e5. students managing the naplex 4:30 - 5:30pm

E5. STUDENTS
MANAGING THE NAPLEX
4:30 - 5:30PM
Speakers: T. Alex Hoopes, PharmD, is the Clinical Services Resident for OutcomesMTM. In this role, Dr.
Hoopes has responsibilities within the Clinical Services Department and beyond. These include providing
clinical expertise to a mix of clients, developing programs that optimize medication therapy, enhancing
claims efficiency using data-driven approaches, and precepting pharmacy students. Alex is a member of a
number of national and local healthcare organizations including the Academy of Managed Care Pharmacy
and the American Health Lawyers Association. Alex received his Doctor of Pharmacy degree from Drake
University in 2013.
Andrea Bennett, PharmD, RPh, is a PGY1 Pharmacy Practice Resident at the University of Iowa Hospitals
and Clinics, where she is receiving professional training in all aspects of hospital pharmacy. She is also
currently conducting research to evaluate the treatment of gastrointestinal bleeding in patients with left
ventricular assist devices. Andrea also is Adjunct Faculty at the University of Iowa College of Pharmacy,
an active member of the Johnson County Pharmacy Association and a member of the Iowa Pharmacy
Association Health-System Liaison Board. Andrea received her Doctor of Pharmacy from the University of
Iowa College of Pharmacy and her Bachelor of Science degrees in biochemistry and dietetics from Iowa
State University.
Janis M. Rood, PharmD, is originally from Ypsilanti, Michigan. She graduated from Hope College in
2002 with a Bachelor of Arts in Psychology and Spanish. Her work in clinical research at the University of
Michigan sparked her interest in patient care, driving her to return to school. In April 2013 she earned her
Doctor of Pharmacy degree from the University of Michigan College of Pharmacy, and is currently a PGY1 Community Practice Resident with the University of Iowa College of Pharmacy at Osterhaus Pharmacy
in Maquoketa, Iowa. Dr. Rood’s professional interests include MTM, immunizations, HME, practice
management and precepting students. After completing her residency, she plans to pursue a Community
Practice joint-faculty position at a U.S. College of Pharmacy.
FEBRUARY 7-9, 2014 | THE MEADOWS EVENTS & CONFERENCE CENTER | ALTOONA, IOWA
NAPLEX & MPJE –
How to Start & What to Expect
ANDREA P. BENNETT, PHARM.D.
PGY-1 PHARMACY PRACTICE RESIDENT
UNIVERSITY OF IOWA HOSPITALS AND CLINICS
ALEX HOOPES, PHARM.D.
PGY-1 CLINICAL SERVICES RESIDENT
OUTCOMES MTM
JANIS M. ROOD, PHARM.D.
PGY-1 COMMUNITY PRACTICE RESIDENT
OSTERHAUS PHARMACY
Faculty Disclosure
 Andrea Bennett, Alex Hoopes, and Janis Rood report no actual or potential conflicts of interest associated with this presentation.  Andrea Bennett, Alex Hoopes, and Janis Rood have indicated that off‐label use of medication will not be discussed during this presentation.
1
Learning Objectives
Upon completion of this activity, pharmacists (or pharmacy technicians) should be able to:
1. Define the purpose of the NAPLEX and MPJE
2. Undergo the registration process for each exam
3. Understand the scoring process of each exam
4. Review for each exam 5. Identify and execute study tips for each exam
6. Identify post‐exam procedures and score notifications
Personal Learning Objectives
Upon completion of this activity, I would like to be able to:
1. 2. 3. 2
Pre‐Assessment Questions
1. Which testing facility administers the NAPLEX and MPJE?
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 NAPLEX and MPJE?
Purpose of the NAPLEX & MPJE
 North American Pharmacist Licensure Examination (NAPLEX)
 Purpose: to determine if it is safe for one to begin practicing pharmacy
 Used by all 50 states, DC and 5 US territories to assess competence to practice pharmacy
 Multistate Pharmacy Jurisprudence Examination (MPJE)
 Purpose: to assess the pharmacy jurisprudence knowledge of prospective pharmacists
 Created by the National Association of Boards of Pharmacy (NABP) for individual states
3
NAPLEX & MPJE Registration
 Register with the NABP to obtain the Authorization to Test (ATT) number
 Online registration for NAPLEX, MPJE, and NAPLEX Score Transfer
www.nabp.net


