NAPLEX (North American Pharmacist Licensure Examination) Practice Exam

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For what condition is DOACs NOT the preferred medication over Warfarin?

Stroke prevention
VTE treatment
Moderate-to-severe mitral valve stenosis
CAD

The correct answer is: Moderate-to-severe mitral valve stenosis

DOACs, or direct oral anticoagulants, are a newer class of medications used for blood thinning and preventing blood clots. They are often preferred over Warfarin because they have fewer interactions with other medications and do not require frequent lab monitoring. However, in patients with moderate-to-severe mitral valve stenosis, DOACs should not be used as they may increase the risk of blood clots forming in the heart due to the uneven blood flow caused by the stenosis. Warfarin, with its ability to maintain a stable level of thinning in the blood, may be a better option in this case. Therefore, for this specific condition, DOACs are not the preferred medication.