naplex review. welcome!!! who am i?? alan j. zillich, pharm.d. assistant professor of pharmacy...

NAPLEX Review

Welcome!!!Welcome!!!

Who am I?? Alan J. Zillich, Pharm.D.

• Assistant Professor of Pharmacy Practice– Purdue University College of Pharmacy

• NOT TOO FAR REMOVED FROM THE EXAM

Who am I?? Alan J. Zillich, Pharm.D.

• Assistant Professor of Pharmacy Practice– Purdue University College of Pharmacy

• NOT TOO FAR REMOVED FROM THE EXAM

3

Welcome!!! Welcome!!! What this course should be:

a review – We know you know this stuff • we can’t cover 6 years in 3 days

interactive – so you get the most out of it…ASK QUESTIONS

informative – so you remind yourself what you know (AND DON’T)

fun?... or as fun as a NAPLEX review can be?

What this course should be: a review – We know you know this stuff

• we can’t cover 6 years in 3 days

interactive – so you get the most out of it…ASK QUESTIONS

informative – so you remind yourself what you know (AND DON’T)

fun?... or as fun as a NAPLEX review can be?

The Lecture Note Book The Lecture Note Book I will cover parts as will Dr. Overholser, but not all

of it Chapters to be covered by me:

1, 2, 8, 15, 16 (7 and 17 somewhat) Chapters to be covered by Dr. Overholser:

1,3, 4, 5, 6, 9, 10, 13

Page number on slide should correspond with book

Self-review the others. They are there as a resource!

I will cover parts as will Dr. Overholser, but not all of it

Chapters to be covered by me: 1, 2, 8, 15, 16 (7 and 17 somewhat)

Chapters to be covered by Dr. Overholser: 1,3, 4, 5, 6, 9, 10, 13

Page number on slide should correspond with book

Self-review the others. They are there as a resource!

About the NAPLEX 1

NAPLEX®NAPLEX®

North American Pharmacist Licensure Examination

National Association of Boards of Pharmacy (NABP®)

700 Busse Highway

Park Ridge, Illinois 60068

USA

847-698-6227

www.nabp.net

North American Pharmacist Licensure Examination

National Association of Boards of Pharmacy (NABP®)

700 Busse Highway

Park Ridge, Illinois 60068

USA

847-698-6227

www.nabp.net

Ref. NAPLEX/MPJE® Registration BulletinRef. NAPLEX/MPJE® Registration Bulletin

8

Purpose of the examination

Developed by the National Association of Boards of Pharmacy (NABP®) for use by the boards as part of there assessment of competence to practice pharmacy.

Keep in mind this is minimum competency

Purpose of the examination

Developed by the National Association of Boards of Pharmacy (NABP®) for use by the boards as part of there assessment of competence to practice pharmacy.

Keep in mind this is minimum competency

PG 3 Ref. NAPLEX/MPJE® Registration BulletinRef. NAPLEX/MPJE® Registration Bulletin

9

Competency StatementsCompetency Statements

NABPTM has prepared “Competency Statements” with three major areas of concentration:

Assure safe and effective pharmacotherapy and optimize therapeutic outcomes (54% of test).

Assure safe and accurate preparation and dispensing of medications (35% of test).

Provide health care information and promote public health (11% of test ).

NABPTM has prepared “Competency Statements” with three major areas of concentration:

Assure safe and effective pharmacotherapy and optimize therapeutic outcomes (54% of test).

Assure safe and accurate preparation and dispensing of medications (35% of test).

Provide health care information and promote public health (11% of test ).

10

“New” Emphasis Topics“New” Emphasis Topics

Herbals OTC questions Communication skills questions

Herbals OTC questions Communication skills questions

11

Step 1

Contact the board of pharmacy in the state in which you want to be licensed. (PRIMARY STATE)

www.nabp.net

Step 2

Fill-out all forms and follow all directions

To score transfer or NOT to score transfer

Find money to pay for it!!♦ NAPLEX – $465 per examination

♦ MPJE – $185 per examination

Step 1

Contact the board of pharmacy in the state in which you want to be licensed. (PRIMARY STATE)

