steady state.

CYP2C19 and clopidogrel activation

Clopidogrel is a prodrug activated by CYP2C19; poor metabolizers and patients taking strong CYP2C19 inhibitors such as omeprazole may have reduced antiplatelet effect.

HLA-B*5701 abacavir screening

HLA-B*5701 testing before starting abacavir identifies patients at risk of a life-threatening hypersensitivity reaction; abacavir must not be used in carriers of the allele.

Cockcroft-Gault creatinine clearance equation

CrCl in mL/min equals (140 minus age) times weight in kg, divided by 72 times serum creatinine in mg/dL, multiplied by 0.85 for female patients.

Alligation method purpose

Alligation calculates the proportion in which two preparations of different percentage strength must be combined to produce a specified intermediate strength product.

Milliequivalent conversion formula

Milliequivalents equal milligrams multiplied by valence, divided by molecular weight; this conversion is used for electrolyte orders such as potassium chloride and sodium bicarbonate.

Sodium chloride equivalent method

The E-value method multiplies each drug's weight by its sodium chloride equivalent and adds sodium chloride so total osmotically active solute equals 0.9 percent of the final volume.

USP 795 default beyond-use dates

Default nonsterile compounding beyond-use dates are 180 days for nonaqueous forms, 14 days refrigerated for water-containing oral liquids, and 30 days for water-containing topical preparations.

DEA Form 222 purpose

Form 222, or its electronic CSOS equivalent, is the order document required to purchase Schedule II controlled substances; each line item may list only one supplier.

Schedule III-V refill limit

Prescriptions for Schedule III, IV, and V controlled substances may be refilled up to five times, and no refill may occur more than six months after the issue date.

FEFO stock rotation principle

First-expired, first-out rotation dispenses inventory with the earliest expiration date before later-dated stock, reducing waste when products with differing shelf lives are stored together.

Biennial controlled substance inventory

Federal regulations require a complete and accurate inventory of all controlled substances every two years, retained at the registered location for at least two years.

Emergency Schedule II oral prescription

In a genuine emergency, a Schedule II prescription may be transmitted orally if the prescriber delivers a written or electronic prescription to the pharmacy within seven days.

Teach-back counseling technique

The pharmacist asks the patient to restate the instructions in their own words, which confirms true understanding and exposes gaps that yes-or-no questions would miss.

Punctal occlusion after eye drops

Gentle pressure on the nasolacrimal duct for one to two minutes after instilling eye drops reduces drainage into the nose and systemic absorption of the medication.

Motivational interviewing OARS skills

OARS stands for open-ended questions, affirmations, reflections, and summaries; these four microskills keep the conversation patient-directed and support behavior change.

Sublingual nitroglycerin instructions

The patient should sit down before placing the tablet under the tongue and call 911 if chest pain persists or worsens five minutes after the first dose.

Spacer use with inhaled corticosteroids

A valved holding chamber improves lung deposition and reduces oropharyngeal drug deposition; patients using inhaled corticosteroids should rinse their mouth after each use.

OBRA 90 counseling requirement

Pharmacies serving Medicaid patients must offer counseling to the patient or caregiver on new and refill prescriptions and must perform prospective drug utilization review.

Combat Methamphetamine Epidemic Act limits

Pseudoephedrine sales are limited to 3.6 grams per day and 9 grams per 30 days per purchaser, with photo identification and a written or electronic logbook.

Class I drug recall definition

A Class I recall involves a product whose use has a reasonable probability of causing serious adverse health consequences or death, requiring the most urgent notification and retrieval.

HIPAA minimum necessary standard

Covered entities must limit uses, disclosures, and requests for protected health information to the minimum amount reasonably needed to accomplish the intended purpose.

NDC number structure

The National Drug Code contains three segments: a five-digit labeler code, a four-digit product code, and a two-digit package code, conventionally written in 5-4-2 format.

DEA registration renewal cycle

A DEA registration remains valid for three years and must be renewed before expiration; practicing with an expired registration is a violation of federal controlled substance law.