NAPLEX Study Guide

Study and pass the 2026 - 2027 NAPLEX exam and become a professional, qualified pharmacist in the United States.
Future pharmacists train with us.

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#NAPLEX #pharmacy #medicine #statins

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💊What is suzetrigine?

Suzetrigine is a non-opioid analgesic that selectively blocks NaV1.8 voltage-gated sodium channels in peripheral pain-sensing neurons, reducing the transmission of pain signals to the brain.

It is used for moderate-to-severe acute pain and does not activate opioid receptors, so it avoids typical opioid effects such as respiratory depression and dependence.

Brand name - Journavx

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💊Angioedema - Leading Drug-induced Causes

☑️ACE inhibitors — especially lisinopril, enalapril, ramipril and benazepril. These are the most important and best-recognized cause; swelling may occur even after months or years of treatment.

☑️NSAIDs and aspirin — including ibuprofen, naproxen and diclofenac, particularly in people with chronic urticaria or NSAID sensitivity.

☑️Antibiotics — particularly penicillins and cephalosporins, usually through an immediate allergic reaction that may also produce hives or anaphylaxis.

☑️Angiotensin receptor blockers (ARBs) — such as losartan and valsartan; the risk is much lower than with ACE inhibitors.

☑️Sacubitril/valsartan — neprilysin inhibition can increase bradykinin-mediated angioedema risk, particularly when used too close to an ACE inhibitor.

☑️DPP-4 inhibitors — such as sitagliptin and linagliptin; risk appears greater when combined with an ACE inhibitor.

☑️Thrombolytic drugs — particularly alteplase, which can cause orolingual angioedema during treatment for ischemic stroke.

☑️Other less common triggers — contrast media, and mTOR inhibitors such as sirolimus or everolimus.

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💊Drug Interaction - NSAIDs + Lithium

NSAIDs can reduce lithium clearance through the kidneys, causing lithium levels to rise and increasing the risk of toxicity (aspirin and sulindac, less so).

High lithium levels can cause severe shaking, confusion, extreme dizziness, slurred speech, vomiting, and severe muscle weakness.

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💊AFICAMTEN - Key Points

🔸Generic & Brand name: aficamten (Myqorzo)

🔸Class: cardiac myosin inhibitor

🔸Indication: symptomatic obstructive hypertrophic cardiomyopathy (oHCM) in adults

🔸Mechanism: reduces cardiac myosin activity, decreasing excessive myocardial contractility and left ventricular outflow tract obstruction

🔸Administration: oral, once daily

🔸Boxed warning: may cause heart failure by reducing left ventricular ejection fraction (LVEF); requires echocardiographic monitoring

🔸Contraindication: rifampin, due to marked reduction in aficamten exposure and loss of efficacy

🔸Major interactions: avoid strong CYP3A and CYP2C19 inducers or inhibitors, which can significantly alter aficamten concentrations

🔸Monitoring: LVEF, LVOT gradient, heart failure symptoms, and echocardiograms before and during therapy

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💊Tirzepatide - Dual Receptor Mechanism

Tirzepatide is the first dual GIP/GLP-1 receptor agonist approved for the treatment of type 2 diabetes. Unlike earlier GLP-1 receptor agonists, tirzepatide activates both:

☑️glucose-dependent insulinotropic polypeptide (GIP) ☑️glucagon-like peptide-1 (GLP-1) receptors

This leads to greater reductions in HbA1c and body weight than many existing therapies.

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💊Complete Guide to Mefloquine

🔶Drug class: Antimalarial

🔶Indications:

☑️Malaria prophylaxis: used to prevent malaria in travelers visiting areas where malaria is common, including regions with chloroquine-resistant Plasmodium falciparum.

☑️Treatment of uncomplicated malaria: Used to treat malaria caused by susceptible strains of Plasmodium falciparum and some other Plasmodium species, typically when resistance patterns support its use.

🔶Mechanism of Action:

Mefloquine accumulates in infected erythrocytes and interferes with the malaria parasite's ability to detoxify heme, leading to parasite death.

🔷Standard Adult Dosing

Malaria Prevention:

☑️250 mg orally once weekly (250 mg mefloquine hydrochloride tablet, equivalent to 228 mg base).

☑️Begin at least 2 weeks before entering a malaria-endemic area (3–4 weeks before travel is preferred if possible to assess tolerability).

☑️Continue once weekly during travel.

☑️Continue for 4 weeks after leaving the malaria-endemic area.

Malaria Treatment:

☑️Total dose: 20–25 mg/kg mefloquine base given orally.

☑️In adults, this is commonly given as a single dose of 1,250 mg mefloquine hydrochloride (5 × 250 mg tablets), though the dose may be divided into 2–3 smaller doses given 6–8 hours apart to improve tolerability.

🔶Common Adverse Effects

Nausea
Vomiting
Diarrhea
Dizziness
Headache
Vivid dreams
Insomnia

Serious Warnings: may cause neuropsychiatric adverse effects, including anxiety, depression, panic attacks, hallucinations, psychosis, and suicidal thoughts, which can persist after discontinuation in some patients.

May also cause balance disorders, dizziness, and vestibular symptoms.

🔶Contraindications

Avoid mefloquine for malaria prophylaxis in patients with:

☑️A history of major psychiatric disorders (e.g., depression, generalized anxiety disorder, psychosis, schizophrenia)
☑️A history of seizures or epilepsy
☑️Known hypersensitivity to mefloquine or related quinoline antimalarials

🔶Key Clinical Factors

🔸Take with food and at least 240 mL of water to minimize gastrointestinal upset.

🔸Because of the potential for serious neuropsychiatric effects, many travel medicine guidelines now favor alternatives such as atovaquone/proguanil or doxycycline for many travelers, depending on destination, resistance patterns, and patient-specific factors.

