MTM Renal Dosing & Adjustments 3

Question 1

A patient with stage 4 CKD (CrCl 20 mL/min) is started on enoxaparin for DVT treatment. What is the recommended dosing adjustment?

Accepted Answer

Reduce dose to 1 mg/kg once daily

Answer

For CrCl < 30 mL/min, enoxaparin DVT treatment dose is reduced to 1 mg/kg subcutaneously once daily.

Question 2

Which of the following describes the 'drug interval extension' strategy for renal dosing adjustments?

Accepted Answer

Giving the same dose at longer intervals

Answer

Interval extension maintains the same dose size but increases the time between doses to compensate for slower elimination.

Question 3

A patient on peritoneal dialysis requires antibiotic therapy for peritonitis. Which route of administration is preferred?

Accepted Answer

Intraperitoneal

Answer

Intraperitoneal antibiotic administration delivers drug directly to the site of infection in peritoneal dialysis patients.

Question 4

Dabigatran is contraindicated in patients with CrCl below what threshold due to risk of bleeding?

Accepted Answer

30 mL/min

Answer

Dabigatran is contraindicated when CrCl < 30 mL/min because 80% is renally eliminated, leading to dangerous drug accumulation.

Question 5

Which pharmacokinetic parameter determines how much drug is removed by hemodialysis?

Accepted Answer

Both volume of distribution and protein binding

Answer

Drugs with low protein binding and small volume of distribution are most readily removed by hemodialysis.

(MTM) Medication Therapy Management Certification for Pharmacists Practice Test