Summary: 2025 Naplex Course Book Study Guide For The Naplex For Those Testing In 2025 | 9798989876204 | Chelsea Bombatch

Read the summary and the most important questions on 2025 NAPLEX Course Book Study Guide for the NAPLEX for Those Testing in 2025 | 9798989876204 | Chelsea Bombatch

• 3 Drug interactions

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• How many weeks does it take for induction effects to disappear completely, once it's stopped?

  2-4 weeks

• 3.1 Common CV drug interactions

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• Which statins are not metabolized by cyp450 enzymes, so they can be used with cyp3a4 inhibitors?

  Lowest risk of DI's: pravastatin, pitavastatin, rosuvastatin

• Warfarin + CYP2c9 INhibitors

  Increase warfarin levels (increases INR and bleed risk)

• Warfarin + CYP2c9 inDucers

  Decrease warfarin levels (decreases INR and increases clotting risk)

• 3.2 INhibitors INcrease substrates

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• CYP3a4 INhibitors + CYP3a4 substrates

  (opioids, fentanyl, hydrocodone, oxycodone, methadone) 
  Decreased substrate causes increased drug levels and ADRs/toxicity.
  DO NOT USE inhibitor with opioid metabolized by cyp3a4 (respiratory depression, fatal)

• What should NOT be taken with grapefruit juice?

  CYP3A4 substrates, amiodarone, simvastatin, lovastatin, nifedipine, tacrolimus

• Monoamine oxidase inhibitors + drugs that increase serotonin (5-HT)

  (SSRIs, SNRIs, TCAs, mirtazapine, trazodone, fentanyl, methadone, tramadol, buspirone, dextromethorphan) 
  High 5-HT: can cause serotonin syndrome  

• CYP3A4 & p-gp INhibitors + Calcineurin inhibitors

  Decreases substrate metabolism- avoid together 

• 3.3 inDucers Decrease substrates

• Current smoker (cyp1a2 inducer) + some antipsychotics, antidepressants, hypnotics, anxiolytics, caffeine, theophylline, warfarin (R)

  Cyp1a2 substrates have decreased levels 

• Smokers that quit + some antipsychotics, antidepressants, hypnotics, anxiolytics, caffeine, theophylline, warfarin (R)

  When the inducer (cigarettes) is stopped, cyp1a2 substrate concentrations increase