Guideline/Drug Updates and Errata

The RxPrep Course Book is published annually. Information in the Course Book and Test Banks is up to date at the time of publishing, but drug information can change rapidly. Refer to the Updates on this page for NAPLEX-relevant information that becomes available before the next RxPrep Course Book is published. Guideline updates that may be relevant to NAPLEX are included. If we find anything that needs a correction or clarification in the RxPrep Course Book, it will be included in the Errata table on this page.

Guideline/Drug Updates: 2021 RxPrep Course Book

NAPLEX-relevant updates from June 2020-May 2021

Page Update Type Description
Chapter 1: Preparing for NAPLEX with RxPrep
p. 12 Revised NABP NAPLEX Competency Statements

Effective January 2021

NABP has released revised NAPLEX Competency Statements (their blueprint of tested items).

Impact for NAPLEX Candidates testing after January 1, 2021:

  • The 2021 NAPLEX Competency Statements have been reorganized across more “Areas” which provides clarity on the percentage of test questions from each Competency Area (see table below).
  • The content you need to know has not changed. Continue to use the 2021 RxPrep Course materials for your NAPLEX preparation.
  • The types of questions and general format of the exam (e.g., number of questions and time to take the test) is the same.

Comparison of 2020 and 2021 NAPLEX Competency Areas:

2020 NAPLEX Competency Statements
(Two Areas)
2021 NAPLEX Competency Statements
(Six Areas)
Area 1 (67%): Ensure Safe and Effective Pharmacotherapy and Health Outcomes

Area 1 (18%): Obtain, Interpret, or Assess Data, Medical, or Patient Information

Area 2 (14%): Identify Drug Characteristics

Area 3 (35%): Develop or Manage Treatment Plans

Area 2 (33%): Safe and Accurate Preparation, Compounding, Dispensing, and Administration of Medications and Provision of Health Care Products

Area 4 (14%): Perform Calculations

Area 5 (11%): Compound, Dispense, or Administer Drugs, or Manage Delivery Systems

Area 6 (7%): Develop or Manage Practice or Medication-Use Systems to Ensure Safety and Quality

Individual Competency Statement wording is different, and often more descriptive and detailed, but the items that will be tested are the same:

  • 2020 Example:
    • Obtain, interpret, assess and/or evaluate patient medical records.
  • 2021 Example:
    • Obtain, interpret, or assess data from medical records: treatment adherence, or medication-taking behavior, chief complaint, medication history, medical history, family history, social history, lifestyle habits, socioeconomic background.
p. 12 NABP NAPLEX Updates

Effective January 2021

The revised NABP Candidate Application Bulletin reflects the following changes:

  • The number of questions on the NAPLEX has decreased from 250 to 225 total questions. Exam results will still be calculated based on answers to 200 questions, but the number of pretest questions has decreased from 50 to 25.
  • NABP will no longer provide a scaled score for the NAPLEX (or MPJE). Exam results will now be provided as either Pass or Fail.
    • For the NAPLEX, exam reports for those who receive a “Fail” will include a section indicating relative performance in each of the 6 competency areas tested on the exam.
Chapter 20: Immunizations
p. 330, 331 & 337 Discontinued Drug

The shingles vaccine Zostavax is no longer available. Continue to recommend the Shingrix vaccine in patients ≥ 50 years.

Chapter 24: Infectious Diseases III
p. 412 Labeling Change

Baloxavir marboxil (Xofluza) has been FDA-approved for post-exposure influenza prophylaxis in patients ≥ 12 years old following contact with an individual who has influenza. It is given as a one-time dose within 48 hours of exposure.

Chapter 26: Human Immunodeficiency Virus
p. 426 & 432 New Drug Approval

Cabotegravir/rilpivirine (Cabenuva) has been FDA-approved for the treatment of HIV in adults. This is an extended-release injectable formulation that is given once monthly as a complete treatment regimen in patients who have been virologically suppressed on a stable regimen.

The FDA also approved cabotegravir in a tablet formulation (Vocabria). Oral cabotegravir plus rilpivirine should be given for one month prior to initiation of Cabenuva to assess tolerability.

Chapter 39: Common Skin Conditions
p. 576 Labeling Change

Ivermectin lotion (Sklice) has been FDA-approved to switch from prescription status to over-the-counter (OTC) status. It is indicated as a topical treatment of head lice in individuals 6 months of age and older. Availability is anticipated at the end of the second quarter of 2021.

Chapter 41: Asthma and Chapter 42: Chronic Obstructive Pulmonary Disease
p. 598, 612 & 613 New Drug Approval

A new three-drug combination inhaler, budesonide/formoterol/glycopyrrolate (Breztri Aerosphere), has been approved for COPD.

p. 598 Labeling Change

Umeclidinium/vilanterol/fluticasone (Trelegy Ellipta) has been FDA-approved for maintenance treatment of asthma in patients ≥ 18 years old.

Chapter 44: Diabetes
p. 633 Labeling Change

Dapagliflozin (Farxiga) has been FDA-approved to reduce the risk of cardiovascular death and hospitalization in heart failure with reduced ejection fraction without diabetes.

p. 629 & 630 Guideline Update

The 2021 American Diabetes Association Standards of Care update was published. Key changes that can impact testing include:

Comprehensive Care

  • p. 629: Antiplatelet Therapy
    • (NEW) Aspirin plus low-dose rivaroxaban can be added in patients with CAD and/or PAD.
  • p. 629: Blood Pressure Control & Kidney Disease
    • (NEW) Diabetes with CAD: use ACE inhibitor or ARB for blood pressure control.

Treatment for Type 2 Diabetes

  • p. 630: The HF, CKD, ASCVD/High ASCVD Risk arm of the flow diagram is simplified to three separate arms, but there are no changes in recommended medications.
Chapter 53: Acute & Critical Care Medicine and Chapter 58: Pain
p. 735 & 778 New Drug Approval

Oliceridine (Olinvyk) is a new IV opioid agonist approved for moderate to severe acute pain in adults. It is indicated for short-term use in controlled clinical settings (i.e., inpatient or outpatient procedures).

Errata: 2021 RxPrep Course Book

Corrections or clarifications for the 2021 RxPrep Course Book

Page Description
Chapter 15: Compounding I
p. 247

The section on "Media-Fill Test" should include this statement: "Media-fill testing must be performed initially during training and at least annually for low- and medium-risk level compounding and semiannually for high-risk compounding."

p. 250

On the clipboard describing USP 797 cleaning requirements, the minimum frequency of cleaning the walls, windows, shelving, bins, carts, chairs and ceiling should be monthly.

Chapter 23: Infectious Diseases II
p. 389

In the Study Tip Gal for HAP/VAP: Selecting an Empiric Regimen, the section on “Antibiotics for Pseudomonas (do not use two beta-lactams together)” should include aztreonam.

Chapter 26: Human Immunodeficiency Virus
p. 433

In the row for Descovy, cross out the statement in the right column. Test HLA-B*5701 prior to use (abacavir).

p. 436

The answer key for the fill-in-the-blank quiz should say:

  • 8. Tenofovir DF & emtricitabine
  • 9. Tenofovir AF & emtricitabine
Chapter 44: Diabetes
p. 629

The last bullet under Vaccinations should say "Pneumococcal vaccine: Pneumovax 23 (1 dose before age 65)."

p. 639

In the Study Tip Gal for Converting Between Insulins, Exception #1 should say "NPH dosed BID → Lantus, Basaglar or Toujeo dosed daily."

View 2020 RxPrep Course Book Guideline/Drug Updates and Errata

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