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Introduction to Pharmacy (Meyonca) > Drug Use Process and Patient Safety Powerpoint > Flashcards

Drug Use Process and Patient Safety Powerpoint Flashcards

1
Q

What is the Greek word for drug?

A

-Pharmakon meaning remedy, poison, magical charm

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2
Q

T/F?

Drugs are defined as Remedies, Poisons and magical charms.

A

true

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3
Q

What drives the classification of drugs? (2)

A

-Social values
(recreational and medicinal)
-patient safety

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4
Q

What are the 5 types of medications?

A
  • controlled
  • prescriptions
  • investigational drugs
  • OTC
  • alternative medications (RX and OTC)
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5
Q

What are the 2 classes of drugs?

A
  • RX

- OTC

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6
Q

Who invited comments in the federal Register on a proposal to create a third class?

A

FDA

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7
Q

What is the 3rd proposed class of drugs?

A

That will be controlled behind the counter by pharmacist who will then prescribe.

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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
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9
Q

T/F?

Drug use and potential for inappropriate drug use is on the rise.

A

true

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10
Q

What may be contributing to noncompliance with recommendations (prescribed/therapeutic)

A

The rise of self-care

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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
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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

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13
Q

Self-medication practices involve what 4 things?

A
  • personal experience
  • advice from friends
  • web based
  • DTC
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14
Q

T/F?

1/4 of patients faced with some illness use the medical system.

A

true

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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

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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
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17
Q

Medication use process (5 steps)

A
  1. prescribing
  2. transcribing/documentation
  3. dispensing
  4. administering
  5. monitioring
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18
Q

T/F?

Pharmacist have a role in the ENTIRE medication use process.

A

true

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19
Q

Who are the 5 statutory prescribers?

A
  • physicians
  • advanced nurse practitioners
  • PAs
  • Dentist
  • Podiatrist
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20
Q

How can a RX be prescribed? (3)

A
  • written (no paper restrictions)
  • faxed
  • given orally
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21
Q

___________ million Americans lack adequate access to primary care physicians in their communities.

A

56 million

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22
Q

Collaborative Practice Agreements

A
  • an agreement between MD and a pharmacist to change a prescription.
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23
Q

How can pharmacist give a patient a flu shot without a prescription?

A

-collaborative practice agreements

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24
Q

What is the transfer of a physician’s prescription order to a medication administration record (MAR)?

A

transcribing/documentation

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25
Q

What can be done to reduce transcription mistakes?

A

-order verification

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26
Q

What 3 strategies reduce transcribing/documentation errors?

A
  • E-prescribing
  • computerized physician order entry
  • bar code identification of patients
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27
Q

When do Pharmacist have the most control over the medication use process?

A

Dispensing

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28
Q

What is the role of a pharmacist in the dispensing process?

A

DUR utilization review

29
Q

What are the 3 aspects of DUR?

A
  • identifying potential and actual drug-related problems
  • resolving actual drug-related problems
  • preventing potential drug-related problems
30
Q

How do pharmacist administer medications? (2)

A
  • immunization services

- educating patients on medication devices

31
Q

Education on medication devices include (4)?

A
  • insulin self injection
  • blood pressure machines
  • inhalation techniques for asthmatic drugs
  • diabetic supplies
32
Q

4 types of patient compliance?

A
  • Initial noncompliance (3 to 20%)
  • Partial compliance (about 50%)
  • Total compliance
  • Hyper compliance
33
Q

Pharmacists are positioned to significantly do what 3 things?

A
  • Impact patient drug knowledge
  • Understand patient prescription needs
  • Influence patient compliance (education, reduction of complexity)
34
Q

Name the compliance-

Patient taking a mediation q4h when prescribed q6h.

A

hyper compliance

35
Q

Name the compliance-

Patient is prescribed and RX that is never filled.

A

initial non-compliance

36
Q

Name the compliance-

A patient starts taking a prescribed 10 day therapy antibiotic but stops after 2 days due to feeling better.

A

-partial compliance

37
Q

Name the compliance-

A patient taking a prescribed medication exactly as prescribed by the MD.

