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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

  1. A pharmacist is working with a 65-year-old patient who has been prescribed both an ACE inhibitor and an ARB for diabetic nephroprotection. Based on current evidence, the pharmacist should recommend:

    Answer: Discontinue the ARB — dual RAAS blockade increases hyperkalemia and AKI risk without added benefit

    Clinical trials (ONTARGET) demonstrated that dual ACE inhibitor plus ARB therapy increases adverse events (hyperkalemia, AKI) without improved cardiovascular or renal outcomes.

  2. A consultant pharmacist is conducting an MTM session with a patient on clozapine. Which monitoring parameter is absolutely mandatory and must be tracked through the REMS program before each dispensing?

    Answer: Absolute neutrophil count (ANC)

    Clozapine's REMS program (CPMRS) requires mandatory ANC monitoring before each dispensing due to the risk of life-threatening agranulocytosis.

  3. During a structured medication review, a pharmacist notes a patient on lithium also recently started ibuprofen for knee pain. The clinical concern is that NSAIDs can:

    Answer: Increase lithium levels by reducing renal clearance, risking toxicity

    NSAIDs reduce prostaglandin-mediated renal blood flow, decreasing lithium clearance and elevating serum lithium levels to potentially toxic concentrations.

  4. A pharmacist is documenting a CMR for a patient who is adherent to all medications, has well-controlled chronic conditions, and has no identified drug therapy problems. The appropriate action is:

    Answer: Document findings, acknowledge positive adherence, and schedule the next CMR per program timeline

    Even when no drug therapy problems are identified, the pharmacist must document the CMR findings, reinforce adherence, and schedule the next review per program requirements.

  5. A patient with heart failure with reduced ejection fraction (HFrEF) is on optimal guideline-directed therapy but continues to have fluid retention. The MTM pharmacist notes the patient is also taking a thiazolidinedione (pioglitazone) for type 2 diabetes. The recommendation should be:

    Answer: Recommend discontinuing or switching pioglitazone, as TZDs cause sodium and water retention that worsens HF

    Thiazolidinediones cause sodium and water retention and are contraindicated in patients with NYHA Class III-IV HF and strongly discouraged in all HFrEF patients.

  6. In assessing medication appropriateness in elderly patients, the Medication Appropriateness Index (MAI) evaluates prescriptions across how many criteria?

    Answer: 10

    The MAI uses 10 criteria to assess prescription appropriateness, including indication, effectiveness, dosage, directions, drug-drug interactions, drug-disease interactions, practicality, cost, and duplication.

  7. A CCP receives a report that a long-term care patient on a fentanyl patch has had two falls this month. The pharmacist's medication-focused assessment should FIRST prioritize:

    Answer: Reviewing the full medication list for CNS depressants, anticholinergics, and orthostatic hypotension-inducing agents

    Falls in elderly patients are frequently medication-related; the pharmacist must assess the full regimen for CNS depressants, anticholinergics, and blood pressure agents that contribute to fall risk.