MTM Anticoagulation Management 3

Question 1

A patient with acute PE is found to have antiphospholipid syndrome (APS). Which anticoagulant strategy is preferred for long-term management?

Accepted Answer

Warfarin with target INR 2–3

Answer

Warfarin remains the preferred anticoagulant for APS because DOACs have been associated with higher rates of arterial thromboembolism in this population.

Question 2

When monitoring unfractionated heparin (UFH) therapy using anti-Xa levels, what is the therapeutic target range for treatment of VTE?

Accepted Answer

0.5–1.0 units/mL

Answer

The therapeutic anti-Xa range for UFH treatment of VTE is 0.3–0.7 units/mL (some guidelines specify 0.3–0.7 or up to 1.0 units/mL depending on the protocol).

Question 3

A 72-year-old patient with non-valvular atrial fibrillation has a CHA₂DS₂-VASc score of 2. What is the recommended anticoagulation approach?

Accepted Answer

Oral anticoagulation is recommended

Answer

A CHA₂DS₂-VASc score ≥2 in males (or ≥3 in females) indicates high stroke risk and warrants oral anticoagulation therapy.

Question 4

Which of the following is a contraindication to the use of fondaparinux?

Accepted Answer

Severe renal impairment (CrCl <30 mL/min)

Answer

Fondaparinux is contraindicated in severe renal impairment (CrCl <30 mL/min) due to drug accumulation and excessive bleeding risk.

Question 5

A pharmacist reviews a patient's medication list and notes they are on warfarin plus amiodarone started 3 months ago. The INR is now 4.8. What best explains this interaction?

Accepted Answer

Amiodarone inhibits CYP2C9 and CYP3A4, reducing warfarin clearance

Answer

Amiodarone inhibits CYP2C9 and CYP3A4, reducing warfarin metabolism; because amiodarone has a very long half-life, this interaction can persist for months after drug initiation.

(MTM) Medication Therapy Management Certification for Pharmacists Practice Test

(MTM) Medication Therapy Management Certification for Pharmacists Practice Test

MTM Anticoagulation Management 3