www.nabp.net

Step 2

Fill-out all forms and follow all directions

To score transfer or NOT to score transfer

Find money to pay for it!!♦ NAPLEX – $465 per examination

♦ MPJE – $185 per examination

Registering for the NAPLEX Registering for the NAPLEX


12

Step 3

After receiving your Authorization to Test (ATT), contact

Pearson VUE • 1-888/709-2679

• www.pearsonvue.com/nabp Testing date

• Testing location

Step 3

After receiving your Authorization to Test (ATT), contact

Pearson VUE • 1-888/709-2679

• www.pearsonvue.com/nabp Testing date

• Testing location

Registering for the NAPLEX Registering for the NAPLEX


13

Pearson VUE – Web AccountPearson VUE – Web Account

First-time test takers must create a Pearson Vue web account.

Please note that account creation may require up to 24 hours.

You will be notified by email when your account is activated.

When creating your account and scheduling your test, you will need your NABP ID number from the ATT letter.

The ATT includes the dates during which you are eligible to take the examination as well as the test authorization number and an expiration date

After you schedule your test, Pearson VUE will send a confirmation letter listing your test date, your testing time, the address and phone number of the test center, and directions to the test center.

First-time test takers must create a Pearson Vue web account.

Please note that account creation may require up to 24 hours.

You will be notified by email when your account is activated.

When creating your account and scheduling your test, you will need your NABP ID number from the ATT letter.

The ATT includes the dates during which you are eligible to take the examination as well as the test authorization number and an expiration date

After you schedule your test, Pearson VUE will send a confirmation letter listing your test date, your testing time, the address and phone number of the test center, and directions to the test center.

14

CancellationCancellation

Must call Pearson VUE Testing Centers to cancel your testing appointment.

No later than noon eastern standard time of the second business day prior to your scheduled appointment. (Saturday is a business day for them)

If you don’t call you lose your money.

Must call Pearson VUE Testing Centers to cancel your testing appointment.

No later than noon eastern standard time of the second business day prior to your scheduled appointment. (Saturday is a business day for them)

If you don’t call you lose your money.


15

On Examination Day

Your ATT (Authorization To Test) card will indicate supplies that you may bring with you. {Generally nothing}

Arrive 30 minutes prior to your exam time.

Be sure to bring your ATT card and two forms of personal identification both with signature, at least one of which should also have your picture. They cannot be expired and must be the same name as your ATT.

After signing in at the Center, you will be assigned your work area.

Requirement as of May 2005 – digital photo taken at test center

On Examination Day

Your ATT (Authorization To Test) card will indicate supplies that you may bring with you. {Generally nothing}

Arrive 30 minutes prior to your exam time.

Be sure to bring your ATT card and two forms of personal identification both with signature, at least one of which should also have your picture. They cannot be expired and must be the same name as your ATT.

After signing in at the Center, you will be assigned your work area.

Requirement as of May 2005 – digital photo taken at test center


16

Taking the Examination

Laminated Note Boards and pencils are provided.

A keyboard and a mouse-operated simple on-screen calculator is available.

Required (Optional) 10-minute break after 2 hours

Examination time: 4 h 15 min.

Extra time for a tutorial before and survey after

Majority will finish in 2.5 – 3 hours

Taking the Examination

Laminated Note Boards and pencils are provided.

A keyboard and a mouse-operated simple on-screen calculator is available.

Required (Optional) 10-minute break after 2 hours

Examination time: 4 h 15 min.

Extra time for a tutorial before and survey after

Majority will finish in 2.5 – 3 hours


17

Examination Format:Examination Format:

PG 4

•NAPLEX® test = 185 questions of which 150 count toward your examination score

• Computer-Adaptive Test (CAT)•Questions of various difficulty•Provided one-at-a-time•Successive measurement•Answers cannot be reviewed or changed


18

Grading of the examination• Answer less than 162 and test is not scored

• Answer less than 185 a penalty will be applied

Results will be sent to your specified Board of Pharmacy

The passing score is set at 75 this is not a % value !

Calculated by determining your ability level on the exam then comparing it to the predetermined minimum acceptable ability level established for the NAPLEX.

Grading of the examination• Answer less than 162 and test is not scored

• Answer less than 185 a penalty will be applied

Results will be sent to your specified Board of Pharmacy

The passing score is set at 75 this is not a % value !

