MTM Behavioral Health Pharmacotherapy 2

Question 1

A patient with bipolar I disorder is started on lithium. Which laboratory parameter is most critical to monitor for toxicity?

Accepted Answer

Serum lithium level

Answer

Serum lithium levels must be monitored closely because the therapeutic window is narrow (0.6–1.2 mEq/L) and toxicity occurs at levels above 1.5 mEq/L.

Question 2

Which antipsychotic is most associated with QTc prolongation and requires baseline and periodic ECG monitoring?

Accepted Answer

Ziprasidone

Answer

Ziprasidone is associated with the greatest QTc prolongation among atypical antipsychotics, necessitating ECG monitoring and avoidance with other QTc-prolonging drugs.

Question 3

An MTM pharmacist is reviewing a patient taking sertraline who reports new-onset agitation, tremor, hyperthermia, and diarrhea after adding linezolid. What is the most likely diagnosis?

Accepted Answer

Serotonin syndrome

Answer

Serotonin syndrome presents with the triad of mental status changes, autonomic instability, and neuromuscular abnormalities, and can occur when SSRIs are combined with linezolid (an MAO inhibitor).

Question 4

Which benzodiazepine is preferred in elderly patients due to its lack of active metabolites?

Accepted Answer

Lorazepam

Answer

Lorazepam undergoes direct glucuronidation without producing active metabolites, making it safer in elderly patients whose hepatic function may be reduced.

Question 5

A patient with schizophrenia on clozapine develops an absolute neutrophil count (ANC) of 900 cells/mm³. What is the most appropriate action?

Accepted Answer

Discontinue clozapine immediately

Answer

Per REMS guidelines, clozapine must be discontinued immediately if ANC falls below 1000 cells/mm³ (severe neutropenia) to prevent agranulocytosis.

(MTM) Medication Therapy Management Certification for Pharmacists Practice Test

(MTM) Medication Therapy Management Certification for Pharmacists Practice Test

MTM Behavioral Health Pharmacotherapy 2