NAPLEX - How To Start And What To Expect Friday

January 20-22, 2012
Des Moines MarrioƩ, 700 Grand Avenue, Des Moines, IA
NAPLEX - How to Start and What to Expect
Friday - 4:00pm - 5:30pm
Speakers: Jordan Baye, PharmD, MA, originally from Sioux Falls, SD, received his Master of Arts in Bioethics
from the Medical College of Wisconsin in 2006 and Doctor of Pharmacy degree from the University of Iowa in
2011. He is currently a PGY-1 Pharmacy resident at the Iowa City VA Health Care System. His areas of interest
include acute care, oncology, and infec ous disease. He plans to complete a PGY-2 residency in acute care or
oncology and pursue a career in clinical pharmacy and academia.
Kyle D. Hilsabeck, PharmD, BA, originally from Marshalltown, Iowa, received his Bachelor of Arts in Biochemistry
and Biology from Wartburg College in Waverly, IA in May 2006 and his Doctorate of Pharmacy from the University
of Iowa in Iowa City, IA in May 2011. He is currently a community pharmacy prac ce resident at Shepley Pharmacy
in Mount Vernon, IA where he is involved with precep ng students, health screenings, vaccina on services,
medica on therapy management, clinical research, and many other ac vi es. He has been ac vely involved
with the Iowa Pharmacy Associa on including appointment to the legisla ve commi ee. Dr. Hilsabeck’s areas of
interest include health risk management, nutri on, complimentary/alterna ve medicine, compounding, health/
wellness coaching, and medica on therapy management. He is undecided on career paths but is considering
clinical pharmacy, faculty, and administra on/organiza onal posi ons.
Stephanie Malenfant, PharmD, MPH, originally from Cedar Rapids, Iowa, is a 2011 graduate of the University
of Iowa College of Pharmacy. She has been involved in the American Society of Health-System Pharmacists and
the Iowa Pharmacy Associa on. Her current interests include hematology/oncology, solid organ transplant, and
infec ous disease. A er comple ng her PGY1 Pharmacy Residency, she plans to pursue a PGY2 residency or a
posi on as a clinical pharmacist in a hospital affiliated with a college of pharmacy.
Kevin Natzke, PharmD, originally from Green Bay, WI, completed his undergrad at the University of WisconsinMadison and received a Doctor of Pharmacy from Creighton University in Omaha, NE in May 2011. He has been
involved with Kappa Psi Pharmaceu cal Fraternity while a ending pharmacy school. He is currently comple ng
his Community Prac ce Pharmacy Residency with the University of Iowa. His prac ce site is at Mercy Family
Pharmacy in Dubuque, IA. His area of interest is in ambulatory care and he would like to pursue a career in
clinical pharmacy.
1/12/2012
Faculty Disclosure
NAPLEX & MPJE: How to Start & What
to Expect
Jordan Baye, Pharm.D., M.A.
Pharmacy Practice Resident, Iowa City VA
Kyle Hilsabeck, Pharm.D.
Community Pharmacy Practice Resident, Shepley Pharmacy
Stephanie Malenfant, Pharm.D., MPH
Pharmacy Practice Resident, UIHC
Kevin Natzke, Pharm.D.
Community Pharmacy Practice Resident, Mercy Family Pharmacy
• Jordan Baye, Kyle Hilsabeck, Stephanie Malenfant, and Kevin
Natzke report no actual or potential conflicts of interest
associated with this presentation.
•
Jordan Baye, Kyle Hilsabeck, Stephanie Malenfant, and Kevin
Natzke indicated that off-label use of medication will not be
discussed during this presentation.
Learning Objectives
Pre-Assessment Questions
 Upon completion of this activity pharmacists (or pharmacy technicians)
1. Which testing facility administers the NAPLEX?
2. What main topics are covered in the NAPLEX?
3. What types of resources are available to help study for the
NAPLEX?
4. How many questions are there on the MPJE?
will be able to:
 Define the purpose of the NAPLEX and MPJE
 Understand the scoring process of each exam
 Undergo the registration process for each exam
 Review for each exam
 Identify and execute study tips for each exam
 Identify post-exam procedures and score notifications
Purpose of the Exams

North American Pharmacist Licensure Examination (NAPLEX)
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Used by all 50 states, DC and 5 US territories to assess competence to practice
pharmacy
Purpose: To determine if it is safe for you to begin practicing pharmacy
Multistate Pharmacy Jurisprudence Examination (MPJE)


