Naplex Review

Front 1

alpha-glucosidase inhibitors (AGIs) are
including...
1.
2.

Back 1

1. Precose (acarbose)
2. Glyset (migitol)

Front 2

what class of Biguanide is?
Ex: Metformin (glucophage)

Back 2

what class of Biguanide is?
Ex: Metformin (glucophage)

Front 3

What are the possibile side effects from
metformin?

Back 3

1. GI upset
2. Megalblastic anemia
3. Lactic acidosis

Front 4

What is MOA of actos?

Back 4

Actos is TZD (Thiazoladinediones;
glitazones/TZD);
1. increase skeletal muscle, adipose tissue, and
insulin sensitivity;
2. Decreased hepatic glucose production

Front 5

What are the common AE of TZD drugs, ex:
Actos, avandia?

Back 5

1. Edema
2. Anemia
3. wt gain
4. excerabation of CHF

Front 6

What is the MOA of Prandin?

Back 6

MOA of Prandin (Repaglinide): To stimulate
pancreatic beta-cells to secrete insulin

Front 7

What are the examples of sulfonylurea diabetes
drugs?
1) 1st generation?
2) 2nd generation?

Back 7

1) 1st Generation:
- Dymelor (acetohexamide)
- Diabinese (chlorpropamide)
- Tolinase (Tolazamide)
- Orinase (Tolbutamide)
2) 2ns generation
- Amaryl (glimeperide)
- Glucotrol (Glipizide)
- Diabeta, Micronase (Glyburide)
Glynase (Glyburide micronized)

Front 8

What are the 2 classes of antidiabetes agents that
can cause 1) weight gain and 2) hypoglycemia

Back 8

1) Sulfonylureas
2) Meglitinides

Front 9

What classes of antidiabetic agent do not cause
hypoglycemia?

Back 9

1. alpha-glucosidase inhibitors (acarbose and
miglitol)
2. Insulin sensitizers (biguanide and TZD)

Front 10

Meformin should be withheld 48 hours after pts
undergoing radiological study. True or False?

Back 10

True

Front 11

List the 6 drugs containing Metformin.

Back 11

1. Glucophage
2. Glucophage XR
3. Riomet
4. Glucovance
5. Avandamet
6. Metaglip

Front 12

What are CIs in metformin?

Back 12

For female, Cr >1.4
For male, Cr > 1.5
Predisposed to potentially fatal lactic acidosis

Front 13

TZD (actose, avandia)+ oral contraceptive pills -->
?

Back 13

Need to increase estrogen dose

Front 14

What are Contraindications in TZD (actose,
avandia)

Back 14

1. ALT >2.5 normal
2. CHF
3. Hepatic patients

Front 15

What are the monitoring parameters taking
metformin?

Back 15

1. Renal
2. Liver,
3. serum B12
4. folic acid
5. Hgb
6. Hct
7. CBC

Front 16

Chlorpropamide + prednisone
--> ??? (DDI)

Back 16

hyperglycemia

Front 17

Phenytoin + tolazamide --> ??

Back 17

Increased BG levels

Front 18

Glimepiride + itraconazole
--> ??? (DDI)

Back 18

Decreased BG level

Front 19

Which insulin can be adminstered IV?

Back 19

Regular (clear); glargine is clear but it's low
pH=4.0 (no IV)

Front 20

What is myxedema?
What are the S/Sx?

Back 20

Myxedema is an end stage of hypothyroidism.
S/Sx: weakness, confusion, hypothermia,
hypoventilation, hypoglycemia, hyponatremia,
coma and shock

Front 21

" High TSH
Low T4"; what is the Dx?

Back 21

Hypothyroidism

Front 22

What is MOA of Levothyroxine?

Back 22

To increase oxygen consumption by most of
tissues and increase metabolic rate of CHO, lipids
and protein

Front 23

Take Levothyroxine with or without food?

Back 23

Without food, take 30 mins before breakfast

Front 24

what is thyroid storm?

Back 24

thyroid stormis life-threatening, fever, tachycardia,
delirium, and coma

Front 25

what is MOA of Propylthiouracil (PTU)?

Back 25

1. The peripheral conversion of T4 to T3
2. Inhibits the synthesis of thyroid hormone by
preventing the incorporation of iodine into
iodothrosine
3. ..by inhibiting the coupling of monoiodotyrosine
nd diiodtyrosine to form T4 abd T3

Front 26

What is the MOA of methimazole?

Back 26

1. Inhibits the synthesis of thyroid hormone by
preventing the incorporation of iodine into
iodothrosine
2. ..by inhibiting the coupling of monoiodotyrosine
nd diiodtyrosine to form T4 abd T3

Front 27

Lithium + Lugol's solution
--> ??? (DDI)

Back 27

Increased Lugol's solution effects

Front 28

what is Grave's disease?

Back 28

Hyperthyrodism

Front 29

What is Cushing's syndrome?

Back 29

1. Increased ACTH by pituitary gland adenomas
(Increased CRH-corticotropin-rleasing hormone
--> Increased ACTH --> Increased adrenal cortex
to produce cortisol
2. Chronic use of glucocortiocoid excess

Front 30

What is the MOA of aminoglutethimide?

Back 30

Inhibits conversion of cholesterol to pregnenolone

Front 31

What is the MOA of metyrapone?

