Practice Test Geeks(MTM) Medication Therapy Management Certification for Pharmacists Practice Test
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Specialty Medication Management 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 Specialty Medication Management flashcards as text

  1. A patient on cyclosporine for organ transplant is prescribed fluconazole for a vaginal yeast infection. What is the MTM pharmacist's BEST action?

    Answer: Alert the prescriber: fluconazole inhibits CYP3A4 and can cause significant cyclosporine toxicity; suggest topical antifungal instead

    Fluconazole strongly inhibits CYP3A4, significantly increasing cyclosporine levels and risk of nephrotoxicity; a topical antifungal is safer.

  2. Which specialty medication for hepatitis C requires genotype testing before prescribing to confirm efficacy?

    Answer: Elbasvir/grazoprevir (Zepatier) — effective for genotypes 1 and 4 only

    Elbasvir/grazoprevir is indicated only for HCV genotypes 1 and 4, making genotype testing essential before prescribing.

  3. A pharmacist identifies that a patient on mycophenolate mofetil (CellCept) has been started on cholestyramine. What is the clinical concern?

    Answer: Cholestyramine binds to mycophenolic acid in the gut, reducing its absorption and potentially leading to transplant rejection

    Cholestyramine interrupts enterohepatic recirculation of mycophenolic acid, significantly reducing drug exposure and risking organ rejection.

  4. A patient on vedolizumab (Entyvio) for Crohn's disease asks if they can receive live vaccines. What is the appropriate counseling?

    Answer: Live vaccines are contraindicated; inactivated vaccines are preferred

    Although vedolizumab is gut-selective, live vaccines are contraindicated in immunocompromised patients on biologics due to risk of vaccine-induced infection.

  5. During MTM, a patient on enzalutamide (Xtandi) for prostate cancer is noted to be on warfarin. What is the major drug interaction?

    Answer: Enzalutamide induces CYP3A4 and CYP2C9, reducing warfarin exposure and INR

    Enzalutamide is a potent CYP3A4 and CYP2C9 inducer, significantly reducing warfarin levels and requiring close INR monitoring with possible dose increases.

  6. A patient on ustekinumab (Stelara) for psoriasis develops signs of bacterial pneumonia. What key drug safety consideration applies?

    Answer: Ustekinumab should be withheld during active serious infection and restarted only after resolution

    Biologic therapy including ustekinumab should be withheld during active serious infections and resumed only after clinical resolution to minimize infection risk.

  7. Which specialty medication for pulmonary arterial hypertension (PAH) requires a mandatory REMS program due to teratogenicity?

    Answer: Ambrisentan (Letairis) via the Letairis REMS program

    Ambrisentan carries a black box warning for teratogenicity and is available only through the Letairis REMS program requiring monthly pregnancy tests.