Hospital Pharmacy Lecture 4 Flashcards
I can’t afford my medicine! When a patient hears that a medication is not covered and what the cash price is they can be overwhelmed. It is our job to explain WHY
________ Authorization (PA)
__________ is too high? Is a tier reduction possible?
Deductible?
_________hole? Medicare savings programs?
________ form needed?
Not on formulary? Is there a formulary alternative?
No insurance?
Specialty pharmacy item?
Prior authorization
Co-pay is too high
Donut hole
DWO
Things to Consider
Is a ________ needed?
What type of _________ does the patient have? (Commercial, Medicare, Medicaid)
What options are available if a medication is covered but is too expensive?
Is there ___________planned?
Who will inform the _____?
How ________ will the patient go without their medication?
Will a lack of medication result in _________?
Prior Authorization (PA)
insurance
followup
patient
long
hospitalization
Medications that are commonly prescribed & expensive
__________
Insulin
_________
Diabetes supplies- ___________, etc.
Brand name medications: Jardiance, Eliquis,Xarelto
Inhalers
GLP-1s
test strips
Alternatives
Insulin
Switch to________ insulin?
Walmart ReliOn Novolin N brand
Meter & test strips
__________ ReliOn Prime meter & test strips (~$20-30)
Consolidating inhalers
______________ inhalers
Trelegy Ellipta (ICS/LABA/LAMA)
switch to NPH insulin
walmart test strips
Combination inhalers
How can you help as the pharmacist?
Brand name medications—>Manufacturer’s ________
Free 30 day trials
Monthly coupons
coupons
Medicare Donut Hole
_____________:Your plan resets on January 1st
Initial coverage: you only pay copays for covered drugs
_________coverage:you pay a certain percentage based on the drug type
__________ coverage: your plan pays 100% covered drugs
Coverage ends December 31st
Catastrophic coverage: continues through the end of the year
Deductible
Less coverage
Catastrophic
Who makes up a hospital interprofessional care team?
Provider:Doctor, PA, NP
_________
____________
Physical Therapist
Occupational Therapist
________Manager
________ Worker
Dietician
Nurses
Pharmacist
Case manager
Social worker
Rounding teams
Attending ___________
________residents
+/- Medical students
+/- Pharmacist
physician
medical residents
Interprofessionalism
The hospital pharmacist is commonly the information resource for _________ and ________
Nursing will contact pharmacy for STAT orders, drug compatibility questions, and questions regarding medication administration
Two way street
“Boots on the ground”
prescribers and nursing
Interventions
________adjustments
________Interchanges
Therapeutic Drug Monitoring
___________ Dosing
Warfarin
Vancomycin
IV to PO & PO to IV
renal dose adjustments
therapeutic interchanges
Medication
It’s all in the wording….
Warfarin 7.5mg is a really high dose for Mr. Smith. How about 5mg? Vs. I see an order for warfarin 7.5mg for Mr. Smith. Based on his INR and his prior dose requirements of 2.5 – 5mg while in the hospital, I would recommend 5 mg of warfarin today.
Be _________
Provide ___________
Allow for discussion
kind
provide reasoning
Practice
The provider calls you to ask how to convert a
patient’s home dose of furosemide to IV since
the patient is currently NPO for an upcoming
surgery. The home dose is 40 mg PO daily.
Practice
You have a patient who is on methadone for
MAT outpatient but currently is unable to
swallow all oral medications. His outpatient
dose is 100 mg PO daily. What would be the IV
equivalent?
Drug Information Requests
Step 1: Obtain ____________
Patient factors to consider
_______ factors
Medication factors to consider
ADRs
____________
background information
Disease factors
Availability
Drug Information Requests
Step 2: ___________ the request
ADRs
Availability
Product administration
DDIs
Pregnancy/Lactation
Identification
Pharmaceutics
Economics
Kinetics
Stability & Compatibility
Toxicology
Categorize
