Lecture 2

Question 1

name 4 types of errors associated with medicine

Answer 1

-ordering
-dispensing
-administration
-judgement

Question 2

ordering errors are ____ based
explain what ordering errors are

Answer 2

ordering errors are PRESCRIBER based
there is QUANTITAVITE and QUALITATIVE ordering errors

Question 3

explain the difference between quantitative and qualitative ordering errors

Answer 3

quantitative – anything to do with numbers
ie: dose, body weight, frequency, age, etc

qualitative – wrong drug choice, wrong route of administration

Question 4

true or false

speaking to the doctor about a potential ordering error is always more beneficial than talking to the patient

Answer 4

false – talking to the patient can sometimes be more helpful. drs are busy and sometimes brush off speaking to pharmacist

Question 5

SMOI protocols are like a document between the ___ and the ____

Answer 5

physician and the pharmacists

Question 6

dispensing errors, most of the time, are ____

Answer 6

MISFILLS

giving patient wrong drug or even wrong number of pills

Question 7

tall man letters are implemented in pharmacies to combat what?

Answer 7

the chance of misfills with look a like sound a like drugs

Question 8

besides misfills, what else could attribute to dispensing errors?

Answer 8

transcription and translation of a prescription

Question 9

what is ISMP

Answer 9

institute for safe medication practices.
has a website where medication errors can be reported, relayed to the healthcare community, and appropriate steps be taken through the FDA to prevent the issue from happening again

Question 10

true or false

immunization is considered a specialized, clinical service

Answer 10

TRUE – but it’s so common it’s not really talked about

Question 11

PS/CMR/MR/CDTM/MTM all have WHAT in common

Answer 11

they are specialized clinical services. all have SMOI in common

Question 12

_____ is considered a retail model
_____ is a hospital/institutional model

Answer 12

MTM is considered a retail model
CDTM is a hospital/institutional model

Question 13

what model is MR part of?

Answer 13

not part of any model (ie: retail/hospital)
used if you’re dispensing drugs, regardless of where

Question 14

MR, though not part of a specific model, is primarily done in a ___ setting

Answer 14

hospital

Question 15

is CDTM regulated and managed by the states or federally?

Answer 15

the states

Question 16

is MR regulated and managed by the states or federally?

Answer 16

neither – not part of a practice model. just done primarily in a hospital setting

Question 17

explain the first word of CDTM

Answer 17

CDTM = collaborative drug therapy management

COLLABORATIVE — indicates there’s 2 or more parties

CDTM is an arrangement between 2 – one is a pharmacist and the other is a provider (usually physician, but sometimes NP)

Question 18

is MTM a state or federal model?

Answer 18

federal

Question 19

_______ made MTM/MTMS possible.

Answer 19

medicare

Question 20

medicare made _____ a part of MTMS.

Answer 20

CMR

Question 21

thanks to medicare, many states have ____ as an independent practice model. why?

Answer 21

many states have CMR as an independent practice model. this is so bc medicare made CMR a part of MTMS

Question 22

___ is a HIGHLY specialized clinical service

Answer 22

PS – provider status (?)

Question 23

~_____% of all prescriptions are dispensed as generic in today’s day

Answer 23

~85%

Question 24

true or false

GS used to be a specialized service, but it’s not anymore

Answer 24

TRUE.
generic substitution used to be a specialized service. generics used to not be as common as they are today.
today, we HAVE to fill generic if the DAW is 0.

Question 25

as mentioned, ~85% of prescriptions today are dispensed as generic.
before GS was a thing, ~___% were dispensed generic?

Answer 25

~5%
generics weren’t nearly as common

Question 26

what does DTC stand for

Answer 26

dtc = direct to consumer

Question 27

are biosimilars considered generics?

Answer 27

NO
biosimilars are medical products that are ALMOST an identical of the original product

Question 28

in generic substitution, the 2 products are exactly the same except for ___,____, and ____

Answer 28

color, size, and appearance

Question 29

are biologics different from conventional pharmaceutics? explain

Answer 29

YES
biologics are made from living cells. this is an evolving area of manufacture and synthesis

Question 30

“clinically highly similar”

Answer 30

biosimilar

Question 31

explain the difference between naming generics and naming biosimilars

Answer 31

we call regular generics by their chemical name (to some extent)

biosimilars each have their own brand name because they are NOT exactly the same as the original product. ie: humira has around 6 or 7 different biosimilars, each with their OWN brand name

Question 32

what year did the first biosimilar come out?

Answer 32

2015

Question 33

true or false

the first biosimilar came out in 2016. since then, only a few biosimilars have been approved while THOUSANDS of true generics have been approved

Answer 33

FALSE – 1st biosimilar came out in 2015.
rest is true

Question 34

the purple book and orange book are rules for….

Answer 34

substitution

Question 35

the purple book and orange book are publications for what population?

Answer 35

pharmacists

Question 36

which is newer – the purple book or the orange book?
explain

Answer 36

purple book is newer
orange book is older

purple book = list of biologics and biosimilars

orange book = approved regular, conventional drug products and generics

Question 37

is immunization optional for a pharmacist?

Answer 37

technically yes – it’s a specialized clinical service. not forced on pharmD as well as all other acronyms listed (PS/CMR/MR/CDTM/MTM)

Question 38

name the 3 criteria to get certification to perform CDM/MTM etc

Answer 38

1. Academic training (beyond PharmD) – residency
2. skill based experience: Clinical experience – 2 years. NOT POSSIBLE IN RETAIL SETTING
3. Lifelong education–continuing education. called CE credits/hours. in NY, minimum is 45 credits every 3 years, but may require additional hours to be one of the things above ^^^

Question 39

today, how do most pharmacists get paid for providing clinical services?
what is the exception

Answer 39

INDIRECTLY through the physician. physician gets paid 1st, then pharmacist

exception = states with provider status. recognize pharmacists as providers

Question 40

what is common to ALL pharmacist specialized programs

Answer 40

SMOI
selection, modification, order, interpret

Question 41

explain how a pharmacist can do the “M” of SMOI

Answer 41

modify – TS/TI/GS