🔸Mefloquine remains an appropriate option for selected patients when used according to current recommendations.

[Pharmacy Times @Pharmacy_Times]

Happy Fourth of July!

Here's to 250 years of independence and a weekend filled with celebration, sunshine, and time with loved ones.

Wishing everyone a safe and happy holiday!

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#NAPLEX #pharmacy #medicine #statins

[Pharmacy Times @Pharmacy_Times]

🚨 An FDA advisory panel has unanimously backed Moderna’s investigational mRNA flu vaccine.
If approved, it could mark a major expansion of mRNA technology beyond COVID-19 and help shape the future of influenza prevention.
🔗 https://t.co/sYbV09vFt1
#mRNA #Influenza #Vaccines #FDA #PublicHealth #PharmacyTimes #MedicalResearch

[NEJM Clinician @NEJMClinician]

A new meta-analysis concludes that Nissen fundoplication provides durable GERD relief, although gas bloating and dysphagia are common, and one quarter of patients resume PPIs. Read the key results: https://t.co/GRNt3uNIfb

#Gastroenterology

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💊How does methotrexate cause lung toxicity?

Methotrexate can cause pulmonary fibrosis by first injuring the lung tissue and triggering an inflammatory immune response:

🔸This damage leads to the release of profibrotic cytokines, particularly transforming growth factor-beta (TGF-β), which activates fibroblasts and promotes their transformation into myofibroblasts—the cells responsible for producing scar tissue.

🔸These myofibroblasts deposit excessive amounts of collagen and other extracellular matrix proteins in the lung interstitium.

🔸As scar tissue accumulates, the normal architecture of the lungs is replaced by fibrotic tissue, causing the lungs to become stiff and reducing their ability to exchange oxygen effectively.

Although methotrexate-induced pulmonary fibrosis is uncommon, it can occur following methotrexate-related lung inflammation and abnormal wound-healing responses.

[Pharmacy Times @Pharmacy_Times]

As endometrial cancer cases continue to rise, so does the need for earlier recognition, equitable care, and informed treatment decision-making.

Megan May, PharmD, BCOP, FHOPA, FAPO, Jennifer MacDonald, PharmD, BCOP, Erin Zacholski, PharmD, BCOP, and Justina Salib, PharmD, BCOP, discuss the growing clinical and economic burden of endometrial cancer, including the increasing prevalence of aggressive histologic subtypes, and the importance of screening and clinical trial enrollment to improve patient outcomes.

This conversation sets the stage for the evolving treatment landscape and the role pharmacists continue to play in supporting timely, evidence-based care.

Watch the clip below, then follow along with the full Peer Exchange series for more expert insights into the future of endometrial cancer management: https://t.co/wZhAvVwWUr

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💊Baxdrostat - what is it?

Baxdrostat is a drug that has just been recently FDA approved.

Key details:

☑️Indicated for the treatment of hypertension in combination with other drugs.

☑️It is a first-in-class drug that works as an aldosterone synthase inhibitor.

☑️Unlike other drugs that target the mineralocorticoid receptor itself, baxdrostat is different in that it targets aldosterone synthesis directly.

☑️Brand name: Baxfendy

[Pharmacy Times @Pharmacy_Times]

🚨 BREAKING: Retatrutide shows “bariatric-level” weight loss in Phase 3 TRIUMPH-1 trial.
New data suggest one of the strongest weight-loss effects seen yet from a GLP-1–based therapy class.
🔗 https://t.co/vKiVb9WAKM
#GLP1 #Obesity #ClinicalTrials #PharmacyTimes #WeightLoss #Healthcare

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💊Dietary Protein and Levodopa

Levodopa can interact with dietary protein.

They are linked because levodopa uses the same transport systems as certain amino acids (the building blocks of protein) in both the intestine and the blood–brain barrier. When a patient eats a high-protein meal, those amino acids compete with levodopa for absorption and brain entry, which can reduce or delay the medication’s effectiveness.

This interaction is especially important in patients with Parkinson's disease, where symptoms such as tremor or stiffness may worsen after protein-heavy meals. For that reason, some patients are advised to take levodopa 30–60 minutes before meals or to shift most protein intake to the evening (“protein redistribution diet”).

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💊What is Difamilast?

Difamilast was FDA approved in February 2026 for the treatment of atopic dermatitis:

✔️difamilast works as a PDE4 inhibitor

✔️it is recommended for mild-to-moderate atopic dermatitis

✔️administered topically

✔️it is sold under the brand name, Adquey

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💊Black Box Warning - Dronedarone

Dronedarone (Multaq) carries a black box warning for an increased risk of death, stroke, and heart failure in patients with permanent atrial fibrillation (AF) or decompensated heart failure.

It is strictly contraindicated in patients with NYHA Class IV heart failure, or Class II–III heart failure with recent hospitalization, as it can double the risk of death.

[Drugs.com @Drugscom]

FDA Approves Langlara (insulin glargine-aldy), an Interchangeable Biosimilar to Lantus https://t.co/lkvM0zssRF

[Medscape @Medscape]

Gabapentinoids like gabapentin and pregabalin are associated with an increased risk for poisoning, with the highest risk occurring around treatment initiation and when combined with benzodiazepines or opioids.

In a large UK study of nearly 17,000 primary care patients, those who had co-initiation of gabapentinoids and benzodiazepines showed double the risk for hospitalization due to drug poisoning within the first month, whereas those with concomitant opioid use showed a 30% increased risk compared with those who took neither medication. https://t.co/djHDrx5vjQ

[Drugs.com @Drugscom]

Dupixent Patient Tips: 7 Things you Should Know https://t.co/bjBhoLeLd6