Calculated by determining your ability level on the exam then comparing it to the predetermined minimum acceptable ability level established for the NAPLEX.


19

SUCCESSFULLY TAKING THE COMPUTER-ADAPTIVE TEST

Take a positive attitude.

Budget your examination time wisely.

There are almost no “trick” questions on the exam.

Drug products introduced in the past 6 months will not be on the exam. Drugs that have been available for 6-12 months may be on the exam, but only as experimental questions

Calculations will be assigned the most weight.

Answer a previous question incorrectly, forget about it and just continue.

Remember…. minimum competency.

SUCCESSFULLY TAKING THE COMPUTER-ADAPTIVE TEST

Take a positive attitude.

Budget your examination time wisely.

There are almost no “trick” questions on the exam.

Drug products introduced in the past 6 months will not be on the exam. Drugs that have been available for 6-12 months may be on the exam, but only as experimental questions

Calculations will be assigned the most weight.

Answer a previous question incorrectly, forget about it and just continue.

Remember…. minimum competency.

PG 14

20

Study and Test-Taking StrategiesStudy and Test-Taking Strategies

Concentrate your efforts on important areas (THINK TOP 200---Chapter 8) http://www.studystack.com/ ---click on medicine

Practice under actual exam conditions Read each question carefully (cover the answers) Don’t cheat (peek) Think about why the wrong answers are there Reflect on your mistakes Practice Exams (Pre-NABPLEX, KAPLAN, Other

books)

Concentrate your efforts on important areas (THINK TOP 200---Chapter 8) http://www.studystack.com/ ---click on medicine

Practice under actual exam conditions Read each question carefully (cover the answers) Don’t cheat (peek) Think about why the wrong answers are there Reflect on your mistakes Practice Exams (Pre-NABPLEX, KAPLAN, Other

books)

p. 8-15

NAPLEX 2007 QbankNAPLEX 2007 Qbank

Customizable database of over 1,000 questions

Create mini-exams by Discipline and/or Patient Cluster

Full analysis, explanations and history

Great addition to your review!

$99 for 1 month of access

Customizable database of over 1,000 questions

Create mini-exams by Discipline and/or Patient Cluster

Full analysis, explanations and history

Great addition to your review!

$99 for 1 month of access

Create Quizzes in Test Mode or Tutorial Mode

Specify whether you only want to

see questions you haven’t yet

used.

Specify whether you want to see stand-alone or patient cluster questions (or

both)

Check off which discipline(s) or patient clusters

you’d like to appear on your

quiz

Calculate the number of available

questions that meet your

chosen criteria

Specify your desire # of

questions and create your test!

24

Study and Test-Taking StrategiesStudy and Test-Taking Strategies

Practice Guessing YOU MUST ANSWER EVERY QUESTION Understand the question (75/25) Effectively narrow Upper then Lower Admit if you are clueless Think moderately Divide and conquer (group)

Practice Guessing YOU MUST ANSWER EVERY QUESTION Understand the question (75/25) Effectively narrow Upper then Lower Admit if you are clueless Think moderately Divide and conquer (group)

p. 8-15

25

Eliminate the answers you know are incorrect

Guessing between 5 answers is 20%

Guessing between 2 answers is 50%.

Eliminate the answers you know are incorrect

Guessing between 5 answers is 20%

Guessing between 2 answers is 50%.

PG 16

Strategies for Answering Multiple-Choice QuestionsStrategies for Answering Multiple-Choice Questions

26

ExampleA common side effect of Motrin® is:

A. Gastritis

B. Myositis

C. Myalgia

D. Gastrocele

E. Hematoma

27

ExampleA common side effect of Motrin® is:

A. Gastritis (inflammation of Stomach)

B. Myositis (Inflammation of voluntary muscle)

C. Myalgia (Pain in muscle)

D. Gastrocele (Stomach hernia)

E. Hematoma (Collection of Blood in an organ)

28

Standard question format:

Ideally, Lovastatin affects blood lipids by:

I. increasing HDLs.

II. decreasing LDLs.

III. decreasing triglycerides.

The standard response format:(A) I only

(B) III only

(C) I and II only

(D) II and III only

(E) I, II, and III

Standard question format:


I. increasing HDLs.

II. decreasing LDLs.

III. decreasing triglycerides.


(B) III only

(C) I and II only

(D) II and III only

(E) I, II, and IIIPG 17

Combined-response questions or “K” questionsCombined-response questions or “K” questions

29

Series of T/F questions togetherSeries of T/F questions together

PG 17

Strategies for Answering K-type questionsStrategies for Answering K-type questions

Answer Choices

A B C D E

Statement I T T T

Statement II T T T

Statement III T T T

30


I. increasing HDLs. T / F

II. decreasing LDLs. T / F

III. decreasing triglycerides. T / F


(B) III only

(C) I and II only

(D) II and III only

(E) I, II, and III






(B) III only

(C) I and II only

(D) II and III only

(E) I, II, and III

PG 17


31






(B) III only

(C) I and II only

(D) II and III only

(E) I, II, and III






(B) III only

(C) I and II only

(D) II and III only

(E) I, II, and III

PG 17


32

NAPLEX® consists of many patient profiles.

Expect the patient to present several conditions.

Each profile will generate 10-12 questions.

Will be stand alone questions mixed in

Don’t analyze the entire patient profile unless absolutely necessary

Focus on “top 200”

Read over the NAPLEX Blueprint http://www.nabp.net/ftpfiles/NABP01/updatednaplexblueprint.pdf

NAPLEX® consists of many patient profiles.

Expect the patient to present several conditions.

Each profile will generate 10-12 questions.

Will be stand alone questions mixed in

Don’t analyze the entire patient profile unless absolutely necessary

Focus on “top 200”

Read over the NAPLEX Blueprint http://www.nabp.net/ftpfiles/NABP01/updatednaplexblueprint.pdfPG 25

REVIEW STRATEGIES FOR THE NAPLEX®

REVIEW STRATEGIES FOR THE NAPLEX®

34

A working knowledge of the interchange is important. Do not learn the companies.

A working knowledge of the interchange is important. Do not learn the companies.

PG 25

Review Drug Names:Generic Versus Trade or Brand Names

Review Drug Names:Generic Versus Trade or Brand Names

35

Example A prescription for zafirlukast will be filled by using:

(A) Accolate.

(B) Diovan.

(C) Effexor.

(D) Remeron.

(E) Singulair.


(A) Accolate.

(B) Diovan.

(C) Effexor.

(D) Remeron.

(E) Singulair.

PG 25

36


(A) Accolate. (Zifirlukast: Leukotriene receptor antagonist)

(B) Diovan. (Valsartan: Specific Angiotensin II antagonist)

(C) Effexor. (Venlafaxine HCl: Antidepressant)

(D) Remeron. (Mirtazapine: Major Depressive Disorder)

(E) Singulair. (Montelukast: Leukotriene receptor antagonist)


(A) Accolate. (Zifirlukast: Leukotriene receptor antagonist)

(B) Diovan. (Valsartan: Specific Angiotensin II antagonist)

(C) Effexor. (Venlafaxine HCl: Antidepressant)

(D) Remeron. (Mirtazapine: Major Depressive Disorder)

(E) Singulair. (Montelukast: Leukotriene receptor antagonist)

PG 25

37

Review characteristics of individual products.

All of the following products contain HCTZ plus another active ingredient EXCEPT:

(A) Dyazide.(B) Vaseretic.(C) Prinivil.(D) Zestoretic.(E) Ziac.



(A) Dyazide.(B) Vaseretic.(C) Prinivil.(D) Zestoretic.(E) Ziac.

PG 27

38



(A) Dyazide. (Triamterene + HCTZ)

(B) Vaseretic. (Enalapril + HCTZ)

(C) Prinivil. (Lisinopril)

(D) Zestoretic. (Lisinopril + HCTZ)

(E) Ziac. (Bisoprolol Fumarate + HCTZ)



(A) Dyazide. (Triamterene + HCTZ)

(B) Vaseretic. (Enalapril + HCTZ)

(C) Prinivil. (Lisinopril)

(D) Zestoretic. (Lisinopril + HCTZ)

(E) Ziac. (Bisoprolol Fumarate + HCTZ)

PG 27

39

Review Dosage forms Dosage forms available for haloperidol include:

I. oral tablets.

II. injection.

III. oral liquid. (A) I only

(B) III only

(C) I and II only

(D) II and III only

(E) I, II, and III


I. oral tablets.

II. injection.


(B) III only

(C) I and II only

(D) II and III only

(E) I, II, and III

PG 27

40


I. oral tablets.

II. injection.


(B) III only

(C) I and II only

(D) II and III only

(E) I, II, and III


I. oral tablets.

II. injection.


(B) III only

(C) I and II only

(D) II and III only

(E) I, II, and III

PG 27

41

PG 28

Review Pharmacologic classification and unique characteristics

Which drug product in Mr. Carlson’s profile is intended for the prevention or treatment of glaucoma?