Programs tab  Examination or Student tab  Examination
NAPLEX Registration (can sign up for both the NAPLEX & MPJE or just one)
 NAPLEX: $485/examination
 MPJE: $200/examination
**Registration Bulletin is VERY helpful**
4
Eligibility Requirements
 Graduation from a recognized college of pharmacy  Or a Foreign Pharmacy Graduate Equivalency Examination (FPGEE) certification
 Proof of internship hour completion for Iowa Board of Pharmacy (1,500 hours) or chosen state

If internship hours were obtained out of state, that state board must transfer hours to Iowa’s Board of Pharmacy
 Applicant is responsible for making contact to the other state board of pharmacy
5
Registration/Eligibility Timeline
 Prior to graduation:
 Register with NABP
 After graduation:
 State board confirms eligibility and notifies NABP
Authorization to Test (ATT) Number
 ATT is 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)
 Schedule exam(s):
 Online or via phone (1.888.709.2679)
 Schedule early – times fill up FAST
 May test at any Pearson VUE, regardless of state where you are seeking licensure
 Email confirmation from Pearson VUE
6
7
Scheduling & Re‐Scheduling
 Must reschedule two (2) business days prior to scheduled exam

$50/exam: Pearson VUE rescheduling fee
 Rescheduling due to a missed appointment or cancellation less than two (2) business days from the scheduled exam


NAPLEX:  $50: Pearson VUE rescheduling fee
 $140: NABP missed appointment fee
MPJE:
 $50: Pearson VUE rescheduling fee
 $90: NABP missed appointment fee
Iowa Testing Sites
 Pearson Professional Centers –
West Des Moines
3737 Woodland Ave
Colony Park Office Building
3rd floor, Suite 340
West Des Moines, IA 50266
(515) 226‐0502
 Pearson Professional Centers ‐
Davenport
100 East Kimberly Road, Suite 401
Northwest Bank & Trust Company
Davenport, IA 52806
(563) 386‐0906
 Pearson Professional Centers –
Coralville
327 2nd St., Suite 370
Wells Fargo Building Coralville, IA 52241
(319) 338‐1148
 Pearson Professional Centers ‐
Sioux City
4300 S. Lakeport, Suite 204
Sioux City, IA 51106
(712) 274‐2114
8
Other Close Testing Sites
 Pearson Professional Centers –
Peoria, IL
 Pearson Professional Centers –
Rochester, MN
4507 N. Sterling Ave
Norwoods Professional Bldg, Suite 302
Peoria, IL 61615
(309) 682‐8638
 Pearson Professional Centers ‐
Omaha, NE
10832 Old Mill Road, Suite 4
Omni Corporate Park
Omaha, NE 68154
(402) 697‐9119
1544 Greenview Drive SW
Greenview Office Bldg, Suite 200
Rochester, MN 55902
(507) 285‐3277
 Pearson Professional Centers –
Madison, WI
8517 Excelsior Drive
Prairie Trail Office Suites II, Suite 202
Madison, WI 53717
(608) 833‐3991
State Licensure Applications
 Iowa
 Illinois
 Minnesota
 Nebraska
 Wisconsin
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Iowa Licensure Application
 Iowa Board of Pharmacy
 http://www.state.ia.us/ibpe/pharmacists/exam.html
 Fees:
 Application and licensure $252
 Requirements:  Notarized application, “Certification of Pharmacy Education” form completed by the dean of your college, fee (personal check acceptable), proof of 1500 hours of internship, photograph
Illinois Licensure Application
 Illinois Department of Financial & Professional Regulation

http://www.idfpr.com/Renewals/apply/Pharmtech.asp
 Fees:
 Application and licensure $200
 Continental Testing Service (CTS) fee $91
 Requirements:
 Application, ED‐PHM form completed by the dean of your college, fees (certified check or money order)
10
Minnesota Licensure Application
 Minnesota Board of Pharmacy
 http://www.phcybrd.state.mn.us/Main‐lic.htm
 Fees:
 Application $130
 Licensure fee $143
 Requirements:
 Application, official college transcript, fees (money order, cashier’s check, certified check), proof of 1600 hours of internship, photograph, official birth certificate Nebraska Licensure Application
 Nebraska Department of Health and Human Services

http://dhhs.ne.gov/publichealth/Pages/crl_medical_pharm_
pharmlic_procedures.aspx
 Fees:

Application and licensure $178
 Requirements:

