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 in a long-term care facility reviews a patient's record and notes that the patient has been on an antipsychotic for 'agitation' without a documented diagnosis of a psychiatric condition or a quarterly review. Under OBRA-87 regulations, the appropriate action is:
Answer: Recommend gradual dose reduction and document the rationale for use or discontinuation
OBRA-87 requires that antipsychotics in long-term care have documented indications, and facilities must attempt gradual dose reductions unless clinically contraindicated.
A patient with stage 3 CKD (eGFR 35 mL/min) is currently prescribed metformin 1000 mg twice daily. According to current FDA labeling, the pharmacist should recommend:
Answer: Dose reduce metformin and reassess if eGFR falls below 30 mL/min, then discontinue
FDA recommends reassessing renal function and considering dose reduction when eGFR is 30-45 mL/min, with contraindication below eGFR 30 mL/min.
During an MTM session, a pharmacist identifies that a patient on chronic opioid therapy for cancer pain is not receiving a scheduled bowel regimen. Which approach best addresses this drug therapy problem?
Answer: Recommend a stimulant laxative such as senna as first-line prophylaxis
Stimulant laxatives (e.g., senna) are first-line prophylaxis for opioid-induced constipation because opioids reduce gut motility via mu-receptor activation.
A pharmacist performs a medication review for an 82-year-old patient on warfarin, aspirin 81mg, and newly started celecoxib. The primary concern regarding this combination is:
Answer: Concurrent use increases GI bleeding risk despite celecoxib's COX-2 selectivity
Even COX-2 selective NSAIDs like celecoxib increase GI bleeding risk when combined with warfarin and aspirin, especially in elderly patients.
In MTM practice, the STOPP (Screening Tool of Older Persons' Prescriptions) criteria differ from Beers Criteria primarily in that STOPP:
Answer: Includes criteria based on clinical indication and drug-drug interactions, not just drug-class avoidance
STOPP criteria incorporate clinical context, diagnosis, and drug-drug interactions, making them more indication-based compared to the Beers Criteria drug-class approach.
A CCP is advising a managed care organization on quality metrics. Medication adherence for which class of drugs is MOST commonly measured as a Part D Star Ratings quality measure?
Answer: Statins, RAS antagonists, and oral diabetes medications
CMS Part D Star Ratings specifically measure adherence to statins, renin-angiotensin system (RAS) antagonists, and oral diabetes medications as Triple Weighted measures.
A pharmacist identifies that a patient's antihypertensive medication (amlodipine) is listed in the pharmacy records but does NOT appear on the patient's self-reported medication list. The most appropriate classification of this discrepancy is:
Answer: Omission error — the medication was excluded from the patient's self-reported list
A medication present in the dispensing record but absent from the patient's own list constitutes an omission error in the medication reconciliation process.