Minimalist Clinical Overview for the NAPLEX

Photo by Oliver Hae on Unsplash

Specific Azoles: Itraconazole (Sporonox ®)

Triazole is the main difference

Metabolized more slowly — far less effects on mammalian sterol synthesis

Less side effect potential is the bottom line

Highly insoluble

  • Manufactured 40:1 with hydroxyl-propyl-b-cyclodextrin (in the capsule)

Itraconazole (Sporonox ®) Indications

Oral caps are drug of choice for, Indolent, non-meningeal infections due to:

ANY Tinea

ANY Candida

oropharyngeal and esophageal, swish and swallow

ANY TDF

Histoplasmosis — Maintenance therapy of HIV patients

Decreased relapse of these infections in AIDS

Mold — Aspergillus (Non-Aids or non-immunocompromised)

Decreased stomach acid, insolubility of drug needs acidity to solubilize the drug

Drug won’t work sufficiently — cannot…


Minimalist Clinical Overview for the NAPLEX

Photo by The Creative Exchange on Unsplash

Specific Azoles: Itraconazole (Sporonox ®)

Triazole is the main difference

Metabolized more slowly – far less effects on mammalian sterol synthesis

Less side effect potential is the bottom line

Highly insoluble

Manufactured 40:1 with hydroxyl-propyl-b-cyclodextrin (in the capsule)

Itraconazole (Sporonox ®) Indications

Oral caps are drug of choice for, Indolent, non-meningeal infections due to:

ANY Tinea

ANY Candida

oropharyngeal and esophageal, swish and swallow

ANY TDF

Histoplasmosis - Maintenance therapy of HIV patients

Decreased relapse of these infections in AIDS

Mold – Aspergillus (Non-Aids or non-immunocompromised)

Decreased stomach acid, insolubility…


A Minimalist Review of Most Common Statin Side Effect (NAPLEX Review)

Photo by Scott Webb on Unsplash

Information Requested:

Which of the statins are associated with a lower percentage of myopathy?

Background information relevant to question:

A patient experienced some muscle pain while taking a statin.

Response:

All statins have similar mechanism of actions in which they all contribute towards the prevention of converting HMG-CoA to mevalonate. This is the primary step needed for the liver to make cholesterol. As a result of this inhibition, LDL receptors are upregulated in the liver forcing circulating LDL to be up-taken into the liver and to ultimately decrease the LDL concentrations. In addition to reducing LDL, statins also play a minor role in improving HDL and reducing triglycerides.


Minimalist Oncology Based Question for the NAPLEX

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Information Requested:

What is the clinical utility of Tagrisso® (osimertinib) in EGFR+ lung cancer?

Background information relevant to question:

Patients with EGFR+ lung cancer are treated with Tarceva® (erlotinib) to prevent further growth and development of tumors. There are instances in which mutations in EGFR results in inability of Tarceva® to be effective. What makes Tagrisso® an alternative for EGFR+ lung cancer?

Response:

About 66% of patients being treated for EGFR+ lung cancer ultimately develop resistance to standard therapy such as Tarceva®. In clinical trials, Tagrisso® was able to reduce tumor size in 59% of 411 patients who already received first line treatment for EGFR+ lung cancer. Although…


Minimalist Review Q/A Perfect for NAPLEX Review

Photo by Sebastien Gabriel on Unsplash

How are fever and neutropenia defined?

a. Fever: defined as a single oral temperature of greater than or equal to 101 F or a temperature of greater than or equal to 101.4 F for greater than or equal to 1 hour

b. Neutropenia: defined as a neutrophil count of less than 500 cells/mm3 or a count of <1000 cells/mm3 with a predicted decrease to <500 cells/mm3

Define patients at high risk. What do we need to know?

a. Patients with anticipated prolonged (>7 days’ duration) and profound neutropenia (ANC </= 100 cells/mm3 following cytotoxic chemotherapy) and/or significant medical co-morbid conditions including: hypotension, pneumonia, new-onset abdominal pain, or neurologic changes

b. We must have a complete knowledge of…


Minimalist Question, Potential NAPLEX Concept

Photo by Daniel von Appen on Unsplash

Information Requested:

Can terazosin be used to treat urinary retention in an 81-year-old female?

Background information relevant to question:

81-year-old female prescribed with terazosin for urinary retention. Will this drug work?

Response:

A few studies implicate that the use of terazosin in females may have an effect to relieve symptoms of urinary fullness, pressure, and discomfort. In a small study of 15 women, the use of terazosin in women with functional bladder obstruction showed that 10 out of the 15 women experienced increased in max urinary flow rate and improved symptoms overall. Increased in quality of life was implied. …

Minimalist / Pharmacist (Admin)

Primary Blogger for The Minimalist / Pharmacist

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