Application, “Certificate of Pharmacy Education” completed by college of pharmacy or an official transcript, fee (personal checks acceptable), proof of 1500 hours of internship, copy of birth certificate, driver’s license, or other proof of age 11
Wisconsin Licensure Application
 Wisconsin Department of Safety and Professional Services

http://dsps.wi.gov/Default.aspx?Page=904de91d‐2a2c‐4f97‐
9887‐c6020d240c18
 Fees:
 Application and licensure $140
 Requirements:
 Notarized application, form #2512 completed by the dean or registrar’s office, fee, proof of 1500 hours of internship Score Transfer
 Transfers NAPLEX score to multiple states
 Apply when registering for the NAPLEX or
 Up to 90 days after taking the NAPLEX
 Allows you to obtain licenses by examination in more than one state
 Using this, x number of states will be a “primary” license

Any of these licenses may lapse without repercussions
12
Score Transfer
 Still need to fulfill all requirements of each state prior to obtaining a license
 Many states require you to complete requirements for licensure within 1‐2 years after receiving your NAPLEX score
 $75 for each score transfer request
 Saves time, paperwork, and $$$!!
License Transfer (Reciprocity)
 Allows licensed pharmacists to transfer their license from one state to another



Many states require at least one year as a licensed pharmacist before transferring a license
MPJE is the required law exam in 48 states
MPJE required within 12 months after license transfer
 Allows transfer without re‐taking the NAPLEX
 You can only reciprocate licenses obtained through examination

Must ALWAYS keep original license valid and current
13
License Transfer (Reciprocity)
 Steps for transferring





Submit preliminary application to NABP
NABP reviews information and will send official application
Official application must be submitted to board of pharmacy within 90 days
Pass MPJE (or applicable state law exam)
License is issued
 Costs 


NABP transfer fees ‐ $350 for first state and $50 for each additional state (if on the same form)
State verification fee
State registration fee
Registration Fee Summary
 NABP Fees:
 NAPLEX: $485
 NAPLEX score transfer: $75 per state
 MPJE: $200 per state
 License transfer (reciprocity): $350 for first state
 State Application & Licensure Fees:
 Varies from state to state
**More state applications  more money**
 Rescheduling & Late Fees:
 AVOID if possible
14
What’s in a name?
Authorization To Test
Identification
Acceptable?
John D. Smith
John David Smith
Yes
John David Smith
John D. Smith
Yes
John Smith
John David Smith
No
John D. Smith
John Smith
No
John David Smith
John Smith
No
15
The NAPLEX
 Assessment of competence to practice pharmacy  Entry level practitioner
 Possible topics:
 Pharmacology
 Calculations
 Pharmacokinetics & pharmacodynamic
 Therapeutics
 Dosage Forms
The NAPLEX
 4 hours, 15 minutes
 Optional 10 minute break after two hours of testing
 185 questions
 150 questions count towards score
 35 questions are pretest questions
 Do NOT count towards NAPLEX score
 Cannot be identified
 Minimum score: 0; Maximum score: 150
 Score needed to pass: 75


Not a percentage
Questions are weighted differently
16
The NAPLEX
 Cannot omit or skip questions
 Cannot return to questions once submitted
 Questions are presented one at a time
 One case may be used for multiple questions
 Answer all questions 
Penalty applies if answer less than 185
 Clock and calculator on computer
 Scroll boxes available 
Not all information is available on screen at one time
 Tutorial prior to examination to practice using computer
NAPLEX Blueprint
 NABP website: http://www.nabp.net
 Assess pharmacotherapy to assure safe and effective therapeutic outcomes

56% of test
 Assess safe and accurate preparation and dispensing of medications

33% of test
 Assess, recommend, and provide health care information that promotes public health

11% of test
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Content Slides
NAPLEX Review Resources
 Top 200 Drugs (brand/generic)
 Class Notes
 Pre‐NAPLEX
 Pharmaceutical Calculations
 Comprehensive Pharmacy Review
 ASHP’s PharmPrep
 APhA’s Complete Review for Pharmacy
 ProntoPass QUICKCARDS
 Live and Online Review Class
18
Pre‐NAPLEX
 Preview of NAPLEX experience
 Only NAPLEX practice examination developed by NABP
 Actual questions from previous NAPLEX exams
 No eligibility requirements
 Estimated, scaled score
 50 questions for $50

