Lecture 4 Flashcards

1
Q

what are the 2 classes of drugs recognized by the FDA

A

legend and non legend

legend = by law, required to carry a “legend” on the product label/container (Rx)

non legend = nonprescription drugs

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2
Q

as mentioned the FDA recognizes 2 classes of drugs – legend and non legend.
what is the unofficial 3rd class of drugs?

A

pharmacy only.
things at pharmacy behind the counter that you need a license to purchase. – pseudophedrine

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3
Q

WHY is this unofficial 3rd class of drugs sold behind the pharmacy counter?

A

they can be used to make street drugs – monitored

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4
Q

what are BTC drugs

A

those sold behind the pharmacy counter.
can be Rx (legend) or the unofficial 3rd class

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5
Q

the FDA regulates the ___ and ___ of drugs

A

safety and efficacy

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6
Q

once sold, a health plan (payer) uses ___ and ___ to evaluate drugs

A

economics and quality

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7
Q

the _________ is beginning to create a class of drugs that pharmacists can prescribe

A

STATE BOARD OF PHARMACIES

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8
Q

everything starts as a _____, then gets upgraded to become a ____ or _____. HIGHEST = _____

A

everything starts as a SERVICE then gets upgraded to become a PROTOCOL or PROGRAM. highest= PRACTICE MODEL

talking abt MTM(MTMS)/MR/CDTM/CMR

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9
Q

between MTM(MTMS)/MR/CDTM/CMR

which is the highest? what is it considered?

A

CDTM — considered a practice model

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10
Q

MTM(MTMS)/MR/CDTM/CMR

each is considered a ____

A

service

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11
Q

service packed “tighter” become a ____

A

program

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12
Q

what was the mission of pharmacy in the 80s? what about the 90s?

A

80s - pharmaceutical care

in 1990s — become MTM (medication therapy management).

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13
Q

what put the pharmaceutical care idea of the 80s into practice?

A

MTM (medication therapy management)

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14
Q

what was the 1st implementation of pharmaceutical care?

A

the asheville project

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15
Q

pharmaceutical care became ____ which became ____ which became ____

A

pharmaceutical care became MTM which became MR which became CDTM

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16
Q

MTM began as a _____ only service

A

MEDICARE

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17
Q

true or false

dispensing and counseling are considered services

A

true.
they are services just not specialized services

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18
Q

CDTM is considered a ….

A

PRACTICE MODEL. groundbreaking

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19
Q

MTMS is a ___ model

A

retial

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20
Q

CDTM is permitted in what settings?

A

only hospital

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21
Q

what were the ORIGINAL parts of medicare?

A

A&B — 1965(6?)

22
Q

explain what parts A and B of medicare are

A

part A = HI (hospital insurance) INPATIENT

part B = SMI (supplemental medical insurance) OUTPATIENT (ie: primary care )

23
Q

explain what medicare part C is

A

CHOICE between traditional and new (new = managed care)

AKA medicare advantage plans. private insurance coverage (managed care orgs) in addition to the benefits of parts A and B. if you have C, dont need the rest

24
Q

why did they semi privatize medicare by adding part C?

A

gives more options for those with certain medical conditions. part C is like any private health plan. can have dental, vision, prescription, etc

25
Q

when was medicare part D added and what does it cover

A

medicare part D (prescription drug coverage) was added to medicare due to the medicare modernization act of 2003

26
Q

what is the downside of utilization management? which part of medicare does it primarily affect?

A

part C (semi privatized)
UM is used to ensure quality and cost control, but some private insurances go too far with it and costs rise a lot

27
Q

as mentioned, MTM used to be medicare ONLY.
is it still like this?

A

no – now done for all patients

28
Q

explain what population health is and what programs it applies to

A

population health = health outcomes of a group

ie:
medicare = population health for the elderly
medicaid = population health for the poor

29
Q

give the purpose of MTM

A

medication therapy management is a distinct service or a group of services that optimize therapeutic outcomes for INDIVIDUAL PATIENTS

-done one patient at a time

30
Q

do medication therapy management services HAVE to occur in conjunction with the provision of a medication product?

A

does not have to, but can.
INDEPENDENT of the drug product

31
Q

do you have to be physically present in the pharmacy to be an MTM pharmacist?

A

NO — you can work from home

32
Q

MTM is primarily a ___ service

A

retail

33
Q

what is common to MTM and CDTM?

A

they are applicable only to SPECIFIC disease states
ie: the 4C’s

-chronic
-costly
-coordination
-compliance challenges

34
Q

true or false

mental health is considered a costly disease

A

true

35
Q

do you need to be a pharmacist to perform MTM?

A

NO
other HC providers can perform as well

36
Q

true or false

medicare’s MTM is the law everywhere, but some states have additional MTM

A

true

37
Q

can a regular retail pharmacist formulate a medication treatment plan?
what do you mean by formulate a medication treatment plan?

A

NO
formulate a medication treatment plan = SMOI

38
Q

____ is part of MTM

A

CMR (comprehensive medication review)

39
Q

what does CPA stand for

A

collaborative practice agreement (arrangement)

40
Q

under CPA = ____________ (a specialized service – a practice model — mentioned previously)

A

CDTM

41
Q

CDTM involves pharmacists practicing where?

A

in facilities (hospital, outpatient clinics, diagnostic center, treatment center etc. NOT LEGAL IN RETAIL)

42
Q

true or false

CDTM is federally imposed and regulated

A

FALSE – the states have their own protocols. NY has multiple

43
Q

true or false

a patient has to consent before CDTM is performed

A

TRUE

44
Q

CDTM is a ____ based arrangement.
what does this mean?

A

PROTOCOL BASED ARRANGEMENT

this means that CDTM allows the pharmacist, in collaboration with the physician. to adjust or manage a drug regimen for a SPECIFIC disease or disease state

45
Q

is CDTM mandatory?

A

NO — voluntary on patient and pharmacist side

46
Q

what does NYSCHIP stand for

A

new york state council of health systems pharmacists

geared toward HOSPITAL + MORE
(used to be just hospital)

47
Q

what is a sunset law?
which specialized service that we talked about is a sunset law in NY?

A

a sunset law is a law that expires.
CDTM is a law that expires every 2 years in NY, but has always been renewed with success

the new law suggests added NPs as providers

48
Q

explain what medication reconciliation means

A

the process of creating the most accurate list of possible medications a patient is taking (including name, dosage, frequency, and route) and comparing that list against the physician’s admission, transfer, and/or discharge orders

with the GOAL of providing correct medications to the patient at ALL TRANSITION POINTS within the hospital

49
Q

why is a pharmacist often utilized to perform med rec?

A

pharmacist trained TOC (help with transition of care so patient’s meds dont get lost track of)

50
Q
A