A

total compliance

38
Q

Part of Medicare Star Ratings

A

***Medicare will reward for value on a scale of 1-5. 80% and above is considered compliant

39
Q

How are medication safety issues being addressed? (2)

A
  • Therapeutic Drug Monitoring (TDM)

- Pharmacovigilance

40
Q

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

A
  • false

- Pharmacovigilance

41
Q

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)?

A

TDM

-Therapeutic Drug Monitoring

42
Q

What type of drugs need TDM?

A

drugs with narrow therapeutic index ( digoxin, phenytoin, aminoglycosides)

43
Q

Drug Usage Evaluation (DUE) or Medication Use Evaluation (MUE)
is often commissioned and approved by who?

A

the P and T committee and criteria led by pharmacy

44
Q

What is a performance improvement method that focuses on evaluating and improving medication use processes with the goal of optimal patient outcomes?

A

Drug Usage Evaluation (DUE) or Medication Use Evaluation (MUE)

45
Q

______ defines ________ as the reduction of risk of unnecessary harm associated with healthcare to an acceptable minimum.

A

WHO; patient safety

46
Q

Why did Brodie put forth drug use control concept as a goal of pharmacy practice? (3)

A
  • Increasing adverse drug reactions
  • Hospitalizations and deaths from drug misadventures
  • Patient non-adherence
47
Q

T/F?

Drug related morbidity/death is greater than deaths caused by accidents, breast cancer and AIDS combined.

A

true

48
Q

To Err is Human promoted what type of approach to medication safety error.

A

“system failure”

49
Q

Who promotes “just culture”

A

ASHP

50
Q

T/F?
“system failure” is an approach to medical error management that recognizes individual accountability for behavioral choices that compromises safety.

A
  • false

- “just-culture”

51
Q

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?)

A

-omitted doses

52
Q

_______ an iatrogenic hazard or incident that consists of the sum of medication errors and adverse drug events.

A

Medication Misadventure

53
Q

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

A

medication error

54
Q

T/F?

ADR is an injury from a medicine (or lack of an intended medicine)

A
  • false

- ADE

55
Q

side effects

A

things that we expect or already know about the drug

56
Q

T/F?

Adverse Drug Reaction reporting is mandated.

A

true

57
Q

T/F?

Medication errors are significantly DECREASED in seniors?

A
  • false

- INCREASED

58
Q

Any unexpected, unintended, undesired, or excessive response to a medication describes what?

A

ADR- Adverse drug reactions

59
Q

In what phase does the FDA mandate manufacturer reporting and voluntary customer or health professional reporting?

A

-phase 4

60
Q

What is the online version of AERS called?

A

-Medwatch

61
Q

__________ is an active surveillance system for comprehensive and timely monitoring.

A

Sentinel System

62
Q

The Sentinel System electronically links what 4 things?

A
  • health record systems
  • administration
  • insurance claims databases
  • registries
63
Q

Root Cause Analysis (RCA) and Failure Mode and Effects Analysis (FMEA) are examples of what?

A

Risk Assessment Tools

64
Q

T/F?

Root Cause Analysis (RCA) is when you ask why 5 times.

A

true

65
Q

T/F?

Root Cause Analysis (RCA) is PROSPECTIVE and Failure Mode and Effects Analysis (FMEA) is RETROSPECTIVE

A
  • false
  • RETROSPECTIVE
  • PROSPECTIVE
66
Q

What identifies many areas of vulnerability or points of potential failure.

A

Failure mode and effects analysis (FMEA)

67
Q

When faced with some form of illness, what do people do?(3)

A
  • ignore/ do nothing
  • self medicate
  • use the medical system
68
Q

Rank the ROI (return on investment) for the following chronic conditions:diabetes, hypertension, hypercholesterolemia

A
  1. Diabetes 7:1
  2. Hypercholesterolemia 5:1
  3. Hypertension 4:1
69
Q

T/F Medwatch is voluntary manufacturing reporting and voluntary customer or health professional reporting?

A

FALSE; mandatory manufacturing reporting

Introduction to Pharmacy (Meyonca) (11 decks)

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