(A) Atropine

(B) Latanoprost

(C) Ipratropium

(D) Gentamicin

(E) Triamcinolone


Which drug product in Mr. Carlson’s profile is intended for the prevention or treatment of glaucoma?

(A) Atropine

(B) Latanoprost

(C) Ipratropium

(D) Gentamicin

(E) Triamcinolone

42

PG 28


Which drug product in Mr Carlson’s profile is

intended for the prevention or treatment of glaucoma?(A) Atropine (cycloplegic refraction: Ciliary muscles)

(B) Latanoprost (Antiglaucoma), prostaglandin agonist

(C) Ipratropium (Bronchodilator, Anticholingergic)

(D) Gentamicin (Aminoglycoside Antibiotic) (E) Triamcinolone (Corticosteroid)


Which drug product in Mr Carlson’s profile is

intended for the prevention or treatment of glaucoma?(A) Atropine (cycloplegic refraction: Ciliary muscles)

(B) Latanoprost (Antiglaucoma), prostaglandin agonist

(C) Ipratropium (Bronchodilator, Anticholingergic)

(D) Gentamicin (Aminoglycoside Antibiotic) (E) Triamcinolone (Corticosteroid)

43

PG 29

Review dosing or dosing regimens

The daily dose usually prescribed for tamsulosin (Flomax) is:

(A) 0.4 mg.(B) 1 mg.(C) 2 mg.(D) 4 mg.(E) 10 mg.

44

PG 29

Review dosing or dosing regimens

The daily dose usually prescribed for tamsulosin (Flomax) is:

(A) 0.4 mg.(B) 1 mg.(C) 2 mg.(D) 4 mg.(E) 10 mg.

45PG 29

Review major clinical laboratory tests used to

diagnose disease or evaluate progress or patient outcomes.

46PG 29

ExampleWhich of the following lab tests should be ordered to aid in the confirmation of a MI?

(A) CPK, Troponin, AST

(B) ALT and alkaline phosphatase

(C) serum creatinine and bilirubin levels

(D) serum K and blood glucose levels

(E) serum Na, K, Cl, and bicarbonate levels

47PG 29

ExampleWhich of the following lab tests should be ordered to aid in the confirmation of a MI?

(A) CPK, Troponin, AST

(B) ALT and alkaline phosphatase

(C) serum creatinine and bilirubin levels

(D) serum K and blood glucose levels

(E) serum Na, K, Cl, and bicarbonate levels

48PG 30

Review the type of information found in the reference books usually used in pharmacies.

Drug information suitable for a patient handout is readily available in:

(A) Remington The Science and Practice of Pharmacy.(B) USP/NF.(C) USP DI Volume I.(D) USP DI Volume II.(E) USP DI Volume III.

49PG 30

Review the type of information found in the reference books usually used in pharmacies.

Drug information suitable for a patient handout is readily available in:

(A) Remington The Science and Practice of Pharmacy.(B) USP/NF.(C) USP DI Volume I.(D) USP DI Volume II.(E) USP DI Volume III.

50PG 31

Review all aspects of pharmaceutical calculations.

Most questions will involve quick calculations, units, conversions, simple dosing, etc., adjustments of strengths, milliequivalent calculations, determination of osmolarity.

Complicated questions concerning pH, drug ionization; pH and pKA of a drug may only constitute one or two questions.

51PG 31

Review the following concepts of enteral and

parenteral nutrition. How formulas are chosen or developed

Methods for administration

Nutritional calorie counts

Compounding and stability problems

52PG 32

Review basic techniques for the compounding of prescriptions

and medication orders including parenteral admixtures.