Created by NABP for individual states
Purpose: To assess the pharmacy jurisprudence knowledge of prospective
pharmacists
NAPLEX Registration
 Register with National Board of Pharmacy to obtain the
Authorization to Test (ATT) Number
 Registration is on-line for NAPLEX, MPJE, and score transfer
 http://www.nabp.net
 Programs tab- Examination
 Students tab- Examination
 NAPLEX Registration (can sign up for both or one here)
 Registration Bulletin will be very helpful
 Cost:
 NAPLEX: $485
 MPJE: $200
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Eligibility Requirements
 Graduation from a recognized college of pharmacy
 Or Foreign Pharmacy Graduate Equivalency Examination (FPGEE) certification
 Proof of internship hour completion for Iowa Board of Pharmacy (or whatever
state you go to)
 If internship hours are from out of state, that state board must transfer hours to
Iowa’s Board of Pharmacy
 You are responsible for making the contact to the other state’s board
 Timeline:
 Prior to graduation: can register with NABP
 State board only confirms eligibility after graduation and all
requirements are met
Authorization to Test (ATT) Number
 ATT emailed after eligibility requirements are met
 DO NOT GIVE A FAULTY EMAIL TO NABP
 Once ATT Number is assigned:
 Register with Pearson VUE (www.pearsonvue.com/nabp)
 Scheduling:
 Online or via phone (1-888-709-2679)
 Schedule early – times will fill up FAST
 May take test at any Pearson VUE, regardless of state where you are seeking
licensure
 Email confirmation from Pearson
Scheduling & Re-Scheduling
 Must reschedule two (2) business days prior to exam
 $50 to reschedule either exam to Pearson VUE
 Rescheduling if missed or cancel less than 2 business days
from the exam:
 NAPLEX $140 to NABP
 MPJE $90 to NABP
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Test Sites in Iowa

Pearson Professional Centers –West Des Moines
3737 Woodland Ave
Colony Park Office Building, 3rd floor, Suite 340
West Des Moines, Iowa 50266
515-226-0502

Pearson Professional Centers – Coralville (Iowa City)
327 2nd Street, Wells Fargo Building, Suite 370
Coralville, Iowa 52241
319-338-1148

Pearson Professional Centers-Davenport (QuadCities)
100 East Kimberly Road, Suite 401
Northwest Bank & Trust Company
Davenport, IA 52806
563-386-0906