Allowed 70 minutes
 May take up to 2 times 
2 unique forms
 http://www.pre‐naplex.com
Understanding Pharmacy Calculations
 Cost : ~$40  ISBN: 978‐1582120959  5‐lesson design with practice problems  200 problems with explanations  100 problem practice test
 “Easy to Understand”
19
Pharmaceutical Calculations  Cost : ~$70
 ISBN : 978‐1451120363
 Practice problems throughout
 Companion website with more practice problems
 Answers to half of problems in back of book
Comprehensive Pharmacy Review
 Cost : ~$50
 ISBN: 978‐1451117042
 Comprehensive outlines & practice questions for topics covered in curriculum
 Law, chemistry, OTC, kinetics, USP 797, prescriptions, etc.
 2 full length tests
 Patient cases similar to format of the NAPLEX
20
ASHP’s PharmPrep
 Cost : ~$50
 ISBN: 978‐1585282555
 Book + Online: Over 2,500 sample questions and 300+ sample cases
 CD‐ROM to simulate NAPLEX
 Companion sections for law, compounding, and calculations
APhA’s Complete Review for Pharmacy  Cost : ~$55
 ISBN: 978‐1582121765  Reviews drug therapy for common diseases, calculations, study tips, top 200 drug list, practice questions, CD‐ROM included
 Practice questions after each chapter with explanations for answers
21
ProntoPass QUICKCARDS®
 Cost: $265  www.prontopass.com
 >1000 QUICKCARDS, 3” x 5” index cards  67 subject areas  Presents the most important facts using pictures, rhymes, and simple sayings
 Math set available: $139 & MPJE set available: $130
 Money‐back guarantee if do not pass NAPLEX
Online and Live Review Classes
 RxPrep NAPLEX Board Review

Online course of 66 lectures – 12 month access

2,3, 4, or 5 day live course
 $988
 Cost – not listed  Several times a year, 1‐2 month notice via website

2400+ question test bank
 $179.00
 Kaplan NAPLEX Live Review Course

3 day live course includes lectures, notes, review questions, and other references
 $449
22
Study Tips
Do:  Review!
 Read all questions carefully  Review your weaknesses 





OTCs/herbals
Calculations
HIV medications
Be confident of what you know Take exams on separate days
Take Pre‐NAPLEX after first review of material Don’t:  Procrastinate  Try to memorize everything  Forget to eat before the exam  Forget to sleep the night’s before the exam
Study Tips ‐ What to Study
 Calculations!  Top 200 brand/generic  Drug Classes  OTCs/herbals  Therapeutic Topics  Guidelines  Focus on weaknesses 23
Calculations

Concentrations: 


Alligation medial/alternate Aliquots TPN 




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 

mmol, mEq, mOsmols, ppm, 1:1000, etc. Dilutions & Concentrations: 


Dosing weight, IBW, ABW, CrCL, BSA, BMI, etc.  Know equations Calculate drip rates Practice
Practice
Practice Content Slides
24
Top 200 Drugs








Brand/generic names Therapeutic class/primary indication
Drug class/MOA
Patient Counseling ADRs Drug Interactions Disease Contraindications Product availability – tablet, IV, suspension, suppository, etc.
**Very little emphasis on manufacturer or chemical structure Therapeutic Topics

Chronic Disease States 
CAD, HTN, lipids, arrhythmias, diabetes 







Transplant
Oncology
HIV Psychology Women’s health
Thyroid/adrenal/endocrine






Critical care
Fluids/electrolytes Nutrition Infectious disease
Dermatology
Immunizations Toxicology RA/OA/gout/lupus
25
Miscellaneous

Basic compounding






Practice! Surfactants, emulsions, etc. Kinetics 


T1/2, steady state, Vd, protein binding
Sterile Products Pharmacogenomics Lab Values Pregnancy category Hepatic/renal dosing adjustments
26
The MPJE Overview
 Pharmacy law examination  Topics include:
 State and federal law
 Controlled substances
 Long‐term care pharmacies
 Telepharmacy & Central Fill
 Retail pharmacies
27
The MPJE Format
 2 hours
 90 multiple‐choice questions
 75 questions will be used to calculate your test score
 15 questions are pretest questions and do NOT affect your score

Pretest questions will be asked throughout the exam
 Cannot identify them
 Computer‐adaptive technology based on answer
The MPJE Scoring
 Score necessary to pass: 75
 Not a percentage value
 Determines your ability level then compares it to the predetermined minimum acceptable ability level
 Minimum: 0
 Maximum: 100
 Not possible to transfer MPJE score to another state

MPJE is unique to state/jurisdiction
28
Taking the MPJE
 Cannot omit or skip a question
 Cannot change an answer once you have confirmed
 Cannot go back and review a question
 Answer all questions to avoid penalty
 Exam includes clock on screen
 Exam tutorial available prior to beginning
MPJE Blueprint
 NABP website: www.nabp.net
 Pharmacy Practice  84% of test
 Licensure, Registration, Certification, and Operational Requirements

