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1. The best pharmacokinetic/pharmacodynamic parameter to guide appropriate dosing of factor Xa inhibitors in patients with obesity is:

A. Prothrombin time/international normalized ratio B. Anti-Xa heparin assay C. Thrombin time D. Drug-specific anti-Xa peak/trough

2. Martha is a 56-year-old woman with diabetes, hypertension, and a body mass index (BMI) of 41.2 kg/m². She was initiated on apixaban at a US Food and Drug Administration-approved dose. You assess her drug peak/trough levels and note they are below the targeted range. Considering data accumulated AFTER ISTH guidelines, what would be the MOST appropriate next step in her care?

A. Consider a dose increase B. Consider a dose decrease C. Switch to dabigatran D. Switch her to warfarin

3. Compared with historical controls, all the following DOACs are associated with an increased volume of distribution (V_d) in patients with AF and extreme obesity, EXCEPT:

A. Apixaban B. Dabigatran C. Edoxaban D. Rivaroxaban

4. Which of the DOACs should be used with caution in patients with nonvalvular AF and a BMI greater than 40 kg/m² owing to a higher observed rate of stroke or transient ischemic attack?

A. Apixaban B. Dabigatran C. Edoxaban D. Rivaroxaban

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