Pharmacy PEBC Practice Exam

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A patient is receiving warfarin (using 2 mg tablets in compliance packaging) according to the following regimen: Sunday (Su), Tuesday (Tu), Thursday (Th) and Friday (F) - 6 mg, Monday (M), Wednesday (W) and Saturday (Sa) - 2 mg. The patient’s recent INR results have been consistently high and it is decided that the weekly dose should be reduced by 20%. Which of the following regimens would be most appropriate if the patient is to continue using 2 mg tablets in compliance packaging?

  1. Su, Tu, F - 5 mg; M, Th - 3 mg; W, Sa - 1 mg

  2. Su, M, Tu, W, Th, F - 4 mg; Sa - no warfarin

  3. 4 mg daily

  4. 3.5 mg daily

The correct answer is: Su, M, Tu, W, Th, F - 4 mg; Sa - no warfarin

Explanation The original regimen prescribed 6 mg on Su, Tu, Th, and F (total of 4 doses) and 2 mg on M, W, and Sa (total of 3 doses). However, switching to a daily dose (option C or D) would result in a higher total weekly dose than what the patient was originally taking. On the other hand, Option A would still result in a higher total weekly dose, as the reduced amounts on Su, Tu, Th and F would be partially offset by the increased amounts on M and W. Therefore, Option B would be most appropriate as it maintains the same total weekly dose as the original regimen while reducing the individual dose amounts on each day. It also ensures that the patient continues to take warfarin on all 7 days of the week.

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