13% of test
 Regulatory Structure and Terms  3% of test
29
MPJE Review Resources
 IPA Educational Expo Materials
 Law Review/Class Notes
 State Law Manual
 State Board of Pharmacy Website
 NABP Website
 DEA Pharmacist Manual:  http://www.deadiversion.usdoj.gov/pubs/manuals/pharm2/index.
html
MPJE Review Resources
 Iowa Pharmacy Law and Information Manual
 $100 with no updates on IPA website
 PDF

http://www.state.ia.us/ibpe/rules_laws/index.html
30
MPJE Review Resources

Pharmacy Practice and the Law 6th Edition (2011): 


ISBN: 978‐0763781293 $75
Guide to Federal Pharmacy Law 7th Edition (2010): 

ISBN: 978‐0967633268
$30
MPJE Review Resources

ProntoPass – MPJE



Several states available
Pass MPJE two weeks from the day you order (money back guarantee)
$130 + $7.95 shipping

Extra $35 per additional state
31
MPJE Review Resources
 Survey of Pharmacy Law
 Revised/published each December
 Four sections:
 Organizational law
 Licensing law
 Drug law
 Census Data
 Available as CD‐ROM ($195)
 Complimentary to all final‐year student pharmacists
NAPLEX/MPJE Registration Bulletin
 Contents include
 Registration instructions
 Testing appointment information
 Test administration
 Information on score results
 Competency statements

Treat as learning objective as you study
 Website:  http://www.nabp.net/programs/examination/naplex/registration‐
bulletin/
32
MPJE Study Tips
 Do not take both NAPLEX and MPJE on the same day
 Make sure you know both state and federal laws
 Stricter rule always prevails
 Use combo study resources, if available
 Prescriptive authority of various healthcare professionals


Know what abbreviations designate each discipline
http://www.deadiversion.usdoj.gov/drugreg/practioners/
MPJE Study Tips
 Controlled Substances Act
 Know schedules for each controlled substance




Example: Fioricet vs. Fiorinal
Know what can be changed on a controlled substance prescription
Know who can prescribe controlled substances
Know “emergency dispensing” requirements
 Iowa Code
 http://www.state.ia.us/ibpe/controlled_substance/index.html
33
MPJE Study Tips
 Technician certification
 New certification requirements/implementation dates
 Immunization laws
 Requirements for a prescription to be legal
 Transferring prescriptions process
 Interstate
 Intrastate  Controlled substances
MPJE Study Tips
 Iowa MPJE:
 Review IPA Educational Expo session notes
 Review law manual
 Outside Iowa:
 Review law manual
 Contact Board of Pharmacy
 Consider ProntoPass if you are worried
34
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
If all else fails…
 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!
35
Questions
Post‐Assessment Questions
 How much does it cost to get licensed in Iowa?
 How many internship hours are required to get licensed in the state of Iowa?
 What are the two ways to obtain licensure in a second state?
 Name three topics that are covered in the NAPLEX.
 Name two specific resources that are available to help study for the NAPLEX.
36
References








http://www.cartoonstock.com/newscartoons/cartoonists/gri/lowres/grin304l.jpg www.danscartoons.com/pharm3_demo.gif
National Association of Boards of Pharmacy (NABP). http://www.nabp.net/
Iowa Board of Pharmacy
 http://www.state.ia.us/ibpe/pharmacists/exam.html
 http://www.state.ia.us/ibpe/rules_laws/index.html
 http://www.state.ia.us/ibpe/controlled_substance/index.html
Illinois Department of Financial & Professional Regulation
 http://www.idfpr.com/Renewals/apply/Pharmtech.asp
Minnesota Board of Pharmacy
 http://www.phcybrd.state.mn.us/Main‐lic.htm
Nebraska Department of Health and Human Services
 http://dhhs.ne.gov/publichealth/Pages/crl_medical_pharm_pharmlic_procedures.aspx
Wisconsin Department of Safety and Professional Services
 http://dsps.wi.gov/Default.aspx?Page=904de91d‐2a2c‐4f97‐9887‐c6020d240c18
References





Pre‐Naplex
 http://www.nabp.net/programs/examination/pre‐naplex/
DEA Pharmacist Manual
 http://www.deadiversion.usdoj.gov/pubs/manuals/pharm2/index.html
ProntoPass – MPJE
 http://www.prontopass.com/index.php?page=MPJE%20Review
Amazon.com – book information
Survey of Pharmacy Law
 http://www.nabp.net/publications/survey‐of‐pharmacy‐law/
37