MTM Behavioral Health Pharmacotherapy 5

Question 1

An MTM pharmacist is counseling a patient on valproate for bipolar disorder who is considering pregnancy. What is the most critical concern?

Accepted Answer

Valproate is a known teratogen causing neural tube defects and cognitive impairment

Answer

Valproate is a category X teratogen associated with neural tube defects (spina bifida), cognitive impairment, and autism spectrum disorder; alternative mood stabilizers should be considered in reproductive-age women.

Question 2

Which receptor mechanism explains why mirtazapine causes sedation and weight gain as side effects?

Accepted Answer

Histamine H1 receptor antagonism

Answer

Mirtazapine's potent histamine H1 antagonism is responsible for its sedating and appetite-stimulating (weight gain) side effects, which can be beneficial in depressed patients with insomnia and weight loss.

Question 3

A patient with schizophrenia refuses oral antipsychotics due to nonadherence history. Which formulation would best address long-term adherence?

Accepted Answer

Long-acting injectable antipsychotic

Answer

Long-acting injectable (LAI) antipsychotics (e.g., paliperidone palmitate, aripiprazole lauroxil) are given every 4–12 weeks and are the preferred option for patients with known nonadherence to oral medications.

Question 4

Which medication used for alcohol use disorder works by causing an aversive reaction (flushing, nausea, tachycardia) when alcohol is consumed?

Accepted Answer

Disulfiram

Answer

Disulfiram inhibits aldehyde dehydrogenase, causing accumulation of acetaldehyde when alcohol is consumed, producing an unpleasant aversive reaction that deters drinking.

Question 5

A patient on fluoxetine is prescribed tramadol for pain. What pharmacokinetic interaction is most concerning?

Accepted Answer

Fluoxetine inhibits CYP2D6, reducing tramadol's conversion to active analgesic metabolite and increasing serotonin syndrome risk

Answer

Fluoxetine inhibits CYP2D6, reducing tramadol conversion to O-desmethyltramadol (active metabolite), decreasing analgesia; additionally, both drugs are serotonergic, increasing serotonin syndrome risk.

(MTM) Medication Therapy Management Certification for Pharmacists Practice Test

(MTM) Medication Therapy Management Certification for Pharmacists Practice Test

MTM Behavioral Health Pharmacotherapy 5