NAPLEX Chapter 6 (Drug Formulations & Patient Counseling)
All of the following medications can be administered as a self-injectable subcutaneous injection EXCEPT:
Invega Sustenna
Assessment and Plan: Discontinue oral Invega. Start Invega Sustenna; first injection to be given prior to discharge. Follow up in clinic in 7 days for second initiation injection.
Which of the following are potential benefits of the new antipsychotic medication being started in this patient? (Select ALL that apply)
Improved adherence and reduced daily pill burden
Many patches work systemically. A few treat a topical condition. Which of the following patches are applied topically to treat pain? (Select ALL that apply.)
Flector is the diclofenac topical pain patch. Lidoderm is the lidocaine topical pain patch.
Which statement regarding nasal spray formulations is correct?
They bypass GI absorption, avoiding traditional drug metabolism
CP is a 12-year-old male experiencing nausea after his tonsillectomy. He has been prescribed ondansetron orally disintegrating tablets. His mother requests counseling on the prescription at the pharmacy pick-up counter. Which of the following instructions should be included when counseling on this dosage form?
Place the tablet on the tongue and wait for it to dissolve
Which of the following patches is changed twice weekly?
Vivelle-Dot
Vivelle-Dot is changed twice weekly, such as on Monday and Thursday.
Select the name of the glatiramer subcutaneous injection that is injected daily or three times weekly for multiple sclerosis.
Copaxone is a common multiple sclerosis medication; it is injected daily or 3 times per week (administered at least 48 hours apart).
Select the transdermal patch that can be applied to the buttock.
Xulane and the oxybutynin patch can be applied to the buttock.
Which of the following patches is changed daily?
Daytrana is changed daily, alternating between left and right hip.
For which of the following patches should be disposed of by flushing down the toilet? (Select ALL that apply.)
Butrans
Daytrana
Duragesic
JJ is a 42-year-old female who takes lisinopril 10 mg once daily for hypertension. JJ calls into the pharmacy and states that she forgot to take her 10 mg dose of lisinopril at 9 am; it is now 1 pm. When should JJ take her missed dose of lisinopril?
Take 10 mg of lisinopril now; resume 10 mg of lisinopril tomorrow at 9am
Which of the following patches is changed every 3 days?
Transderm-Scop
Which medication patch is paired with the correct dosing interval?
Catapres-TTS- apply once weekly
A Candida infection at which site is best treated with a clotrimazole troche?
Mouth
Which of the following counseling statements concerning eye drop administration are correct? (Select ALL that apply.)
Wash hands thoroughly before using eye drops
While looking up, use one finger to gently pull down the lower eyelid
After inserting a drop, close the eye and press a finger between the eye and the top of the nose for one minute
Which of the following medications is applied topically to treat low testosterone?
Androgel
What is the primary purpose of using a glycerin suppository in a child or adult?
To treat constipation
A 32-year-old man was prescribed Flector (diclofenac) patch for a high ankle sprain he sustained while playing basketball. How frequently should the patch be applied?
Twice daily
What is the reason that some patches need to be removed prior to an MRI procedure (e.g., Androderm or clonidine)?
The MRI will cause the metal in the patch to burn the skin
Which of the patient's medications can be cut at the score line so the medication can be administered as two smaller pieces?
Carbidopa/levodopa ER
Which statements regarding the application instructions for SB's lidoderm patch medication are correct? (Select ALL that apply.)
The patch can be cut if needed
Apply the patch for 12 hours, then remove for 12 hours
Up to three patches can be applied at a time
Which statement describes a benefit of sublingual nitroglycerin administration?
It avoids first pass metabolism
Assessment and Plan:
Change current ADHD regimen to optimize medication management.
Switch to osmotic controlled-release oral delivery system
methylphenidate (Concerta); follow up in one month.
What are the benefits of the new medication prescribed for this patient? (Select ALL that apply)
Decreased frequency of drug administration
Extended drug release
Fast drug delivery
Reduced fluctuations in serum drug level
GJ's physician would like to switch her to a long-acting intramuscular injection to treat her psychiatric condition. Which of the following medications can be recommended?
Risperdal Consta
How often should the patient's clonidine patch be applied?
Weekly
When GJ visits her primary care physician, she asks if there is anything she can take for sleep that works faster than her current medication. Her physician tells her that the same medication comes in a sublingual tablet. Which of the following options would be an appropriate substitution for the medication GJ currently uses for insomnia?
Edluar
What counseling information should the pharmacist provide for GJ's patch medication?
Put the adhesive cover over the patch to hold it in place
Which patch formulation is dispensed with its own adhesive cover to hold the patch in place?
Clonidine (Catapres-TTS) comes with its own adhesive cover to hold the patch in place. Fentanyl (Duragesic) and buprenorphine (Butrans) can only be covered by Tegaderm or Bioclusive. Most patches cannot be covered with tape.
What is the patient seeing in his stool when taking Cardura XL?
Empty shell of Cardura XL
Which of the following patients would benefit most from the use of an orally disintegrating tablet?
A 62 y/o female with dysphagia
HL is a 60-year-old female with mild hypokalemia who picked up a new prescription for potassium chloride ER capsules two days ago. She has been having difficulty swallowing the capsules. She calls the pharmacy to ask whether she can open the capsule, crush its contents, then mix them with water to make the medication easier to take. What is the risk of administering the medication this way?
Delivery of a supratherapeutic dose
The following patch is used for topical pain relief and can be cut into pieces by the patient to be applied "where it hurts":
Lidoderm
Which patches can be covered with a permitted adhesive film (such as Tegaderm) if the patch does not stick well to the skin? (Select ALL that apply.)=
Duragesic (fentanyl) and Butrans (buprenorphine) can only be covered by the permitted adhesive dressings Bioclusive or Tegaderm to help the patch stick to the skin.
Which drug formulation would be best for abortive treatment of this patient's migraine episodes?
Nasal spray