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ContributorsiComprehensivePharmacy Reviewfor NAPLEXPractice Exams, Cases,and Test PrepEighth EditionMutnick 00 FM.indd i07/16/12 2:46 PM

Mutnick 00 FM.indd ii07/16/12 2:46 PM

ContributorsiiiComprehensivePharmacy Reviewfor NAPLEXPractice Exams, Cases,and Test PrepEighth EditionEDITORSAlan H. Mutnick, PharmD, FASHP, RPhCorporate Director, Clinical ServicesCatholic Health PartnersCincinnati, OhioPaul F. Souney, MS, RPhVice PresidentMedical Affairs and Pharmacotherapy ManagementMedical Outcomes Management, Inc.Sharon, MassachusettsLarry N. Swanson, PharmD, FASHP, RPhProfessor and ChairmanDepartment of Pharmacy PracticeCampbell University College of Pharmacy and Health SciencesBuies Creek, North CarolinaLeon Shargel, PhD, RPhPresidentApplied BiopharmaceuticsRaleigh, North CarolinaAffiliate Associate ProfessorDepartment of PharmaceuticsSchool of PharmacyVirginia Commonwealth UniversityRichmond, VirginiaMutnick 00 FM.indd iii07/16/12 2:46 PM

Acquisitions Editor: Sirkka HowesProduct Manager: Michael MarinoMarketing Manager: Joy Fisher WilliamsDesign Coordinator: Teresa MallonProduction Services: Absolute Service, Inc.Eighth EditionCopyright 2013, 2010, 2007, 2004, 2001 by Lippincott Williams & Wilkins, a Wolters Kluwer business.351 West Camden StreetBaltimore, MD 21201Two Commerce Square2001 Market StreetPhiladelphia, PA 19103Printed in ChinaAll rights reserved. This book is protected by copyright. No part of this book may be reproduced or transmitted in anyform or by any means, including as photocopies or scanned-in or other electronic copies, or utilized by any informationstorage and retrieval system without written permission from the copyright owner, except for brief quotations embodiedin critical articles and reviews. Materials appearing in this book prepared by individuals as part of their official duties asU.S. government employees are not covered by the above-mentioned copyright. To request permission, please contactLippincott Williams & Wilkins at Two Commerce Square, 2001 Market Street, Philadelphia, PA 19103, via e-mail atpermissions@lww.com, or via website at lww.com (products and services).9 8 7 6 5 4 3 2 1Library of Congress Cataloging-in-Publication DataComprehensive pharmacy review for NAPLEX : practice exams, case studies and test prep / editors, Alan H. Mutnick .[et al.]. — 8th ed.p. ; cm.Rev. ed. of: Comprehensive pharmacy review practice exams / editors, Alan H. Mutnick . [et al.]. 7th ed. c2010.Companion to Comprehensive pharmacy review for NAPLEX / editors, Leon Shargel . [et al.]. 8th ed. c2013.ISBN 978-1-4511-1987-9 (pbk.)I. Mutnick, Alan H. II. Comprehensive pharmacy review practice exams. III. Comprehensive pharmacy review forNAPLEX.[DNLM: 1. Pharmacy—Examination Questions. QV 18.2]615.1076—dc232012023402DISCLAIMERCare has been taken to confirm the accuracy of the information present and to describe generally accepted practices.However, the authors, editors, and publisher are not responsible for errors or omissions or for any consequences from application of the information in this book and make no warranty, expressed or implied, with respect to the currency, completeness, or accuracy of the contents of the publication. Application of this information in a particular situation remains theprofessional responsibility of the practitioner; the clinical treatments described and recommended may not be consideredabsolute and universal recommendations.The authors, editors, and publisher have exerted every effort to ensure that drug selection and dosage set forth inthis text are in accordance with the current recommendations and practice at the time of publication. However, in view ofongoing research, changes in government regulations, and the constant flow of information relating to drug therapy anddrug reactions, the reader is urged to check the package insert for each drug for any change in indications and dosage andfor added warnings and precautions. This is particularly important when the recommended agent is a new or infrequentlyemployed drug.Some drugs and medical devices presented in this publication have Food and Drug Administration (FDA) clearancefor limited use in restricted research settings. It is the responsibility of the health care provider to ascertain the FDA statusof each drug or device planned for use in their clinical practice.To purchase additional copies of this book, call our customer service department at (800) 638-3030 or fax orders to(301) 223-2320. International customers should call (301) 223-2300.Visit Lippincott Williams & Wilkins on the Internet: http://www.lww.com. Lippincott Williams & Wilkins customerservice representatives are available from 8:30 a.m. to 6:00 p.m., EST.Mutnick 00 FM.indd iv07/16/12 2:46 PM

ContentsPreface viiContributors ixTaking a Test xiIntroduction to the NAPLEX xivNAPLEX Blueprint xv5. PRACTICE CALCULATIONS177Appendix A: Common Prescription Drugs 2011. TEST 1Patient Profiles and Questions 1Answers and Explanations 41Appendix B: Prescription Dispensing Informationand Metrology 210Appendix C: Reference Charts for PatientCounseling 215Appendix D: National and State Boards of PharmacyContact Information 2752. TEST 2Patient Profiles and Questions 59Answers and Explanations 993. CASES4. OTC AND RELATEDQUESTIONS 170113Appendix E: Budgeting for Drug InformationResources 281Appendix F: Common Systems of Measurement andIntersystem Conversion 283Appendix G: Glossary of Pharmaceutical DosageForms and Drug Delivery Systems 293vMutnick 00 FM.indd v07/16/12 2:46 PM

