NAPLEX Flashcards: Drug Drug Drug Food Drug Disease

What this deck covers

This deck focuses on Drug Drug Drug Food Drug Disease, giving you a quick way to review the definitions, rules, and examples that matter most for NAPLEX.

How to use these flashcards

Work through these flashcards in short sessions. Try to answer each prompt before flipping the card, then revisit any cards you miss until the explanation feels automatic.

Flashcard 1: What is the interaction between clopidogrel and omeprazole?

Answer: CYP2C19 inhibition reduces clopidogrel activation. Omeprazole inhibits CYP2C19, impairing conversion of clopidogrel to its active metabolite and reducing antiplatelet efficacy.

Flashcard 2: What is the interaction between rifampin and many CYP substrates (e.g., apixaban)?

Answer: Strong induction lowers drug levels; reduced efficacy. Rifampin potently induces multiple CYP enzymes, decreasing substrate concentrations and compromising therapeutic outcomes.

Flashcard 3: Identify the disease state in which NSAIDs commonly worsen renal function and fluid status.

Answer: Chronic kidney disease. NSAIDs inhibit prostaglandins that maintain renal perfusion, leading to acute kidney injury and fluid retention in CKD patients.

Flashcard 4: What is the key drug–food interaction for MAO inhibitors with tyramine-rich foods?

Answer: Hypertensive crisis risk. Tyramine displaces norepinephrine in the presence of MAO inhibition, causing acute hypertension and potential cardiovascular emergencies.

Flashcard 5: Which anticonvulsant decreases oral contraceptive effectiveness via enzyme induction?

Answer: Carbamazepine. Carbamazepine induces CYP3A4, accelerating estrogen metabolism and diminishing contraceptive reliability.

Flashcard 6: What is the primary interaction mechanism between warfarin and amiodarone?

Answer: CYP2C9 inhibition increases warfarin effect; INR rises. Amiodarone inhibits CYP2C9, reducing warfarin metabolism and potentiating its anticoagulant effects, which elevates INR levels.

Flashcard 7: Identify the dangerous interaction between nitrates and PDE-5 inhibitors (e.g., sildenafil).

Answer: Severe hypotension from additive vasodilation. Nitrates and PDE-5 inhibitors both promote vasodilation, leading to profound hypotension when combined.

Flashcard 8: Which disease state is a contraindication to isotretinoin due to teratogenicity concerns?

Answer: Pregnancy. Isotretinoin is a potent teratogen, causing severe fetal malformations, thus contraindicated during pregnancy.

Flashcard 9: Which cardiac condition is a contraindication to nondihydropyridine CCBs (verapamil/diltiazem)?

Answer: Heart failure with reduced ejection fraction (HFrEF). Nondihydropyridine CCBs depress myocardial contractility, worsening systolic dysfunction in HFrEF patients.

Flashcard 10: Which antibiotic class is contraindicated with tizanidine due to CYP1A2 inhibition?

Answer: Fluoroquinolones (especially ciprofloxacin). Fluoroquinolones inhibit CYP1A2, increasing tizanidine levels and risking severe hypotension or bradycardia.

Flashcard 11: What is the interaction between ACE inhibitors and potassium-sparing diuretics?

Answer: Hyperkalemia risk increases. Both classes promote potassium retention, leading to potentially life-threatening hyperkalemia.

Flashcard 12: Which disease state makes nonselective beta-blockers risky due to bronchospasm?

Answer: Asthma. Nonselective beta-blockers antagonize beta-2 receptors in airways, exacerbating bronchoconstriction in asthmatic patients.

Flashcard 13: Which opioid partial agonist can precipitate withdrawal if given with full opioid agonists?

Answer: Buprenorphine. Buprenorphine's high mu-receptor affinity displaces full agonists, inducing acute withdrawal symptoms in dependent individuals.

Flashcard 14: What is the interaction between lithium and thiazide diuretics?

Answer: Lithium levels increase; toxicity risk increases. Thiazides reduce lithium renal clearance, elevating serum levels and increasing toxicity risks like neurotoxicity.

Flashcard 15: What is the drug–food interaction between metronidazole and alcohol?

Answer: Disulfiram-like reaction risk. Metronidazole inhibits aldehyde dehydrogenase, causing acetaldehyde buildup and symptoms like flushing and nausea upon alcohol ingestion.

Flashcard 16: Which antiarrhythmic is contraindicated with dofetilide due to QT prolongation risk?

Answer: Verapamil. Verapamil increases dofetilide exposure via P-glycoprotein inhibition, amplifying QT prolongation and torsades de pointes risk.

Flashcard 17: What is the drug–food interaction between tetracyclines and dairy products?

Answer: Chelation reduces absorption. Calcium in dairy forms insoluble complexes with tetracyclines, decreasing antibiotic bioavailability and therapeutic effectiveness.

Flashcard 18: Identify the interaction between trimethoprim-sulfamethoxazole and warfarin.

Answer: INR increases; bleeding risk increases. Trimethoprim-sulfamethoxazole inhibits CYP2C9 and vitamin K-producing bacteria, potentiating warfarin's anticoagulant effects.

Flashcard 19: What is the interaction between linezolid and SSRIs/SNRIs?

Answer: Serotonin syndrome risk (MAOI activity). Linezolid's MAOI properties combined with serotonergic agents can cause excessive serotonin accumulation, leading to syndrome manifestations.

Flashcard 20: What is the key drug–drug interaction between simvastatin and clarithromycin?

Answer: CYP3A4 inhibition increases statin; rhabdomyolysis risk. Clarithromycin inhibits CYP3A4, elevating simvastatin levels and heightening the risk of muscle breakdown and kidney damage.

Flashcard 21: Which beverage increases simvastatin/atorvastatin levels by inhibiting intestinal CYP3A4?

Answer: Grapefruit juice. Grapefruit juice inhibits intestinal CYP3A4, reducing first-pass metabolism and elevating statin concentrations with myopathy risk.

Flashcard 22: What is the key drug–food interaction between warfarin and vitamin K–rich foods?

Answer: High vitamin K intake decreases warfarin effect (lower INR). Vitamin K antagonizes warfarin's inhibition of clotting factor synthesis, reducing anticoagulant efficacy and INR values.

Flashcard 23: Identify the drug–food interaction for levothyroxine with calcium or iron products.

Answer: Reduced absorption; separate administration. Calcium and iron bind levothyroxine, impairing gastrointestinal absorption and necessitating timed separation for optimal efficacy.

Flashcard 24: What disease state makes metformin inappropriate due to increased lactic acidosis risk?

Answer: Severe renal impairment. Severe renal impairment reduces metformin clearance, increasing lactate accumulation and lactic acidosis risk.

Flashcard 25: What is the recommended warfarin action when starting amiodarone?

Answer: Reduce warfarin dose and monitor INR closely. Amiodarone's inhibition of warfarin metabolism necessitates dose reduction and frequent INR monitoring to prevent bleeding complications.