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When you are completing a medication reconciliation using the medication lists above, what are some concerns regarding FP’s medication list?

A. Drug−drug interaction between lisinopril and alendronate

B. Drug−drug interaction between ranitidine and pantoprazole

C. No indication for alendronate in the patient’s past medical history

D. Patient is not taking any medications for the treatment of GERD

Correct answer: C

Rationale: Technically, there is no indication for alendronate on this patient’s profile. Because of her age and the fact that she is a woman, it is likely that she does have osteoporosis, but this should be documented in the chart. There is no drug–drug interaction between lisinopril and alendronate so option A is incorrect. There is no drug–drug interaction between ranitidine and pantoprazole so option B is incorrect. The patient is on multiple medications for GERD; therefore, option D is incorrect.

You arrive at FP’s home to go over her medication regimen and you ask her family members to participate in the discussion. FP’s daughter reports that her mother frequently requests refills on her alendronate, but they are often too early to refill the prescription through the insurance at the pharmacy. FP’s daughter does not understand what the issue is since her mother is taking this medication daily as instructed by her previous PCP. What concerns do you have regarding FP’s attempt at refilling her alendronate too soon?

A. FP cannot afford to pay the out-of-pocket/cash price of alendronate

B. FP is not taking her medication at all, putting her at higher risk of fractures

C. FP is taking alendronate more frequently than prescribed, putting her at an increased risk of adverse drug events

D. FP suspects that her stomach issue is getting worse, and decides to increase her dose of alendronate to protect her stomach

Correct answer: C

Rationale: It is assumed that FP is running out of medication early by taking it more often than prescribed, because every time she refills her prescription, it is too early. Although option A may be appropriate since the patient can pay out of pocket for the medication if it is not covered through insurance, the prescription should not be refilled if the patient is taking this medication incorrectly. Option B is incorrect because it states that FP is not taking her medication at all; however, according to the daughter, she is taking the medication. Option D is incorrect as there is no ...

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