Discuss NABP NAPLEX Exam Topic 1 Question 27

LT is a 42-year-old white female with past medical history of epilepsy, gastroesophageal reflux disease and seasonal allergies. She weighs 86 kg, height 5'6'' and allergic to Aspirin (rash) and Phenobarbital (difficulty breathing).

Her medications include Omeprazole 40mg daily, Phenytoin 200mg twice daily, Valproic acid 500mg four times daily, Loratadine 10mg daily. She comes to your community pharmacy to pick up prescription for Primidone 250mg twice daily.

Pertaining to Primidone what is the most appropriate action to take?

ANotify the physician, Primidone dose is too low.

BNotify the physician, Primidone in contraindicated in patient with phenobarbital allergy.

CNotify the physician, Primidone in contraindicated in patient with Aspirin allergy.

DNotify the physician, patient is already on three anti-seizure medication and primidone is not needed.

ENotify the physician, Primidone in contraindicated in patient with gastroesophageal reflux disease.

Suggested Answer: B

Primidone is an anticonvulsant drug that is structurally related to phenobarbital. Primidone is metabolized to

phenobarbital and therefore shares its anticonvulsant and sedative properties. Primidone may be more effective than therapy with phenobarbital alone because primidone and both of its metabolites, phenobarbital and phenylethylmalonamide (PEMA), possess anticonvulsant activity.

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11 comments · newest first

Eun 11 months ago

I thought Primidone was safe for GERD patients?

Hailey 12 months ago

She’s already on three anti-seizure meds, so D makes sense too.

Ilona 12 months ago

Wait, is Primidone really that risky with just a phenobarbital allergy?

Penney 12 months ago

Totally agree, B is the way to go!

Denise 1 year ago

Primidone is contraindicated with phenobarbital allergy, right?

Walker 1 year ago

I recall a practice question about allergies and medications, and I think the phenobarbital allergy is significant here. So, option B seems correct to me.

Shawnda 1 year ago

I thought Primidone was contraindicated in patients with a phenobarbital allergy, but I’m not 100% confident. I should probably go with B.

Mollie 1 year ago

I’m not entirely sure, but I feel like the dose might be okay since she’s on other anti-seizure meds. Maybe option D is the right choice?

Janae 1 year ago

I remember discussing Primidone in class, and I think it’s related to phenobarbital, so I’m leaning towards option B.

Tracey 1 year ago

This is a tricky one. There are a lot of moving parts with the VPN, transit gateway, and overlay IP address. I'll need to really think through each option to make sure I select the right configurations.

Mozell 1 year ago

This question seems straightforward, but I want to make sure I understand the implications of advanced currency management before selecting my answers.

NABP NAPLEX Exam - Topic 1 Question 27 Discussion