822 Final Flashcards
What is the omnibus budget reconciliation act of 1990?
It mandated the offer to counsel and the provision of certain information to medicaid patients
What are the three non-negotiable steps to ensure patient care when counseling?
Introduction
Patient verification
Medication verification
What are the three prime questions?
(Use) What is this medication used for?
(Directions) How much and how often do you take this medication
(Other important info) What else do you know about this medication / What possible side effects did the doctor talk about
Is asking a patient if they need to counsel with a pharmacist law?
Yes, its provided that you ask
What are generic drugs?
Chemically equivalent, lower cost versions of brand-name drugs
How much cheaper are generics compared to brand names?
Usually 30-80% cheaper
What % of medication is filled as a generic?
90% of medication filled is generic
What are some of the key points to ensure that the generic product is the same?
Active ingredient, dosage form, safety profile, strength, route of administration, quality, stability, purity, performance characteristics, intended use
What are some differences in generic drugs?
Shape / Apperance
Scoring configuation
Packaging
Excipients (color, flavors, preservatives)
Expiration time
What is the orange book?
An FDA approved book that lists the approved drug product with therapeutic equivalence evaluations (Halloween = orange book)
What makes a drug therapeutically equivalent?
Pharmaceutical equivalence + Bioequivalence
TE codes? AB1?
First letter indicates the therapeutic equivalence
second letter indicates the dosage form
three characters are only equivalent to the other drugs with the same 3 code
What are some NTI (narrow therapeutic index) drugs?
Warfarin, Dilantin, Synthroid, Lanoxin
Medicaid is….?
A state funded program
Low income families
Most rx is covered and some OTC
What is medicare?
Federally funded program
Elderly patients
What does part A medicare cover?
Hospital
What does part B medicare cover?
Outpatient, some meds
What does part C medicare cover?
Advantage, deductible coverage, increasing Rx coverage
What does medicare part D cover?
prescription drug coverage which covers 48 million americans
Part D plans switch what medications they cover all the time
What is required by law to be on a phone in prescription?
Patient name
Patient address
Drug name
Strength or size
Quantity
Directions
Date issued
Prescribers name
2 Helpful techniques when getting a phone in prescription
Interruption technique
Echo-back technique
What is a statute?
A written law enacted by the legislature
What is a regulation?
A rule having the force of law issued by an administrative agency
Who are the 4 legal prescribers in the US
Physicians (MD or DO)
Dentists (DDS or DMD)
Podiatrists (DPM)
Vertrinarians (DVM)
Who are 4 other MID-LEVEL practitioners
Optometrist (OD)
Advanced practiced registered nurse (APRN)
Physician assistant (PA)
Pharmacists (RPh)
What are legend drugs
Drugs that require a prescription
What are non legend drugs?
OTC over the counter
BTC behind the counter
Medical devices
Medical food
What are the two OTC products with special rules?
Pseudoephedrine
Syringes
What do the numbers mean in a sig code?
First 5 identify the manufacturer
Next 4 identify the strength, dosage form, and formulation
Last 2-3 numbers identify the package size assigned by the manufacturer
What are the 5 schedule medications (CS) controlled substance
Schedule 1: no medical use, unsafe, highest potential abuse
Schedule 2: medical use, high potential abuse, highly addictive
Schedule 3: medical use, medium abuse and addiction potential
Schedule 4: medical use, low-medium abuse and addiction potential
Schedule 5: limited abuse potential, and / or physical or psychological dependance
How to know if a DEA number is legit
1st + 3rd + 5th number =x
2nd + 4th + 6th number = y
y x 2 = z
z + x = the last number of the DEA code
What do the letters in a DEA number mean?
The first letter is the scope of practice
Second number is the first letter of the last name
What is an NPI number?
A unique verification number for covered health care providers
A 10 diget numeric identifier
Must be used in HIPPA standard transactions
Is there any limitations when prescribing opioids?
Theres a 7 day max supply for
Patients first time being prescribed opioids
Children under 18 years old
Animals
(Dosen’t apply to cancer patient, palliative care, treatment for substance use disorder, or if in prescribers professional judgement they need more than a 7 day supply)
Can a C-II medication be prescribed from a faxed Rx?
No, can only be dispensed from an e-Rx or electronic
New law for all controlled substances starting January 1st 2022
All controlled substance medication in Indiana must be an e-Rx
Additional security requirements for controlled substances
Prescribers address
Prescribers DEA#
Dosage form
No advertisements
Prescription expiration and refill information
C-II medication expires no later than a year from issued date, no refills
C-III, C-IV, and C-V expire no later than 6 months from issue date, 5 refills maximum
Limitations on transferring a medication
Non-controlled medication, no limits
C-III, C-IV, C-V once in 6 months since date Rx was issued, multiple times if its in the same store only after its been filled once
What are the two signature lines at the bottom of a prescription say
Dispense as written
May substitute
What is the swiss cheese model?
A way to ensure the saftey of the patient when picking up a medication
Similar to SCHOLAR what is MAC?
Medication use (OTC and Rx)
Allergies
Coexisting conditions
Know when to refer these patients as well
What is ISMP?
Institute of Safe Medical Practices
A private entity focued on increasing. saftey of healthcare practice through documentation of how/way medication errors occur to help develop better practice
FDA medwatch?
A government agency interested in product failures and serious adverse effects like medical devices, medical food, and all types of medication
