Assisting the pharmacist Flashcards
in ambulatory pharmacy, what are PT responsible for? (8)
processing prescriptions/data entry, checking accuracy, refilling prescriptions, working with 3rd party/insurance, filling orders, customer service, administrative tasks, organization
in a hospital, what is the PT responsible for? (7)
preparing IV admixtures, prepping meds, delivering meds to nursing floors, filling dispensing systems, communicating with doctors/nurses, administrative, unit-dosing meds
what is an ambulatory setting pharmacy
patients can walk to get to the pharmacy
what is the ambulatory pharmacy workflow
greeting patient > data entry > dispensing > verification > release
all hard copies of prescriptions must be kept for ___ years
2
what is included in the hard copy of a prescription (7)
patient - 4
prescriber - 5
patient name/phone/address/DOB
prescriber name/address/phone/signature/DEA
date prescription written
med strength/quantity/dose/dosage form
administration route
signa/directions
refill info
controlled substances must be signed by ___ and not the PA/NP
physician
C6 meds expire a year after written date
C2
C3-C4
C2 = filled only once (no refill)
C3-4 = 6 months after written
true or false
PT can transfer meds from different pharmacies
false - only pharmacist
NKA means
no known allergies written on prescriptions
when looking for forged prescriptions, look for (5)
handwriting, signatures, quantities/refill looks altered, looks copied, different pen colors
when transferring prescriptions from another pharmacy, we need (9)
patient name/address/phone/DOB/allergies/insurance
previous pharmacys phone
prescription # & drug
when transferring prescriptions from another pharmacy, we need (9)
patient name/address/phone/DOB/allergies/insurance
previous pharmacys phone
prescription # & drug
(dose, strength, quantity, fill date, refills, directions, physicians name obtained by pharmacist)
C3-C5 controlled substances can be transferred between pharmacies how many times
once
what are therapeutic duplications
drugs in same drug class with same functions prescribed
what are special considerations added to a patients profile (2)
anything restricting patient such as arthritis preventing opening of a bottle or language restriction
what is medication therapy management (MTM) (4)
pharmacists review patients medication history to check for compliance with taking medication, therapeutic duplications, patient counseling , and inconsistencies in drug therapy
who is medicare for? (4)
65+, youngers blind, widowed, disabled due to long-term illness
what do each part of medicare cover? ABCD
A - hospital services/inpatient
B - doctors appointments/outpatient
C - medicare advantage plans
D - prescription drugs
who is TRICARE for
servicemen and veterans
for formularies, (list of drugs approved by insurance) what are 1st, 2nd, 3rd tier drugs?
1 - generic, copay lowest
2 - preferred brands
3 - non-formulary drugs, highest copay
who is medicaid for? (4)
income below poverty level, blind, disabled, members of family with children only supported by one parent (and financially eligible)
what are daw codes? What is 0-9?
-when doctor/patient prefers brand drugs over generic
0 = no instructions, generic okay
1 = no substitution by prescriber, brand necessary
2 = patient prefers brand
3 = pharmacist chose brand
4 = generic not in stock, substitution okay
5 = brand name dispensed at generic price
6 = override code
7 = brand dictated by law
8 = generic not available
9 = other
what is the grace period allowed by insurance companies to refill
5-7 days
step therapy
when insurance companies require patients to use first-line drug before others
what are some reasons for claim reject? (7)
expired coverage, invalid PI, quantity exceeds limit, refill too soon, prescriber not covered, NDC not covered, PA required
reimbursement in the ambulatory setting is done as ___ (2)
retrospective payment or fee for service
what is WAC & AMP
wholesale acquisition cost = the price manufacture sells to the wholesaler
average manufacturers price = price paid to manufacturers from wholesalers to distribute to pharmacies
examples of health insurance fraud (5)
billing for services not rendered
altering monetary amount on claims
leaving important information off claim
using another persons insurance card
billing for duplicate payment
READ what is on a pharmacy label (15)
patient name & address
date of fill and refill
original prescription date
expiration date
order number
drug manufacturer & NDC
name, dose, dosage strength
dispense quantity
signa/sig code
# refills
pharmacy name, address, phone
initials of pharmacist verifying prescription
initials of PT entered prescription into system
auxiliary labels
What 3 things does the NDC # tell? Which section must be the same for generic substitutions? Which section must be the same for it to be the same medication?
-manufacturer, product, package size (quanitity)
-first section/labeler/manufacturer must be the same
-second section/product code must be the same
1 dram = ___ oz
1/8 oz
which act ruled that caps must be chilproof
poison prevention packaging act of 1970
what is DUR (6)
drug utilization review = alerts of therapeutic duplications, drug-disease contraindications, incorrect dosage, incorrect duration of treatment, drug allergies, drug misuse
what are PT monthly (not daily) tasks in an ambulatory pharmacy
cycle counts (counting meds), checking expiration dates
what is the 3040B program
federal law that reduces costs of medication by having drug manufacturers give discounts to hospital in return for using their medication
the ___ alerts nurses as to when the medication needs to be administered
medication administration record - MAR
what information must medication orders in hospitals contain? (9)
patient name, weight, height, allergies, DOB, medical conditions,
medical #,
hospital room #, nursing unit floor
dosage form, strength of drug
drug schedule
preparation instructions
route of administration
directions for use
For IVs: concentration & base solution
CATH
cardiac catheterization lab
CCU
coronary cardiac care unit
ED or ER
emergency room
ENDO
endoscopy
L&D
labor and delivery
MICU
medical intensive care unit
NICU
neonatal intensive care unit
OR
operating room
PACU
post-anesthesia care unit
PEDS
pediatrics
SICU
surgical intensive care unit
TCU
transitional care unit
X-RAY
raidiology
PT prepares enough of a scheduled order to last ___ (time)
24 hours
what is CSP
compound sterile preparations/IV mixtures
where is sterile medication compounded
sterile room
what is central vs decentralized pharmacy
central = where center of pharmacy operations (compounding, med preparation, unit-dosed) occur
decentralized = nursing unit med rooms with automated dispensing machines (where patient specific meds prepared)
in a hospital pharmacy all medications must be ___
unit-dosed (blister packages)
the PT will prepare med for a patient for the next ___ (time)
24 hours
how does a day as a PT in a hospital look like/flow (4)
- print labels for meds needed in the next 24 hours, fill meds, label meds, deliver it to decentralized pharmacy (nursing stations) after pharmacist verifies
- filling meds in automated machines
- fill STAT drugs (drugs needed to be prepared ASAP)
- prepare CSPs
prepped medications are delivered to ___ in a hospital by PTs
nursing unit
PTs check the ___ to see if a patient has been discharged
cencus
why is it good to use pharmacy automation?
improve efficiency and accuracy
investigational new drugs (INDs) must be approved by the ___
FDA
True or false
Record keeping for all INDs is responsible by the PT
true
for both hospitals and ambulatory pharmacies, all prescriptions start with the ___ putting in the order
physicians
narrow therapeutic index (NTI) drugs (4)
drugs that cannot be substituted with generic drugs because small changes in dosages can result in adverse events or therapeutic failure
e.g., carbamazepine, cyclosporine, digoxin, levothyroxine, lithium carbonate, phenytoin, warfarin
therapeutic substitution
the substitution of a prescribed drug with another medication that produces the same therapeutic effect (usually from the same class)
benzodiazepines
drug class prescribed to reduce anxiety and relax muscles (–pam)
e.g., alprazolam (Xanax)
anaphylaxis
life-threatening allergic reaction that requires immediate emergency care
drug-disease interaction
when a medication taken for one disease causes or exacerbates a different disease
