NAPLEX Practice Questions

PDE5 inhibitors like sildenafil can cause significant hypotension when used with alpha blockers like tamsulosin or terazosin. Counsel on symptoms and slow position changes.

Diltiazem (a non-dihydropyridine CCB) does not significantly prolong QT, while most antiarrhythmics, especially Class IA (eg, quinidine, procainamide) and III (eg, dofetilide, sotalol, amiodarone), do.

Natalizumab (Tysabri) is reserved for patients who fail first-line multiple sclerosis therapies due to the risk of PML, a potentially fatal brain infection.

High-intensity statins like atorvastatin 80 mg improve outcomes post-MI when started promptly.

Triamcinolone for asthma is marketed as Azmacort; Nasacort AQ is for allergic rhinitis.

Ribavirin is not indicated for hepatitis B; this combo is for hepatitis C.

1 gal = 3785 mL --> 3785×0.20 = V2×0.40 --> V2 = 1892.5 mL

Low albumin means more free (active) phenytoin, making the effective level higher than what appears in labs.

Paul is under 65 but has diabetes, which places him in a high-risk group for pneumococcal disease. Current ACIP guidelines recommend: Pneumococcal vaccination: Patients aged 19–64 with diabetes should receive either: PCV20 alone, or PCV15 followed by PPSV23 (at least 1 year apart, or 8 weeks in immunocompromised).
Annual influenza vaccination: He should receive an inactivated influenza vaccine like Fluvarin. FluMist is not recommended in high-risk patients (e.g., diabetes, chronic conditions). Shingles vaccine (Shingrix) is approved for immunocompetent adults ?50 years or ?19 if immunocompromised, so Peter does not yet qualify based on age alone.

All are appropriate due to CNS effects, abuse potential, and safety risks.