NAPLEX — Pulmonary, Oncology and Immunology flashcards
10 of 80 cards free to study here · 3 topics · the whole deck is built into Willys
Asthma, COPD and pulmonary hypertension therapy, inhaler technique, chemotherapy toxicities and protectants, antiemetics and supportive care, targeted and immune therapies, transplant drugs, biologic infection screening, gout, anaphylaxis and vaccines — with no doses.
Learn deck · part of PTCB PTCE / NAPLEX · written against: Top-drug lists and federal pharmacy law as of 2026; PTCE content outline effective 6 January 2026. Updated 2026-10-10.
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Why do current GINA recommendations advise against SABA-only treatment for adults and adolescents with asthma?SABA-only treatment leaves airway inflammation untreated, and heavy SABA use is linked to more severe exacerbations and asthma deaths. Every adult and adolescent with asthma should receive ICS-containing therapy, and GINA's preferred reliever is as-needed ICS–formoterol.Pulmonary › Asthma
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In maintenance-and-reliever therapy (MART), why must the combination inhaler contain formoterol rather than salmeterol?MART uses one ICS–LABA inhaler for both daily control and symptom relief, which only works if the LABA acts quickly. Formoterol has a rapid onset, whereas salmeterol's onset is slow, so salmeterol combinations cannot serve as a reliever.Pulmonary › Asthma
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Why is a long-acting beta-2 agonist never used without an inhaled corticosteroid in asthma?LABA monotherapy raises the risk of severe exacerbations and asthma-related death, because it relieves symptoms while inflammation progresses unchecked. In asthma a LABA is always given with an ICS, preferably in a single combination inhaler so the two cannot be separated.Pulmonary › Asthma
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What boxed warning does montelukast carry, and how does it affect its use for allergic rhinitis?Serious neuropsychiatric events, including agitation, sleep disturbance, depression and suicidal thoughts or actions. For allergic rhinitis it is reserved for patients who respond poorly to or cannot tolerate other treatments, and families are told to report mood or behavior changes.Pulmonary › Asthma
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Which agent protects against anthracycline cardiotoxicity, and what other anthracycline problem does it treat?Dexrazoxane, an iron chelator that limits anthracycline-related free-radical injury to the heart. It is also the antidote for anthracycline extravasation.Oncology › Chemotherapy Toxicities
Watch out: anthracycline cardiomyopathy rises with lifetime cumulative exposure, so ejection fraction is measured before and during therapy. -
Besides hemorrhagic cystitis, which neurotoxicity is characteristic of ifosfamide, and what is sometimes used to treat it?Encephalopathy (confusion, somnolence, hallucinations, sometimes coma) caused by a toxic metabolite. Ifosfamide is stopped and methylene blue is sometimes given; mesna protects the bladder but not the brain.Oncology › Chemotherapy Toxicities
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Which measures protect the kidneys during cisplatin therapy?Vigorous IV hydration around each dose, magnesium replacement because cisplatin wastes magnesium, and avoiding other nephrotoxins such as aminoglycosides and NSAIDs. Amifostine is a cytoprotectant that can reduce cumulative kidney toxicity.Oncology › Chemotherapy Toxicities
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Which adverse effects do tacrolimus and cyclosporine share as calcineurin inhibitors?Nephrotoxicity, hypertension, hyperkalemia and hypomagnesemia, neurotoxicity such as tremor, and post-transplant diabetes. Both are monitored by trough levels because exposure varies widely between patients.Immunology › Transplant Immunosuppressants
Watch out: azoles, macrolides, non-dihydropyridine calcium channel blockers and grapefruit raise their levels through CYP3A4 and P-gp inhibition. -
How do tacrolimus and cyclosporine differ in their cosmetic and metabolic adverse effects?Cyclosporine causes gingival hyperplasia and hirsutism and more hypertension and hyperlipidemia. Tacrolimus causes more new-onset diabetes, tremor and hair loss.Immunology › Transplant Immunosuppressants
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A kidney transplant patient on tacrolimus starts taking St John's wort. What is the risk?St John's wort induces CYP3A4 and P-glycoprotein, lowering tacrolimus levels and risking acute rejection. Rifampin, carbamazepine and phenytoin do the same, so levels are checked whenever an interacting drug is started or stopped.Immunology › Transplant Immunosuppressants
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Review status: Second-reader reviewed, with corrections applied.
Checked against:
- NABP NAPLEX competency statements (topic outline only; no text copied)
- Checked against FDA prescribing information and standard pharmacotherapy references (reference only; no text copied)
- Checked against the GINA 2025 report and its 2026 update, the GOLD 2026 report, the 2020 ACR gout guideline, the FDA's 2025 notices on endothelin receptor antagonist REMS, the FDA's 2025–2026 capecitabine and fluorouracil labeling on DPD deficiency, ACR guidance on TB screening before biologics, and AAAAI/ACAAI anaphylaxis practice parameters (reference only; no text copied)
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