53PG 34

Review the principles of the pharmacokinetics of drugs and drug

therapy.A drug that follows nonlinear pharmacokinetics is likely to:

(A) follow first-order kinetics(B) follow zero-order kinetics(C) follow second-order kinetics (D) graph as a straight line on semilog paper(E) exhibit erratic absorption and excretion

54PG 34

Review the principles of the pharmacokinetics of drugs and drug

therapy.A drug that follows nonlinear pharmacokinetics is likely to:

(A) follow first-order kinetics(B) follow zero-order kinetics(C) follow second-order kinetics (D) graph as a straight line on semilog paper(E) exhibit erratic absorption and excretion

55PG 35

Review the dispensing protocols that pharmacists follow when performing a

prospective review of a new prescription with that patient’s drug profile or drug

history.Auxiliary labels

Appropriate use

Side effects

Allergies

Pregnant or likely to become pregnant

Auxiliary equipment

Does the patient understand

56PG 37

Review the general classes of the OTC drugs.

Active ingredient

Dosing and appropriate use

Therapeutic activity

Potential drug interactions with prescription drugs

57PG 39

Format of NAPLEX® Profile Questions

Institutional/nursing home profilePatient history(age,weight, primary diagnosis, secondary diagnosis, previous conditions, allergies

Current patient information (lab/diagnostic tests

Medication orders

Additional orders (dietary, social)

Physician orders

Community practice profileThis profile is less extensive than above profiles but contains prescription refills

60PG 39

General Comments for Answering Questions

Ignore the profile until you have read and attempted to answer the question presented.

Ignore standard orders (e.g., Colace)

Reason for new “real drugs”

New drug has the same or opposite effect of other drugs previously listed?

New drug prescribed to counteract the side effects of an older drug?

Contraindicated?

Allergies?

61PG 40

Example of a community medication profile

62PG 40

ExampleMs. Doolittle should be counseled concerning her compliance with which of the following drugs?

I. Calan

II. Glucophage

III. Calcium gluconate

(A) I only

(B) III only

(C) I and II only

(D) II and III only

(E) I, II, and III

63PG 40

ExampleMs. Doolittle should be counseled concerning her compliance with which of the following drugs?

I. Calan

II. Glucophage

III. Calcium gluconate

(A) I only

(B) III only

(C) I and II only

(D) II and III only

(E) I, II, and III

64

Example

The pharmacist should question the prescriber concerning the dose of which one of the drugs in Ms. Doolittle’s profile?

A. Caclium gluconateB. GlucophageC. CalanD. HydroDiurilE. Actos

65

Example

The pharmacist should question the prescriber concerning the dose of which one of the drugs in Ms. Doolittle’s profile?

A. Caclium gluconateB. GlucophageC. CalanD. HydroDiurilE. Actos

66PG 44

Example of institution/nursing home medication profile

67PG 45

ExampleA lab test that may clarify Mr. Newman’s diabetes state will measure:

(A) HCG.

(B) Hct.

(C) A1c.

(D) PSA.

(E) BSA.

68PG 45

ExampleA lab test that may clarify Mr. Newman’s diabetic state will measure:

(A) HCG.

(B) Hct.

(C) A1c.

(D) PSA.

(E) BSA.

69PG 46

Admitting orders

70PG 46

ExampleBased on the admission orders and present medications, the patient is suffering from:

I. a severe, acute infection.

II. cardiovascular disease.

III. edema.

(A) I only

(B) III only

(C) I and II only

(D) II and III only

(E) I, II, and III

71PG 46

ExampleBased on the admission orders and present medications, the patient is suffering from:

I. a severe, acute infection.

II. cardiovascular disease.

III. edema.

(A) I only

(B) III only

(C) I and II only

(D) II and III only

(E) I, II, and III

72

ExampleThe order “protime stat and daily” is a lab test used to monitor therapy with:

(A) aspirin

(B) Lasix

(C) Glucophage

(D) Lanoxin

(E) warfarin

73

ExampleThe order “protime stat and daily” is a lab test used to monitor therapy with:

(A) aspirin

(B) Lasix

(C) Glucophage

(D) Lanoxin

(E) warfarin

naplex review. welcome!!! who am i?? alan j. zillich, pharm.d. assistant professor of pharmacy...

Documents

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competency statements

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minimum competency purpose

public health

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