Drug Use Process and Patient Safety Powerpoint Flashcards
1
Q
What is the Greek word for drug?
A
-Pharmakon meaning remedy, poison, magical charm
2
Q
T/F?
Drugs are defined as Remedies, Poisons and magical charms.
A
true
3
Q
What drives the classification of drugs? (2)
A
-Social values
(recreational and medicinal)
-patient safety
4
Q
What are the 5 types of medications?
A
- controlled
- prescriptions
- investigational drugs
- OTC
- alternative medications (RX and OTC)
5
Q
What are the 2 classes of drugs?
A
- RX
- OTC
6
Q
Who invited comments in the federal Register on a proposal to create a third class?
A
FDA
7
Q
What is the 3rd proposed class of drugs?
A
That will be controlled behind the counter by pharmacist who will then prescribe.
8
Q
Who opposed the “3rd” drug class? (2)
A
- Opposed by the American Academy of Family Physicians (AAFP)
- Board chair (Roland Goertz MD) cited patient safety because there will be no physician supervision
9
Q
T/F?
Drug use and potential for inappropriate drug use is on the rise.
A
true
10
Q
What may be contributing to noncompliance with recommendations (prescribed/therapeutic)
A
The rise of self-care
11
Q
What 3 things are contributing to self-medication increase?
A
- RX to OTC switches
- Internet (increased access to the info)
- Lack of insurance/high deductibles
12
Q
T/F?
When patients are faced with some form of illness 1/3 of the time they ignore it or do nothing.
A
true
13
Q
Self-medication practices involve what 4 things?
A
- personal experience
- advice from friends
- web based
- DTC
14
Q
T/F?
1/4 of patients faced with some illness use the medical system.
A
true
15
Q
How often do patients obtain prescriptions when using the medical system when faced with some form of illness?
A
2/3rds of the time
16
Q
What are the 8 medication related problems?
A
- needed drug therapy
- use of wrong drug
- dosage is too high
- not receiving drug
- unnecessary drug therapy
- dosage is too low
- adverse rxn
- drug interaction
17
Q
Medication use process (5 steps)
A
- prescribing
- transcribing/documentation
- dispensing
- administering
- monitioring
18
Q
T/F?
Pharmacist have a role in the ENTIRE medication use process.
A
true
19
Q
Who are the 5 statutory prescribers?
A
- physicians
- advanced nurse practitioners
- PAs
- Dentist
- Podiatrist
20
Q
How can a RX be prescribed? (3)
A
- written (no paper restrictions)
- faxed
- given orally
21
Q
___________ million Americans lack adequate access to primary care physicians in their communities.
A
56 million
22
Q
Collaborative Practice Agreements
A
- an agreement between MD and a pharmacist to change a prescription.
23
Q
How can pharmacist give a patient a flu shot without a prescription?
A
-collaborative practice agreements
24
Q
What is the transfer of a physician’s prescription order to a medication administration record (MAR)?
A
transcribing/documentation
25
What can be done to reduce transcription mistakes?
-order verification
26
What 3 strategies reduce transcribing/documentation errors?
- E-prescribing
- computerized physician order entry
- bar code identification of patients
27
When do Pharmacist have the most control over the medication use process?
Dispensing
28
What is the role of a pharmacist in the dispensing process?
DUR utilization review
29
What are the 3 aspects of DUR?
- identifying potential and actual drug-related problems
- resolving actual drug-related problems
- preventing potential drug-related problems
30
How do pharmacist administer medications? (2)
- immunization services
| - educating patients on medication devices
31
Education on medication devices include (4)?
- insulin self injection
- blood pressure machines
- inhalation techniques for asthmatic drugs
- diabetic supplies
32
4 types of patient compliance?
- Initial noncompliance (3 to 20%)
- Partial compliance (about 50%)
- Total compliance
- Hyper compliance
33
Pharmacists are positioned to significantly do what 3 things?
- Impact patient drug knowledge
- Understand patient prescription needs
- Influence patient compliance (education, reduction of complexity)
34
Name the compliance-
| Patient taking a mediation q4h when prescribed q6h.
hyper compliance
35
Name the compliance-
| Patient is prescribed and RX that is never filled.
initial non-compliance
36
Name the compliance-
| A patient starts taking a prescribed 10 day therapy antibiotic but stops after 2 days due to feeling better.