Back 31

To decrease cortisol synthesis by inhibition of
11-hydroxylate activity

Front 32

What are adverse effects of Cytadren?

Back 32

rash, blood dyscrasias and hypothyrodism; may
also decrease effects of warfarin

Front 33

What is Addison's disease?

Back 33

Primary adrenocortical deficiency; in result of
glucococorticoid and mineralocorticoid deficiency

Front 34

what are therapeutic uses of desmopressin?

Back 34

Nocturnal enuresis, diabetes insipidus, hemophilia
A, von Willebrand's disease; Also increase clotting
factor VII levels

Front 35

Androgens and anabolic steroids are NOT
scheduled drugs. True or False?

Back 35

False; they are scheduled III

Front 36

During postmenopausal,
1)Estrogen decreased or increased?
2)Progesterone decreased or increased?
3)FSH decreased or increased?
4)LH decreased or increased?

Back 36

1)Estrogen decreased
2)Progesterone decreased
3)FSH increased
4)LH increased

Front 37

To treat a women with an intact uterus for
postmenopausal hormone replacement therapy,
which hormone is must included?

Back 37

Progestin to reduce the risk of endometrial
cancer/hyperplasia

Front 38

Climara, once a week or twice weekly?

Back 38

Once a week

Front 39

FemPatch once or twice a week?

Back 39

Once

Front 40

"Alora, Esclim, Estraderm, Menostar, Vivelle,
Vivelle Dot" once a week or twice a week?

Back 40

Twice a week

Front 41

What is Vagifem dosing?

Back 41

25 mcg/tab QHS for 2 weeks, and then twice a
week for 2 weeks (18 tabs for a month supply)

Front 42

What's the frequency of Estring?

Back 42

90 days ( evry 3 months)

Front 43

What are the common adverse effects of ERT
(Estrogen replacement therapy)?

Back 43

1. Breast tenderness
2. Heavy bleeding
3. Headache
4. Nausea

Front 44

What are the common adverse effects of progestin
therapy?

Back 44

1. Depression
2. Irritability
3. Headache

Front 45

s Estrogen a CYP450 2D6, 1A2, 2C9 or 3A4
inhibitors?

Back 45

3A4 inhibitors

Front 46

Synthroid + Warfarin --> ??? (DDI)

Back 46

Increased metabolism of Vit-K--> decreased
warfarin effects --> may neeed to increased
warfarin dose

Front 47

Estrogen + thyroid hormone
--> ??? (DDI)

Back 47

Decreased thyroid hormone effects

Front 48

When are "mini-pills" indicated?

Back 48

1. breastfeeding women
2. Free CVD risks associated with
estrogen-containing products

Front 49

What is estrogen's MOA in birth control pills?

Back 49

1. To prevent development of a dominant follicile
by supression of FSH;
2. Do not block ovulation

Front 50

What is progestin's MOA in birth control pills?

Back 50

Block ovulation by increasing the thickness and
atrophy of the endometrium

Front 51

List 3 Oral contraceptive pills are progestin only
pills.

Back 51

1. Camila
2. Ortho Micronor
3. Errin
4. Nor-QD
5. Nora-BE
6. Ovrette

Front 52

What much estrogen content in high-dose estrogen
OC?

Back 52

50 mcg; ex: Neocon 1/50, Ovcon50, Zovia 1/50

Front 53

What much estrogen content in low-dose estrogen
OC?

Back 53

from 10 - 35 mcg

Front 54

List 3 drugs/classes can increase oral
contraceptives level.

Back 54

List 3 drugs/classes can increase oral
contraceptives level.

Front 55

Oral contraceptives + pioglitazone (Actos) --> ???
(DDI)

Back 55

Decreased OC effects

Front 56

Oral contraceptives + hypoglycemics
(tolbutamide, Diabinese, Orinase, Tolinase)

Back 56

Decreased effects hypoglycemics agents

Front 57

Oral contraceptives + cortisone --> ??? (DDI)

Back 57

Increased toxicity of cortisone

Front 58

what types of hormone imbalance from the finding
"Spotting" and "Early, or mid-cycle? breakthrough
bleeding"
How do we adjust that?

Back 58

Estrogen deficiency; increased estrogen levels

Front 59

what types of hormone imbalance from the finding
"fatigue" "weight gain" "acne or oily scalp" "
depressoin" " increased appetite"?
How do we adjust that?

Back 59

Progestin excess;
decreased progestin levels

Front 60

what are the daily Calcium and Vit-D
recommended?

Back 60

Calcium 1000-1500 mg
Vitamin D 400-800 IU/day

Front 61

What is the MOA of actonel, fosamax?

Back 61

Bisphosphonates; Binds to bone (hydroxyapatite)
and incorporates into boneto increase and stablize
bone mass

Front 62

Fosamax 10 mg/day + ASA
--> ??? (DDI)

Back 62

Increased risk of upper GI bleeding

Front 63

What is the MOA of SERM (selective estrogen
receptor modulator, ex: Evista)?

Back 63

Raloxifene (Evista; act as estrogen receptor
agonist at the skeleton, decrease bone resorption
and overall bone turnover

Front 64

Evista + warfarin --> ??? (DDI

Back 64

Decreased Warfarin effects

Front 65

What is the MOA of Miacalcin?

Back 65

Inhibit bone resorption by binding to osteoclast
receptors