Which is NOT true of xylazine, a common adulterant in fentanyl street drugs?
Xylazine use has been associated with open skin ulcerations and chronic skin wounds that can occur regardless of route of administration.
Xylazine is a centrally acting α2-agonist, which means it's in the same class of drugs as dexmedetomidine, clonidine, and tizanidine.
The sedation caused by xylazine is reversible with timely administration of naloxone.
The greatest prevalence of xylazine is currently in the Northeast U.S. — especially in Pennsylvania (notably, Philadelphia), Maryland, New York, and Connecticut.
Xylazine's effects include sedation, analgesia, and muscle relaxation; it also can cause hypotension and bradycardia.
You are correct. Intoxication or overdose with xylazine is NOT reversed by naloxone. However, because the life-threatening effects of xylazine–fentanyl overdoses likely are attributable to fentanyl, naloxone remains the reversal agent of choice.

Source: Dressler, DD. (2023, November 28). NEJM Journal Watch. Informing Practice. An Increasingly Frequent Adulterant in Fentanyl Street Drugs. https://www.jwatch.org/na56663/2023/11/28/xylazine-increasingly-frequent-adulterant-fentanyl-street
By rray, 27 November, 2023
By rray, 27 November, 2023
In a prospective cohort study of cognitively healthy drivers aged 65 years and older, use of any of the following drug classes was linked to higher risk of failing a road test EXCEPT for which one?
NSAIDs
antidepressants (SSRIs or SNRIs)
hypnotics
anticholinergic or antihistamine drugs
sedatives
You are correct. Use of an antidepressant (including SSRIs and SNRIs), sedative or hypnotic drug, or NSAID was linked to increased risk of receiving a marginal/fail rating on a road test vs. non-use, in a prospective cohort study of older drivers (N=198, mean age 72.6 years old). No statistically significant association was noted between anticholinergic or antihistamine drugs and poor road test performance.

Source: Carr, DB, et al. JAMA Network Open. Medication and Road Test Performance Among Cognitively Healthy Older Adults. 2023 Sep 5;6(9):e2335651. PubMed®abstract
Can you identify this pill?
tolterodine
Uloric (febuxostat)
Vraylar (cariprazine)
abacavir/lamivudine/zidovudine
You are correct. Uloric (febuxostat) is a uric acid reducer indicated for gout prophylaxis in adults.

As a reminder, you can use the Pill ID feature to identify a pill based on its imprint code or physical characteristics, including shape, color, and scoring. Find Pill ID in the epocrates app or on epocrates Web.
Can you identify this pill?
dextroamphetamine/amphetamine
finasteride
buprenorphine/naloxone
amlodipine
You are correct. Amphetamine and dextroamphetamine is a combination medication used to treat narcolepsy and ADHD in adults and children.

As a reminder, you can use the Pill ID feature to identify a pill based on its imprint code or physical characteristics, including shape, color, and scoring. Find Pill ID in the epocrates app or on epocrates Web.
Can you identify this pill?
doxepin
tadalafil
methotrexate
abacavir
You are correct. Tadalafil is a phosphodiesterase inhibitor used in benign prostatic hyperplasia, erectile dysfunction, and pulmonary arterial hypertension.

As a reminder, you can use the Pill ID feature to identify a pill based on its imprint code or physical characteristics, including shape, color, and scoring. Find Pill ID in the epocrates app or on epocrates Web.