-partial compliance
37
Name the compliance-
| A patient taking a prescribed medication exactly as prescribed by the MD.
total compliance
38
Part of Medicare Star Ratings
***Medicare will reward for value on a scale of 1-5. 80% and above is considered compliant
39
How are medication safety issues being addressed? (2)
- Therapeutic Drug Monitoring (TDM)
| - Pharmacovigilance
40
T/F?
TDM is the science and activities relating to the detection, assessment, understanding and prevention of adverse effects or any other possible drug-related problems
- false
| - Pharmacovigilance
41
What Allows the clinician/pharmacist to adjust doses, select alternative therapy, avoid pharmacokinetic drug interactions, and select optimal doses for patients (especially in disease management)?
TDM
| -Therapeutic Drug Monitoring
42
What type of drugs need TDM?
drugs with narrow therapeutic index ( digoxin, phenytoin, aminoglycosides)
43
Drug Usage Evaluation (DUE) or Medication Use Evaluation (MUE)
is often commissioned and approved by who?
the P and T committee and criteria led by pharmacy
44
What is a performance improvement method that focuses on evaluating and improving medication use processes with the goal of optimal patient outcomes?
Drug Usage Evaluation (DUE) or Medication Use Evaluation (MUE)
45
______ defines ________ as the reduction of risk of unnecessary harm associated with healthcare to an acceptable minimum.
WHO; patient safety
46
Why did Brodie put forth drug use control concept as a goal of pharmacy practice? (3)
- Increasing adverse drug reactions
- Hospitalizations and deaths from drug misadventures
- Patient non-adherence
47
T/F?
| Drug related morbidity/death is greater than deaths caused by accidents, breast cancer and AIDS combined.
true
48
To Err is Human promoted what type of approach to medication safety error.
"system failure"
49
Who promotes "just culture"
ASHP
50
T/F?
"system failure" is an approach to medical error management that recognizes individual accountability for behavioral choices that compromises safety.
- false
| - "just-culture"
51
Diagnosed with pulmonary embolus. Stat dose of enoxaparin (Clexane) prescribed but does not appear to have been given. Patient arrested and died. (THIS IS AN EXAMPLE OF WHAT?)
-omitted doses
52
_______ an iatrogenic hazard or incident that consists of the sum of medication errors and adverse drug events.
Medication Misadventure
53
What are preventable events that may cause or lead to inappropriate medication use or patient harm while the medication is in the control of the healthcare professional or patient/caregiver
medication error
54
T/F?
| ADR is an injury from a medicine (or lack of an intended medicine)
- false
| - ADE
55
side effects
things that we expect or already know about the drug
56
T/F?
| Adverse Drug Reaction reporting is mandated.
true
57
T/F?
| Medication errors are significantly DECREASED in seniors?
- false
| - INCREASED
58
Any unexpected, unintended, undesired, or excessive response to a medication describes what?
ADR- Adverse drug reactions
59
In what phase does the FDA mandate manufacturer reporting and voluntary customer or health professional reporting?
-phase 4
60
What is the online version of AERS called?
-Medwatch
61
__________ is an active surveillance system for comprehensive and timely monitoring.
Sentinel System
62
The Sentinel System electronically links what 4 things?
- health record systems
- administration
- insurance claims databases
- registries
63
Root Cause Analysis (RCA) and Failure Mode and Effects Analysis (FMEA) are examples of what?
Risk Assessment Tools
64
T/F?
| Root Cause Analysis (RCA) is when you ask why 5 times.
true
65
T/F?
| Root Cause Analysis (RCA) is PROSPECTIVE and Failure Mode and Effects Analysis (FMEA) is RETROSPECTIVE
- false
- RETROSPECTIVE
- PROSPECTIVE
66
What identifies many areas of vulnerability or points of potential failure.
Failure mode and effects analysis (FMEA)
67
When faced with some form of illness, what do people do?(3)
- ignore/ do nothing
- self medicate
- use the medical system
68
Rank the ROI (return on investment) for the following chronic conditions:diabetes, hypertension, hypercholesterolemia
1. Diabetes 7:1
2. Hypercholesterolemia 5:1
3. Hypertension 4:1
69
T/F Medwatch is voluntary manufacturing reporting and voluntary customer or health professional reporting?
FALSE; mandatory manufacturing reporting