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PrefaceThis practice exam book is a companion to Comprehensive Pharmacy Review. Whereas Comprehensive PharmacyReview presents most of the subjects in the pharmacy curriculum in outline form with review questions interspersed,this booklet offers two examinations that are similar in format and coverage to those in the licensing examination required of all pharmacists.Both patient profile–based and free-standing test itemsare included in the examinations. The questions are of twogeneral types. In the first type (Example 1), the correct response most accurately completes a statement or answersa question. In the second type (Example 2), three statements are given. The correct answer may include one, two,or all three of these statements; these questions are to beanswered according to the direction block that accompanies them.EXAMPLE 2 (MULTIPLE TRUE–FALSE)EXAMPLE 1 (MULTIPLE-CHOICE)Allow a maximum of 4 hours for each examination.Answers, with explanations, are given at the end of each test.Additional cases, questions, and calculations exercises areincluded following the two practice tests. Also, several appendices are included at the back of the book for reference.Drugs that demonstrate nonlinear pharmacokinetics showwhich of the following properties?A. A constant ratio of drug metabolites is formed as theadministered dose increases.B. The elimination half-life increases as the administereddose is increased.C. The area under the curve (AUC) increases in direct proportion to an increase in the administered dose.D. Both low and high doses follow first-order eliminationkinetics.E. The steady-state drug concentration increases in directproportion to the dosing rate.Antimuscarinic agents are used in the treatment of Parkinson disease and in the control of some neuroleptic-inducedextrapyramidal disorders. These agents include which of thefollowing?I. ipratropiumII. benztropineIII. trihexyphenidylI onlyIII onlyI and IIII and IIII, II, and IIIviiMutnick 00 FM.indd vii07/16/12 2:46 PM

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ContributorsConnie Lee Barnes, PharmDProfessorDirector, Drug Information CenterDepartment of Pharmacy PracticeCampbell University College of Pharmacy and Health SciencesBuies Creek, North CarolinaBrooke Bernhardt, PharmD, BCOPClinical Pharmacy Specialist, Hematology/OncologyTexas Children’s HospitalHouston, TexasK. Paige D. Brown, PharmDAssistant Director of Experiential EducationAssistant Professor of Pharmacy PracticeCampbell University College of Pharmacy and Health SciencesBuies Creek, North CarolinaTodd A. Brown, MHP, RPhClinical Instructor and Vice ChairDepartment of Pharmacy PracticeBouve College of Health Sciences School of PharmacyNortheastern UniversityBoston, MassachusettsMarcia L. Buck, PharmD, FCCP, FPPAGClinical Pharmacy Coordinator, Children’s HospitalAssociate Professor, PediatricsSchool of MedicineClinical Associate ProfessorSchool of NursingUniversity of Virginia Health System, Department of PharmacyServicesCharlottesville, VirginiaDean S. Collier, PharmD, BCPSAssistant ProfessorDepartment of Pharmacy PracticeUniversity of Nebraska Medical CenterClinical PharmacistDepartment of Pharmacy PracticeThe Nebraska Medical CenterOmaha, NebraskaRobert B. Greenwood, RPh, PhDAssociate Dean of Academic AffairsProfessor of Pharmaceutical SciencesCampbell University College of Pharmacy and Health SciencesBuies Creek, North CarolinaJames B. Groce III, PharmD, CACPProfessor, Department of Pharmacy PracticeCampbell University College of Pharmacy and Health SciencesClinical Assistant Professor of Medicine, Department of MedicineUniversity of North Carolina School of MedicineClinical Pharmacy Specialist—AnticoagulationDepartment of PharmacyCone HealthGreensboro, North CarolinaTerri S. Hamrick, PhDAssociate ProfessorDepartment of Pharmaceutical SciencesCollege of Pharmacy and Health SciencesCampbell UniversityBuies Creek, North CarolinaJulie J. Kelsey, PharmDClinical Pharmacy SpecialistWomen’s Health and Family MedicineDepartment of Pharmacy ServicesUniversity of Virginia Health SystemCharlottesville, VirginiaD. Byron May, PharmD, BCPSProfessorDepartment of Pharmacy PracticeCampbell University College of Pharmacy and Health SciencesBuies Creek, North CarolinaClinical Specialist in Adult Internal MedicineDepartment of PharmacyDuke University HospitalDurham, North CarolinaAlan H. Mutnick, PharmD, FASHP, RPhCorporate Director/Clinical ServicesCatholic Health PartnersCincinnati, OhioAndrew J. Muzyk, PharmDAssistant ProfessorDepartment of Pharmacy PracticeCampbell University College of Pharmacy and Health SciencesBuies Creek, North CarolinaClinical Pharmacy SpecialistDepartment of PharmacyDuke University HospitalDurham, North CarolinaixMutnick 00 FM.indd ix07/16/12 2:46 PM