An 85-year-oia patient who has several disease conditions and is enrolled in Medicare Part D presents to a pharmacy to refill prescriptions After reviewing the patient's medication vials to provide refills, the pharmacist realizes that, even though the refills are due. many of the vials are still half full with medication Which Initial reaction by the pharmacist lo this observation would be BEST?

During an MTM session the pattern reveals being currently treated with ifosfamind ana complains of symptoms that suggest severe central nervous system toxicity. Which agent should be used to counter this effect'

When conducting a comprenensive medication review. whichquestion would De MOST appropriate for a pharmacistto ask to assess the patient's healthliteracy associated with reading instructions, pamphlets. and other written material from a physician?

A newly diagnosed epilepsy patient with few episodes or focal onset seizures in the past week presents to the pharmacy with a new prescription for a carbamazepine ER 200mg once daily The patent has an ongoing diagnosis of bipolar disorder and a history of migraines and takes valproic acid 750mg in divided doses daily.
Which one of the following severe and RARE side effects should the pharmacist discuss with the patient?

A patient presents to his scheduled appointment Tor face-to-face MTM with a pharmacist. The patient has a list of personal medications and bottles of over-the counter herbal supplements Upon review ol the entire medication checklist the pharmacist wants to educate the patient on managing the drug interaction that was found between warfarin and SI John's won supplement What would be the BEST approach to guide the patient in managing the drug interaction?