Comprehensive Medication Review & Optimization Flashcards
7 cards from real MTM practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
Read the first 7 Comprehensive Medication Review & Optimization flashcards as text
A CMR reveals a patient with atrial fibrillation and a CHA₂DS₂-VASc score of 3 is not on anticoagulation. This represents which type of drug therapy problem?
Answer: Need for additional drug therapy
A CHA₂DS₂-VASc score ≥2 in men or ≥3 in women warrants anticoagulation; its absence represents a need for additional drug therapy.
During a CMR, a pharmacist discovers that a patient is taking two different NSAIDs concurrently prescribed by two different providers. This represents:
Answer: Therapeutic duplication requiring intervention
Concurrent use of two NSAIDs provides no additional benefit and doubles the risk of GI bleeding, renal injury, and cardiovascular events — a classic therapeutic duplication.
When conducting a brown-bag review during a CMR, which item should the pharmacist ask the patient to bring?
Answer: All prescription medications, OTC drugs, vitamins, herbals, and supplements
A brown-bag review is only comprehensive when it includes ALL medications: Rx, OTC, vitamins, herbals, and dietary supplements.
A patient on simvastatin 80 mg is newly prescribed amlodipine. What is the pharmacist's appropriate action?
Answer: Recommend reducing simvastatin dose to no more than 20 mg/day
Amlodipine inhibits CYP3A4-mediated simvastatin metabolism; FDA recommends a simvastatin dose cap of 20 mg/day with amlodipine to reduce myopathy risk.
Which of the following best describes the difference between a CMR and a TMR in the MTM framework?
Answer: CMR is a comprehensive annual review; TMR targets a specific condition or set of medications
A CMR is a comprehensive annual medication review covering all medications, while a TMR focuses on a specific condition or targeted subset of medications.
A CMR patient is adherent to her antihypertensive but blood pressure remains uncontrolled. After ruling out white-coat effect and medication interactions, what is the most appropriate recommendation?
Answer: Intensify therapy by increasing dose or adding a complementary agent
When a patient is adherent but the therapeutic goal is unmet, the appropriate response is therapy intensification — dose increase or addition of a complementary mechanism.
A pharmacist completes a CMR and identifies five drug therapy problems. In what order should they generally be prioritized?
Answer: By clinical urgency and potential for patient harm
Drug therapy problems are prioritized based on clinical urgency and the potential severity of harm if left unaddressed.