Starting a blood thinner for atrial fibrillation
PEBC OSCE practice station
Medicines counselling · 2 min to read · 7 min to perform
Try a real conversation · PEBC OSCEAI practice
Counsel him on his new medicine and answer his questions.
Rajesh NairGood afternoon. My doctor gave me this prescription for a blood thinner and said to pick it up today. I do not really know much about it.
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You are a pharmacist in a community pharmacy. Mr Rajesh Nair, aged 71, brings a new prescription for apixaban 5 mg twice daily after his doctor found atrial fibrillation. He is alone and has never taken a blood thinner. Counsel him on his new medicine and answer his questions. The assessor will not take part in the conversation.
What this station tests
- Always ask about nonprescription products: NSAIDs, aspirin and supplements change bleeding risk.
- Teach specific bleeding signs and say which need 911 and which need a call to the pharmacy.
- Missed-dose advice should follow a Canadian reference. Never suggest doubling.
- Do not let patients stop an anticoagulant for procedures without prescriber input.
- Use teach-back to confirm he can state the routine and the warnings.
Sources for the clinical content
- Thrombosis Canada: apixaban patient information sheet
- Thrombosis Canada: DOACs comparison and frequently asked questions
- Thrombosis Canada: DOACs perioperative management
An original practice scenario with invented patients. Not an exam question.