MTM Specialty Medication Management 2

Question 1

A patient on adalimumab for rheumatoid arthritis develops a positive QuantiFERON-TB Gold test before therapy initiation. What is the appropriate MTM intervention?

Accepted Answer

Initiate latent TB treatment with isoniazid for 9 months before starting adalimumab

Answer

Latent TB must be treated (typically 9 months of isoniazid) before initiating TNF inhibitors like adalimumab to prevent reactivation.

Question 2

Which monitoring parameter is MOST critical when initiating sacubitril/valsartan (Entresto) in a heart failure patient already on an ACE inhibitor?

Accepted Answer

Serum potassium and renal function after a 36-hour washout period

Answer

A 36-hour washout of ACE inhibitors is required before starting sacubitril/valsartan to prevent life-threatening angioedema due to bradykinin accumulation.

Question 3

A patient taking lenalidomide for multiple myeloma asks about pregnancy prevention. What is required per the REMS program?

Accepted Answer

Two forms of contraception plus monthly pregnancy testing and counseling enrollment in RevAssist

Answer

RevAssist REMS requires two forms of contraception and monthly pregnancy testing for females of reproductive potential due to severe teratogenicity.

Question 4

When counseling a patient on oral anticoagulation with rivaroxaban who also takes omeprazole, which interaction concern is MOST clinically relevant?

Accepted Answer

Rivaroxaban 20 mg must be taken with the evening meal; omeprazole has no significant interaction

Answer

Rivaroxaban 20 mg must be taken with the evening meal to maximize bioavailability; omeprazole does not significantly alter rivaroxaban pharmacokinetics.

Question 5

A pharmacist performing MTM for a patient on clozapine identifies an ANC of 800 cells/µL. What action is required?

Accepted Answer

Immediately discontinue clozapine and notify the prescriber

Answer

An ANC below 1000 cells/µL mandates immediate discontinuation of clozapine per REMS requirements due to risk of severe neutropenia/agranulocytosis.

(MTM) Medication Therapy Management Certification for Pharmacists Practice Test

(MTM) Medication Therapy Management Certification for Pharmacists Practice Test

MTM Specialty Medication Management 2