Medication Therapy Management Flashcards
7 cards from real CCP practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
Read the first 7 Medication Therapy Management flashcards as text
A consultant pharmacist reviews a nursing home resident's medication list and notes that metoclopramide has been prescribed continuously for 18 months. Which concern should be raised with the medical team?
Answer: Risk of tardive dyskinesia with long-term use beyond 12 weeks
FDA requires a black-box warning on metoclopramide for tardive dyskinesia risk with use beyond 12 weeks, making long-term prescribing a significant concern.
During a CMR, a patient with type 2 diabetes reports that she skips her evening metformin dose 'because it upsets her stomach.' The pharmacist's BEST recommendation to improve adherence while minimizing GI side effects is:
Answer: Switch to metformin extended-release taken with the evening meal
Extended-release metformin has significantly lower GI side effects than immediate-release and, when taken with food, further reduces GI intolerance.
In the context of MTM documentation, a 'Personal Medication Record' (PMR) differs from a 'Medication Action Plan' (MAP) in that:
Answer: The PMR lists all current medications and is for the patient's reference; the MAP lists specific actions the patient needs to take
The PMR is a comprehensive patient-held medication list, while the MAP is a patient-centered action document specifying steps the patient must take to optimize therapy.
A pharmacist is evaluating a 70-year-old patient's medications using the Beers Criteria. Which combination of findings would be MOST consistent with Beers Criteria concerns in this population?
Answer: Diphenhydramine for sleep + oxybutynin for urge incontinence + diazepam for anxiety
Diphenhydramine, oxybutynin, and diazepam are all strongly anticholinergic or CNS-depressant agents listed as potentially inappropriate in older adults per Beers Criteria.
An MTM pharmacist is performing a medication reconciliation for a patient transitioning from hospital to home. The patient's discharge medication list includes warfarin 5mg daily, but the pharmacist's pre-admission record shows the patient was on warfarin 2.5mg daily. The most appropriate next step is:
Answer: Contact the discharging physician to determine if the dose change was intentional
A dosage discrepancy between pre-admission and discharge records for a high-alert medication like warfarin requires immediate prescriber clarification to prevent harm.
A CCP reviewing a patient's anticoagulation therapy notes the patient is on apixaban for atrial fibrillation but also takes clarithromycin for a respiratory infection. The pharmacist should be MOST concerned about:
Answer: Increased apixaban exposure due to combined P-gp and CYP3A4 inhibition
Clarithromycin inhibits both P-glycoprotein and CYP3A4, the primary elimination pathways for apixaban, leading to significantly increased apixaban exposure and bleeding risk.
Which of the following outcomes is MOST directly aligned with the goals of an MTM program as defined by the Medicare Prescription Drug, Improvement, and Modernization Act (MMA)?
Answer: Optimizing therapeutic outcomes and reducing adverse drug events
The MMA established MTM programs to optimize therapeutic outcomes for targeted beneficiaries and reduce the risk of adverse drug events.