NAPLEX Review
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
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?
3
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!
About the
NAPLEX
1
®
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
Ref. NAPLEX/MPJE® Registration Bulletin
Purpose of the examination
PG 3

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
Ref. NAPLEX/MPJE® Registration Bulletin
8
Competency 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 ).
9
“New” Emphasis Topics



Herbals
OTC questions
Communication skills questions
10
Registering for the NAPLEX
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
PG 4
Ref. NAPLEX/MPJE® Registration Bulletin
11
Registering for the NAPLEX
Step

3
After receiving your Authorization to Test (ATT), contact
Pearson VUE
• 1-888/709-2679
• www.pearsonvue.com/nabp

Testing date
• Testing location
PG 4
Ref. NAPLEX/MPJE® Registration Bulletin
12
Pearson 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.
13
Cancellation

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.
Ref. NAPLEX/MPJE® Registration Bulletin
14
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
Ref. NAPLEX/MPJE® Registration Bulletin
15
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
Ref. NAPLEX/MPJE® Registration Bulletin
16
Examination Format:
•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
PG 4
Ref. NAPLEX/MPJE® Registration Bulletin
17
Grading of the examination
• Answer less than 162 and test is not scored
• Answer less than 185 a penalty will be applied
PG 4

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.
Ref. NAPLEX/MPJE® Registration Bulletin
18
SUCCESSFULLY TAKING THE COMPUTERADAPTIVE 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.

PG 14
Remember…. minimum competency.
19
Study 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)
20
p. 8-15
NAPLEX 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
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!
Study 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)
24
p. 8-15
Strategies for Answering
Multiple-Choice Questions

Eliminate the answers you know are
incorrect

Guessing between 5 answers is 20%

Guessing between 2 answers is 50%.
25
PG 16
Example
A common side effect of Motrin® is:
A. Gastritis
B. Myositis
C. Myalgia
D. Gastrocele
E. Hematoma
26
Example
A 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)
27
Combined-response questions or “K” questions

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
PG 17
28
Strategies for Answering K-type questions
Series
of T/F questions together
Answer Choices
A
Statement I
B
T
D
T
Statement II
Statement III
C
T
T
E
T
T
T
T
T
29
PG 17
Combined-response questions or “K” questions
Ideally, Lovastatin affects blood lipids by:
I. increasing HDLs.
T / F
II. decreasing LDLs.
T / F
III. decreasing triglycerides.

T / F
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
PG 17
30
Combined-response questions or “K” questions
Ideally, Lovastatin affects blood lipids by:
I. increasing HDLs.
T / F
II. decreasing LDLs.
T / F
III. decreasing triglycerides.

T / F
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
PG 17
31
REVIEW STRATEGIES
FOR THE NAPLEX®
 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
PG 25
32
 http://www.nabp.net/ftpfiles/NABP01/updatednaplexblueprint.pdf
33
Review Drug Names:
Generic Versus Trade or Brand Names

A working knowledge of the interchange is
important. Do not learn the companies.
34
PG 25
Example
A prescription for zafirlukast will be filled by using:
(A) Accolate.
(B) Diovan.
(C) Effexor.
(D) Remeron.
(E) Singulair.
35
PG 25
Example
A prescription for zafirlukast will be filled by using:
(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)
36
PG 25
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.
37
PG 27
Review characteristics of
individual products.
All of the following products contain HCTZ plus
another active ingredient EXCEPT:
(A) Dyazide. (Triamterene + HCTZ)
(B) Vaseretic. (Enalapril + HCTZ)
(C) Prinivil. (Lisinopril)
(D) Zestoretic. (Lisinopril + HCTZ)
(E) Ziac. (Bisoprolol Fumarate + HCTZ)
38
PG 27
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
39
PG 27
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
40
PG 27
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
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 (cycloplegic refraction: Ciliary muscles)
(B) Latanoprost (Antiglaucoma), prostaglandin agonist
(C) Ipratropium (Bronchodilator, Anticholingergic)
(D) Gentamicin (Aminoglycoside Antibiotic)
(E) Triamcinolone (Corticosteroid)
42
PG 28
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.
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 major clinical
laboratory tests used to
diagnose disease or evaluate
progress or patient outcomes.
PG 29
45
Example
Which 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
PG 29
46
Example
Which 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
PG 29
47
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.
PG 30
48
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.
PG 30
49
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.
PG 31
50
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
PG 31
51
Review basic techniques for the
compounding of prescriptions and
medication orders including
parenteral admixtures.
PG 32
52
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
PG 34
53
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
PG 34
54
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
PG 35
55
Review the general classes of the
OTC drugs.
Active ingredient
Dosing and appropriate use
Therapeutic activity
Potential drug interactions with prescription
drugs
PG 37
56
Format of NAPLEX® Profile
Questions
Institutional/nursing home profile
Patient 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 profile
This profile is less extensive than above profiles but
contains prescription refills
PG 39
57
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?
PG 39
60
Example of a community
medication profile
PG 40
61
Example
Ms. 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
PG 40
62
Example
Ms. 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
PG 40
63
Example
The pharmacist should question the prescriber concerning the
dose of which one of the drugs in Ms. Doolittle’s profile?
A. Caclium gluconate
B. Glucophage
C. Calan
D. HydroDiuril
E. Actos
64
Example
The pharmacist should question the prescriber concerning the
dose of which one of the drugs in Ms. Doolittle’s profile?
A. Caclium gluconate
B. Glucophage
C. Calan
D. HydroDiuril
E. Actos
65
Example of institution/nursing
home medication profile
PG 44
66
Example
A lab test that may clarify Mr. Newman’s diabetes
state will measure:
(A) HCG.
(B) Hct.
(C) A1c.
(D) PSA.
(E) BSA.
PG 45
67
Example
A lab test that may clarify Mr. Newman’s diabetic
state will measure:
(A) HCG.
(B) Hct.
(C) A1c.
(D) PSA.
(E) BSA.
PG 45
68
Admitting orders
PG 46
69
Example
Based 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
PG 46
70
Example
Based 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
PG 46
71
Example
The order “protime stat and daily” is a lab test used
to monitor therapy with:
(A) aspirin
(B) Lasix
(C) Glucophage
(D) Lanoxin
(E) warfarin
72
Example
The 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