Block I - Prescribing Issues and Drug Info

Question 1

Rational prescribing

Answer 1

Make specific dx -> Consider pathophys (helps pt make links to tx) -> Select specific therpeutic objective -> Select drug of choice -> Determine appropriate dosing regimen (consider pharmacokinetics of pt) -> Devise monitoring plan and determine end point of therapy (helps adherence) -> plan pt education program

Question 2

Pros/cons: PDR

Answer 2

Package inserts; no off-label use

Question 3

Pros/cons: Micromedex

Answer 3

Collection of many drug databases.

Question 4

Define dispensing

Answer 4

Giving meds directly to pt at a clinic

Question 5

Off-label use

Answer 5

Using drug for non-FDA approved use. May be substantial research and evidence regarding off-label use, but should only be used under strict scrutiny from provider.

Question 6

Reducing medication errors

Answer 6

Dictation errors (sound alike), lack of knowledge (wrong drug), dose calculation error, decimal point placement, wrong dosage form, wrong frequency, use of nonapproved abbreviations, overlooked drug interactions, failure to adjust for patient in renal failure, incomplete pt hx (didn’t recognize allergy).

Question 7

Preventing forgery

Answer 7

Controlled substance = write out dispensed quantities; don’t always include DEA number; using watermarked, heat-sensitive paper.

Question 8

Schedule I

Answer 8

Illegal; high potential for abuse; no accepted medical use (ya know… except Mary Jane)

Question 9

Schedule II

Answer 9

High potential for abuse; accepted medical use; abuse may lead to severe psychological and/or physical dependence; cannot be refilled; must be written and signed

Question 10

Schedule III

Answer 10

Potential for abuse less than C-II; accepted medical use; abuse may lead to moderate psychological and/or physical dependence; may be refilled 5 times in 6 months; may be written or verbal

Question 11

Schedule IV

Answer 11

Low potential for drug abuse compared to other schedules; accepted medical use; abuse may lead to limited psychological and/or physical dependence; may be refilled 5 times in 6 months; may be written or oral

Question 12

Schedule V

Answer 12

Low potential for drug abuse compared to other schedules; accepted medical use; abuse may lead to limited psychological and/or physical dependence; limits on refills not as strict.

Question 13

Black box warning

Answer 13

Warn clnician and pt of special drug problems leading to death or serious injury. Provider needs to communicate black box warnings to pt to determine if benefits outweigh risks; monitoring provided as needed.