Managing Drug Interactions with Direct Oral Anticoagulants

Course #95011 - $15-


Self-Assessment Questions

    1 . Which is important to keep in mind regarding drug transporter systems (e.g., P-glycoprotein [P-gp])?
    A) These proteins can affect pharmacokinetics.
    B) Breast cancer resistance protein moves drugs into the liver.
    C) Most available data are related to organic anion transporting polypeptides.
    D) It is rare for medications to impact P-gp and CYP450.

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    2 . Which drug transport system has the most available data related to its effects on drug pharmacokinetics?
    A) BCRP
    B) MATEs
    C) OATPs
    D) P-gp

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    3 . Which pair of direct oral anticoagulants are significantly metabolized by CYP3A4?
    A) Apixaban and dabigatran
    B) Edoxaban and rivaroxaban
    C) Apixaban and rivaroxaban
    D) Edoxaban and dabigatran

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    4 . Which of the following medications is a strong inhibitor of CYP3A4?
    A) Nafcillin
    B) Oxcarbazepine
    C) Rifabutin
    D) Voriconazole

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    5 . Which of the following medications is a strong inducer of P-gp?
    A) Amiodarone
    B) Diltiazem
    C) Erythromycin
    D) Phenytoin

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    6 . Which medication is most likely to decrease levels of a DOAC and increase thrombosis risk?
    A) Rifampin
    B) Ritonavir
    C) Ranolazine
    D) Famotidine

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    7 . Which of the following medications is most likely to raise levels of a direct oral anticoagulant (DOAC) and increase bleeding risk?
    A) Itraconazole
    B) Levofloxacin
    C) Phenytoin
    D) Famotidine

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    8 . Which of the following statements regarding DOAC interactions with nirmatrelvir/ritonavir is TRUE?
    A) All DOACs should be held during treatment with nirmatrelvir/ritonavir.
    B) Nirmatrelvir/ritonavir may be a concern with DOACs because it inhibits CYP3A4 and P-gp.
    C) DOAC doses should generally be increased during treatment with nirmatrelvir/ritonavir.
    D) Nirmatrelvir/ritonavir may be a concern with DOACs because it induces CYP1A2 and P-gp.

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    9 . What is advised for patients receiving apixaban for venous thromboembolism treatment if a strong CYP3A4 and P-gp inducer is required?
    A) Reduce the apixaban dose by 50%.
    B) Change apixaban to rivaroxaban.
    C) Change apixaban to warfarin.
    D) Continue apixaban at the standard dose.

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    10 . What is generally advised for patients receiving apixaban for stroke prevention in atrial fibrillation and aspirin for cardiovascular primary prevention?
    A) Continue apixaban and aspirin.
    B) Stop aspirin.
    C) Change aspirin to clopidogrel.
    D) Reduce the apixaban dose by 50%.

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