Pearson Professional Centers – Sioux City
4300 S. Lakeport, Suite 204
Sioux City, Iowa 51106
712-274-2114
Other Close Test Sites
 Pearson Professional Centers – Rochester
1544 Greenview Drive SW
Greenview Office Building, Suite 200
Rochester, MN 55902
507-285-3277
 Pearson Professional Centers – Omaha
10832 Old Mill Road, Suite 4
Omni Corporate Park
Omaha, NE 68154
402-697-9119
 Pearson Professional Centers-Sioux Falls SD
5101 South Nevada Avenue
VanBuskirk Office Building
Suite 130
Sioux Falls, SD 57108
605-362-6151
State Licensure Applications
Iowa Licensure Application
 Iowa
 Board of Pharmacy:
 Nebraska
 http://www.state.ia.us/ibpe/pharmacists/exam.html
 Illinois
 Costs for Application & Licensure: $300
 Minnesota
 One current photograph (passport quality)
 Wisconsin
 Completion of “Certification of Pharmacy Education” to be
completed by college
 Proof of 1500 hours of internship
Nebraska Licensure Application
Illinois Licensure Application
 Department of Health & Human Services
 Illinois Board of Pharmacy
 Division of Professional Regulation: Pharmacy
 Application Available at:
 www.hhs.state.ne.us
 Search for Pharmacist
 Cost for Application & Licensure: $178
 Certificate of Pharmacy Education – to be sent from the
college
 Proof of 1500 internship hours
 Copy of birth certificate/driver’s license/or other proof of
age
 http://www.idfpr.com/dpr/apply/Phrmtech.asp
 Cost for Application & Licensure: $200
 Continental Testing Service (CTS) fees:
 NAPLEX Administrative fee: $92
 MPJE Administrative fee: $92
 Supporting documentation: Official transcripts, ED-PHM form
(showing graduation), etc
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Minnesota Licensure Application
Wisconsin Licensure Application
 Minnesota Board of Pharmacy
 Wisconsin Board of Pharmacy:
 www.phcybrd.state.mn.us
 Cost of Application & Licensure: $165 prior to sitting for
exam
 Authorization to Practice Fee: $105 after passing exam
 Proof of 1600 hours of Internship within last 3 years of 6-
year curriculum, 18 years of age
 http://drl.wi.gov/board_detail.asp
 Pharmacist
 Licensing- Applications/Forms
 Cost of Licensure & Application: $155 (Exam Fee [$60], Initial
Credential Fee [$75], DOA Exam Fee [$20]).
 Proof of 1500 hours of internship
 “Pharmacist Certificate of Professional Education” (Form #2512)
– to be completed by the college
Registration Fee Summary
Score Transfer
 NABP for NAPLEX & MPJE
 Available: Prior to taking the NAPLEX
 NAPLEX: $485
 MPJE: $200
 State Application & Licensure Fee
 Varies from state to state
 Reminder: more states = more $$$$
 Rescheduling / Late Fees
 Recommended to avoid if possible
 Transfer the NAPLEX score to additional states/jurisdictions
for licensure there
 Still need to fulfill all additional requirements for each state
prior to obtaining license
 Must be received at least five (5) business days prior
to any scheduled NAPLEX test date
 Using this, x number of states will be a “primary” license –
any of these may lapse without repercussions
 Transfer or Reciprocity Fees
Score Transfer
License Reciprocity
 Required to take MPJE to complete licensure for
 Electronic Licensure Transfer Program (ELTP)
the additional states within 1 to 2 years of the
testing date
 Awards an license by examination (not by reciprocity)
 Cost: $75 per state
 Saves time, paperwork, and money!
 Available: After already licensed as a pharmacist in a state
 This transfers the license, but MPJE is still required within 12
months of approval
 Allows transfer without re-taking NAPLEX exam
 Must complete the NABP Preliminary Application for License
Transfer
 Once application is approved: Submit approval and state specific
fee to state board of pharmacy
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Reciprocity
 Original license is used as the basis for transferring the
licensure
 Must ALWAYS maintain original license
 Must complete CE and requirements (pay fees, etc.) for
original board of pharmacy
 Must be in current & good standing with original board of
pharmacy
 Cost: $350 for first state & $50 for each additional state (if
on the same form)
 Plus state application fee of $100 to over $300
The NAPLEX
The NAPLEX
 Assesses competence to practice pharmacy
 4 hours 15 minutes
 Topics range from:
 Optional 10 minute break after 2 hours of testing
 Pharmacology
 Total: 185 questions
 Calculations
 150 questions count for the score, other 35 are “pilot”
 Pharmacokinetics & Pharmacodynamics
 Therapeutics
 Dosage forms
questions
 Must answer to receive score: 162
 Score needed to pass: 75
 Not a percentage
 Questions are weighted differently
The NAPLEX
NAPLEX Blueprint
 Cannot omit or skip questions
 NABP website: http://www.nabp.net
 Cannot return to questions once submitted
 Assure safe & effective pharmacotherapy & optimize
 Questions presented 1 at a time
 Cases are repeated with each question
 Should answer all questions- penalty applies if answer less than
185
 Clock on the computer
 Scroll boxes available – not all information is available on screen at
one time
 Tutorial prior to examination to practice using computer
therapeutic outcomes
 56%
 Assure safe & accurate preparation and dispensing
medications
 33%
 Provide health care information & promote public health
 11%
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NAPLEX Resources
 Top 200 Drugs (brand / generic)
 Class Notes
 Pre-NAPLEX®
 Pharmaceutical Calculations
 Comprehensive Pharmacy Review
 ASHP’s Pharm Prep
 APhA’s Complete Review for Pharmacy
 ProntoPass QUICKCARDS®
 Live and Online Review Classes
Pre-NAPLEX
Pharmaceutical Calculations
 Developed by NABP

Cost: $40-49
 Actual questions from previous exams

 Estimates score on NAPLEX

ISBN: 978-1582120331
5-lesson design with practice
problems
100 problems with
explanations
“Easy to Understand”
 Preview of NAPLEX experience
 $50 for 50 questions
 Allowed 70 minutes
 May take up to two times
 www.pre-naplex.com


Pharmaceutical Calculations
Comprehensive Pharmacy Review

Cost: $70-77

Cost: $49-54

ISBN: 978-1582558370
Practice problems throughout
Answers to half of problems in
back of book

ISBN: 978-1582557113
Comprehensive outlines & practice
questions for topics covered in
curriculum
Law, chemistry, OTC, kinetics, etc.
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APhA’s Complete Review for
Pharmacy
ASHP’s Pharm Prep

