E1 Lecture 5 Flashcards
Big 4 Prescribers
Physicians (MD/DO)
Dentists (DDS/DMD)
Podiatrists (DPM)
Veterinarians (DVM)
Characteristics of Big 4
“full prescribers”
can prescribe in any part of US as long as they are licensed in at least 1 jurisdiction of US
Characteristics of Mid-Level Practioners
do not have authority to prescribe across all states and prescriptions may not be honored in all jursidictions
Scope of Practice
Physicians: whole body for humans
Dentists: mouth and maxillofacial for humans
Podiatrists: feet, ankles, hands for humans
Veterinarians: whole body for animals
Law of Agency
- prescriber authorizes an agent (person without independent authority to prescribe) to deal with a pharmacy
- nurse or PA can call in a prescription, clarify an order, and complete other tasks on behalf of the prescriber
- agents cannot make decisions on behalf of the prescriber, they can only be their voice
Federal Prescription Requirements
- federally, no uniform standards for non-controlled prescriptions
- federally, no standards for prescription expiration or refills
Prescription Label to be Exempt from Misbranding
Name & Address of Dispenser
Serial # of Prescription
Date of prescription or filling
Name of Prescriber
IF STATED ON PRESCRIPTION, name of patient
IF CONTAINED ON PRESCRIPTION, directions for use
IF CONTAINED ON PRESCRIPTION, cautionary statements
When does the expiration date start ticking for refills & expirations of scripts?
Date written
How long is a script for OTC good for & how many refills?
1 year
no limit for refills
How long is a script for Rx Only good for & how many refills?
1 year
no limit for refills
How long is a script for CIII, CIV, CV good for & how many refills?
6 months
5 refills max
How long is a script for CII good for & how many refills?
1 year
zero refills
Omnibus Budget Reconciliation Act (OBRA ‘90)
targeted spending on medications by Medicaid beneficiaries
4 Requirements:
- Prospective Drug Utilization Review (DUR)
- Retrospective Drug Utilization Review
- Offer to conduct patient counseling
- maintaining patient records
States applied to all patients, not just Medicaid
Prospective DUR
pharmacist must review drug therapy before each prescription is filled for accuracy & appropriateness
Review…
- therapeutic duplications
- drug disease contraindications
- drug drug interactions
- incorrect dosage or duration
- drug allergy interactions
- clinical abuse
Retrospective DUR
states review medication use and compare how they are being used against accepted standards
Review…
- adverse drug events
- signs of drug abuse
Effects…
- change prescribing habits
- educational programs
DUR Panel Consists of?
Physicians (33% minimum)
Pharmacists (33% minimum)
Other HC professionals
Patient Counseling
requires offer to have a pharmacist counsel
- OBRA ‘90 only requires Medicaid, but states applied to all
Is a consultation required when individual refuses?
No
Patient Records
pharmacist must obtain, record, and maintain the following:
- name, address, phone #, DOB, gender
- disease state, allergies, drug reactions, list of meds
- pharmacist counseling
OBRA ‘90 only requires Medicaid, but states applied to all
Dietary Supplement Health and Education Act (DSHEA)
defined dietary supplement intended to supplement the diet containing 1 or more of the following:
- vitamin
- mineral
- herb
- amino acid
- combination of any of the following
Dietary Labeling
Name of Product + “Dietary supplement”
Quantity of contents
Manufacturers, packers, distributors name & address
Directions for use
Supplement Factors Panel
- serving size
- list of dietary ingredients
- amount per serving size
- percent daily value
Dietary Supplement Claims
Health Claim
- relationship between a product & potential impact on disease state/condition
Nutrient Content Claim
- description of nutrient or dietary substance in product
Structure-Function Claim
- description of maintaining proper body function independent of specific disease states
Do health claims and nutrient content claims have to be FDA approved?
Yes
Do structure-function claims have to be FDA approved?
No
What disclaimer does a dietary supplement making a claim say?
“this statement has not been evaluated by the FDA. this product is not intended to diagnose, treat, cure, or prevent disease”
