Exam 1 Flashcards
What are the Components of Medication
Assessment?
Appropriateness
Safety
Effectiveness
Adherence
What falls under appropriateness?
Current/valid indications
Duplicate therapy
What falls under safety?
Adverse effects
High dose
Allergic reactions
What falls under effectiveness?
Is it working?
Is it achieving the desired therapeutic goal?
What falls under adherence?
Cost
Complexity
Other barriers
What is a drug DRP?
Drug related problems
Any undesireable event associated with or caused by drug therapy which interferes with achieving the desired goals of therapy
What are the common causes of DRP?
Unnecessary drug therapy
Ineffective drug
Needs addition therapy
Dosage too low
Adverse drug reactions
Dosage too high
Nonadherence
How do you prioritize DRPs?
Urgency
Responsibility
Synergy
U- Which problems must be resolved immediately and what can wait?
R- Which problem can be resolved by the practitioner and patient directly
S- Which problem require interventions by someone else
What are the components of stating DRPs?
Description of the patient’s medical condition or clinical state
Drug therapy involved
Specific association between the drug therapy and the patient’s condition
What is MTM?
Medication therapy management
Assessment and evaluation of a patient’s complete medication therapy regimine
Who usually completes MTMs?
Pharmacists
What is the PPCP?
A systemic consistent process for delivering patient-centered care in any setting
Plan
Assess
Implement
Follow up
Collect
What should the plan be?
Patient centered
Individualized
Be collaborative
What is the PLAN?
This is your course of treatment
What questions are asked to develop a patient centered plan?
What are the goals of therapy?
What are you going to do to resolve any DRP?
What interventions are you goind to provide?
When are you going to follow up to determine the actual outcomes?
What are the general approaches to problem solving?
Trial and error
Step by step procedure
Self explanation
Brainstormiing
Analongies
Root cause analysis
What does SMART mean in terms of goals?
Specific
Measurable
Achievable
Realistic
Time specific
What does the S in smart ask?
Specific
What do you want to do?
What does the M in SMART ask?
Measurable
How will you know when you’ve reached it?
What does the A in SMART ask?
Achievable
Is it in your power to accomplish it?
What does the R in smart ask?
Realistic
Can you realistically accomplish it?
What does the T in smart ask?
Time specific
When exactly do you want to accomplish it
What should you do to resolve DRPs and Optimize therapy?
Consider the clinical goals set by the provider
Consider the patient’s preference
Prioritize the problem list
Establish short and long term goals to optimize therapy
What should each plan include in documentation?
Indication
Summary of signs and symptoms
Goals of therapy
Medications and dosage intstructions
Non pharmacologic interventions
Dates for follow up
Each care plan is documented _____
separately
Each medical condition being managed should have a _____ care plan
Separate
What does implement do?
Put the plan into action
Collaborate with patient
Collaborate with other health care professionals
What should you document during implement?
All communication (SBAR, SOAP)
What are the questions do ask during the follow up?
How are things going?
Is the plan effective?
What changes do we need to make?
What should be monitored and evaluated?
Medication appropriateness, effectiveness and safety
Patient adherence
Outcomes of care
How can you implement a plan?
Address medication and health related problems and engage in preventative care strategies
Do what you said you would do in the plan
Initiate modify discontinue or administer med therapy as authorized
Schedule follow ups
What is the medication use process?
A multistep process in which a drug travels from the pharmacy to the patient
What are the 5 key steps of the medication use process?
Prescribing
Transcribing/Documenting
Dispensing
Administering
Monitoring
What happens during prescribing step of the 5 key steps?
Evaluation of patient
Establish need for medicine
Select right medicine
Determine interactions and allergies
Prescribe medicine
What happens during the transcribing/document step?
Transcribe prescription/order
Transmit to pharmacy
What happens during dispensing step?
Review prescription order
Confirm transcription
Contact prescriber for discrepancies
Prepare medicine
Distribute medicine
What happens during the admistering step?
Review prescription order
Confirm transcription
Review warnings, interactions and allergies
Evaluate patient
Administer medicine
What happens during monitoring step?
Asses patient’s response to medicine
Report and document results
Who is responsible for patient safety throughout the medication use process?
You, the pharmacist
What do centralized systems include?
Traditional manual systems and fixed robotic systems utilizing barcode technology
What do decentralized systems include?
Medications dispensed directly to the health care provider via automated dispensing cabinets, satellite pharmacies, or floor stock systems
What is the preferred method of dispensing?
Unit dose dispensing - because the medication is in a form ready to administer to the patient with appropriate labeling
What do pharmacy techs do?
Support the pharmacist with order fulfillment
Manage all tasks not requiring a pharmacist
Free time for the pharmacist to perform professional responsibilities
Certification and CE may be required
What do Pharmacy clerks do?
Manage certain tasks in the store
Usually work the cash register in the pharmacy
May assist with accepting new prescriptions, triaging customer inquiries and healping to answer general questions
What is the ratio of techs to pharmacist?
3:1
What can pharmacy techs do?
Prepare prescriptions to be dispensed
Attach labels to bottles
Obtain and replace meds and supplies
Send and recieve prescription RR and PAs
Resolve third party insurance claims
Transfer and pre package as a unit dose medication in institutional settings
What is the NDC?
National Drug Code
Universal drug identifier
What do the first four numbers of the NDC tell?
The labeler/vender
What do the second 4 numbers of the NDC do?
Product code
What do the last two numbers of the NDC tell?
The package size
Unless requested not to do so, all medicationshall be dispensed in ______ _______ packages.
Child resistant
What is transcribing?
Act of writting down or copying from one place to another
Entering prescription information into pharamcy software
What is the goal of transcribing?
Transform the prescription into a dispensed medication with correct instructions than can safely be interpreted by patients/caregivers
What is required on a prescription?
Patient name
Date of issuance
Name of prescriber
Name, strength, dosage form, and quantity of drug
Directions for use
Refills
Prescriber’s signature
Control has address and DEA
What should you collect when accepting a prescription?
Allergies
Comorbidities
Indications
Duration
