Exam 4 - Yorra Material Flashcards
Prescription
Order for specific medication and its dosage issued by a physician, dentist or other properly licensed medical practitioner
MGL 94C
Law pertaining to controlled substance
MA practitioners who can prescribe
Physicians NP, PA, Nurse Anesthetist Nurse Mid-wives Optometris Dentist Pharmacists w/ (CDTM)
DEA # needed
Mass Controlled Substance Registration number
High Alert Med from ISMP
Warfarin Enoxaparin Fentanyl Patches Methotrexate (oral) Hydrocode w/ acetaminophen Oxycodone w/ acetaminophen Insulin analogs
CPOE
Computerized Physician Order Entry
EMR
Electronic Medical Records
Access to all data Can be shared across platforms and locations Allows for seamless patient care Allows for telemedicine Captures all services Coordinate care Better patient outcomes
Compounded Prescriptions
Has to say if its sterile or non-sterile
must have a phone number to pharmacist staffed at least 56 hrs/week
PCA pump
Secure delivery
Key driven locking system adds security on several levels
Pole clamp locks to IV pole, Medication door locked, programming lock-out
Mandatory e-prescribing
seen as tool in combating opioid abuse
some states mandated electronic prescribing and may implement in 2020
All medicare D prescriptions electronic by 1/1/2020
Roman numbers
I - 1 V - 5 X - 10 L - 50 C - 100 D - 500 M - 1000 SS - 1/2
M. Ft. ung.
Mix and make an ointment
Ft. sup. no xii
Make 12 suppositories
M. ft. cap. d.t.d. no. xxiv
Mix and make capsules, give 24 such doses
caps.i.q.i.d.pc. et h.s
Take 1 capsule 4 times a day after each meal and at bedtime
gt. ii rt. eye every a.m
Instill 2 drops in the right eye every morning
tab ii stat tab. 1 q. 6h. x 7d.
Take 2 tablets immediately, then take 1 tablet every 6 hrs for 7 days
q.s.ad
add sufficient quantity
Patient compliance
patient understanding and adherence to the direction for use
Patient non-compliance
The failure to comply with a practitioner’s or labeled direction in the self-admin of any medication
Responsibility of pharmacist to ensure that each prescription and medication order is…
correct in its form and content
appropriate for the patient being treated
filled, labeled, dispensed, and admin correctly
Review step by step order
prescriber info
date of the order and its currency
patient identification info
patients age, weight (if pertinent to dose determination)
Use of abbreviations and symbols to reduce medical errors
whole number should be shown without a decimal point and without zero
quantity smaller than one should e shown with 0 before decimal point
leave space between a number and the unit
use whole numbers when possible and not equivalent decimal fraction
Med error prevention
use full name of drugs not abbreviations
use USP designations for units of measure, spell “unit” out
spell out “every day”
don’t use D for “day” or “dose”
amplify prescribers directions on the prescription
Tall man letters
tall and capital lettering in certain portions of drug names
Info on Adherence
over 50% of patients don’t take med correctly
cost of failed outcomes in the billions of dollars
ACA focusing on outcomes rather than process so providers must show positive outcomes
providers who do not have enough positive outcomes will lose money and clients
Cause of non-adherence - Patient related
Lack of understanding, involvement, medication literacy
costs, transportation, poor mental health, lack of family support
Cause of non-adherence - Physician related
complex drug regimens
failing to explain benefits/side effects
failing to know costs
failure to look at herbal or alternative therapies
transition of info between practitioners is not coordinated
Cause of non-adherence - Health System causes
fragmented care
lack of centralized EMR
Lack of time due to high volume of patients
costs
access to services - long wait times in the clinic and pharmacy
Solutions for non-adherence
patient education, get them involved
minimize multidose therapy to 1 or 2 a day
set achievable goals
improve health/reading literacy
Pharmacoeconomics
including med costs, cost-benefit analysis, cost-effectiveness analysis, alternative treatments and pricing