Cost: $57-63

Cost: $52-65

ISBN: 978-1585281480
Over 2500 sample questions
and 244 patient cases
CD-ROM to simulate NAPLEX
Companion sections for law,
compounding, and calculations

ISBN: 978-1582121451
Practical information is presented
in a clear, reader-friendly format
Reviews drug therapy for common
diseases, calculations, study tips,
Top 200 drug list, practice
questions, CD-ROM included

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
ProntoPass QUICKCARDS®
Online and Live Review Classes
 RxPrep NAPLEX Board Review
 Cost: $365
 Online course of 54 lectures
 www.prontopass.com
 >1000 QUICKCARDS, 3” x 5” index cards
 67 subject areas
 Presents most the important facts using pictures, rhymes, and simple
 $749
 5 day live course
 $1,198
sayings
 Math set also available: $139
 Money-back guarantee if do not pass NAPLEX
 Kaplan NAPLEX Review Course
Study
Tips
Study
Tips
Study Tips: What to Study

Do:

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Review!
Read all questions carefully
Review your weaknesses

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OTCs/herbals
Calculations
HIV medications
Be confident of what you know
Get a good nights sleep prior to
exam
Do (cont.):



Take exams on separate days
Take Pre-NAPLEX after first
review of material
Don’t:

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Procrastinate
Try to memorize everything
Forget to eat before the exam
 3 day live course includes lectures, notes, review questions, and
other references
 $449
 Calculations!
 Top 200 brand/generic
 Drug Classes
 OTCs/herbals
 Therapeutic Topics
 Guidelines
 Focus on weaknesses
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Calculations

Concentrations:


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Dosing weight, IBW, ABW, CrCL,
BSA, BMI, etc.

Calculate drip rates
Na+ equivalents
Temperature measurement, weight
conversions


1 cup = 236.6 ml
F  C; C  F
Calories to Grams
Calcium-Phos products
Ratios
Specific dosages
Isotonic Solutions

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Alligation medial/alternate
Aliquots

TPN

Dilutions & Concentrations:

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mmol, mEq, mOsmols, ppm,
1:1000, etc.

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Know equations
Practice
Practice
Practice
Top 200 Drugs

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Therapeutic Topics
Brand/generic names
Drug classes
MOA
Patient Counseling
ADRs
Drug Interactions
Disease Contraindications
Product availability – tablet, IV, suspension, suppository, etc.

Chronic Disease States

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CAD, HTN, lipids, arrhythmias,
diabetes
Transplant
Oncology
HIV
Psych

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Critical Care
Fluids/Electrolytes
Nutrition
ID
Dermatology
Immunizations
Toxicology
 Do not need to know manufacturer or chemical structure
Miscellaneous

Basic compounding
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Kinetics
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Surfactants, emulsions, etc.
T1/2, steady state, Vd, protein
binding
Sterile Products
Pharmacogenomics
Lab Values
Pregnancy category
Hepatic/Renal Failure
Reductions
Case Example
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Practice
Practice
Practice
 Which side effect is most commonly associated with Tarceva?
 A. Rash
 B. Bone pain
 C. Headache
 D. Vomiting
 Need to know generic for Tarceva (erlotinib)
 Asking for most common side effect – all listed ARE side effects
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The MPJE
The MPJE
The MPJE
The MPJE
 The law exam for licensure
 2 hours
 Topics range from:
 90 Multiple Choice Questions
 State and federal law
 75 questions will be used to calculate the test score
 Controlled substances
 The remaining 15 items serve as pretest questions, and do
 Long-term care pharmacies
 Retail pharmacies
NOT affect the MPJE score
 The pretest questions are dispersed throughout the
examination and cannot be identified
The MPJE
The MPJE
 Score needed to pass: 75
 Cannot omit or skip a question
 Not a percentage
 Questions are weighted differently
 No distinction is made in the examination between federal
and state jurisprudence questions
 You are required to answer each question in terms of the
prevailing laws of the state in which you are seeking licensure
 Cannot change an answer once you have confirmed
 Cannot go back and review a question
 Best interest to answer all questions
 Computer has clock and calculator on screen
 Computer tutorial available prior to taking exam
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MPJE Blueprint
MPJE Review Resources
 NAPB website: www.napb.net
 IPA Educational Expo Materials
 Effective January 25, 2011:
 Law Review/Class Notes
 Pharmacy Practice
 Iowa Pharmacy Law Manual
 84%
 State Board of Pharmacy website
 Licensure, Registration, Certification, and Operational
 NABP website
Requirements
 DEA Pharmacist Manual:
 13%
http://www.deadiversion.usdoj.gov/pubs/manuals/pharm
2/index.html
 Regulatory Structure and Terms
 3%
MPJE Review Resources
MPJE Review Resources
 Iowa Pharmacy Law and Information

