NAPLEX (North American Pharmacist Licensure Examination) Practice Exam

What is the second line treatment for hepatic encephalopathy?

1. Spironolactone

2. Rifaximin

3. Propranolol

4. Ceftriaxone

The correct answer is: Rifaximin

Hepatic encephalopathy is a condition in which the liver is unable to properly remove toxins from the blood, resulting in symptoms such as confusion and disorientation. The first line treatment for this condition is typically lactulose, a medication that helps reduce the amount of toxins in the blood. If this treatment is not effective, the second line treatment is usually rifaximin. This option is correct because it is specifically indicated for hepatic encephalopathy and has been shown to improve symptoms and prevent future episodes. The other options may be used for other conditions, but they are not considered second line treatments for hepatic encephalopathy. Spironolactone is a diuretic used to treat conditions such as high blood pressure and heart failure. Propranolol is a beta blocker typically used to treat conditions such as high blood pressure and angina. Ceftriaxone is an antibiotic commonly used to treat bacterial infections. While these medications may be used in conjunction with rifaximin, they are not the primary treatment for hepatic encephalopathy.