Manual
Pharmacy Practice and the
Law 6th Edition (2011):
 $100 with no updates on IPA website

 PDF Online

ISBN: 978-0763781293
$75

Guide to Federal Pharmacy
Law 7th Edition (2010):


ISBN: 978-0967633268
$47
 http://www.state.ia.us/ibpe/rules_laws/tablecon.html l
MPJE Review Resources

PharmSuccess.com


Offers several practice tests,
including NAPLEX and
MPJE
Price varies based on
products purchased ($80$300)

ProntoPass – MPJE



Several states available
Pass MPJE two weeks from
the day you order (money
back guarantee)
$130
Survey of Pharmacy Law

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Revised & published annually
Consists of 4 sections:

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Organizational law
Licensing law
Drug law
Census data
Broken down by general law
Requirements by state listed alphabetically
Legend at the end of the section
Produced now only as a CD-ROM

http://www.nabp.net
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NABPLAW Online

Comprehensive, national databank of state
pharmacy laws & regulations
Search capabilities allows users to research
subjects one state at a time or across all 50 states
Website:

Access will be provided upon receipt of payment

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MPJE Study Tips
 Do not take both NAPLEX and MPJE on the same day
 Make sure you know both state and federal laws.
 The stricter rule always prevails
 Prescriptive authority of various healthcare professionals
http://www.nabp.net/programs/member-services/nabplaw/
1 day subscription: $10
1 week subscription: $50
1 month subscription: $195
6 month subscription: $695
MPJE Study Tips
MPJE Study Tips
 Controlled Substances Act
 Technician certification
 Know schedules for each controlled substance
 Example: Fioricet vs. Fiorinal
 Know what can be changed on a controlled substance
prescription
 Specifically – differences between CII & CIII-CV
 Know who can prescribe controlled substances
 Know “emergency dispensing” requirements
 New certification requirements/implementation dates
 Immunization laws
 Requirements for a prescription to be LEGAL
 Transferring Prescriptions Process
 Interstate
 Intrastate
 Iowa Code (with 2009 amendments)
http://www.state.ia.us/ibpe/controlled_substance/index.html
If a pharmacist is absent from the pharmacy
which tasks cannot be performed?
Dispensing of prescriptions
2. Transferring prescriptions
3. Patient counseling by a pharmacy intern
4. Patients turning in new prescriptions
1.
1 and 2
B. 2 and 3
C. 1, 2, 3, and 4
D. 1, 2, and 3
A.
After the Test
 In Iowa, scores are posted online within 2 to 10 business days
 Scores only updated ONCE daily!
 Scores are only reported for candidates seeking licensure in
Iowa
 http://www.state.ia.us/ibpe/pharmacists/scores.html
 Write down your ATT before taking exam!
 ATTs are assigned by NABP upon test registration
 ATT will be used to post scores
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If all else fails…
Questions?
 Retake policy
 NAPLEX: Must wait a minimum of 91 days
 MPJE: Must wait a minimum of 30 days for the same
jurisdiction
 If not passed on 2nd try must petition the Board to take the
exam again
 Candidates who have failed the exam three or more times
must obtain remedial education prior to taking the exam
again
 ALL FEES MUST BE PAID AGAIN!
Post-Assessment Questions
References
1. How much does it cost to get licensed in Iowa?
2. How many internship hours are required to get licensed in
the state of Iowa?
3. What are the two ways to obtain licensure in a second state?
4. Name three topics that are covered in the NAPLEX.
5. Name two specific resources that are available to help study
for the NAPLEX.
 http://www.cartoonstock.com/newscartoons/cartoonists/gri/l
owres/grin304l.jpg
 http://studentblog.registrar.ualberta.ca/matthew/images/Carto
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on.gif
http://fc.tvdsb.on.ca/~r.matches/math%20cartoon.jpg
www.danscartoons.com/pharm3_demo.gif
www.nabp.net
http://www.state.ia.us/ibpe/index.htm
Amazon.com for book information
ASHP website for book information
APhA website for book information
Continuing Pharmacy Education (CPE)
To receive your CPE Statement of Credit:
 Log-on to the CEI Website www.TheCEInstitute.org
 Enter your user name/password or click on “New to CEI” to create a
portfolio; Click on MY PORTFOLIO
Enter the Access Code: (case sensitive)
Pharmacists - ___________
Technicians - ___________
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