lesson 7 Flashcards

1
Q

It is the act of the pharmacist in supplying one or more drug products to a patient, usually in response to an order from a prescriber, utilizing his/her professional knowledge, judgment,
and skills.

A

Dispensing

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2
Q

The pharmacist ___, ____, ___ and ___ the
maintenance and delivery of medicines along with the information needed for its proper storage and administration.

A

plan, develop, control and monitor

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3
Q

Dispensing in hospital pharmacy is intended for its ___ and ___ at all economic levels.

A

in/out-patients and the general public

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4
Q

The Responsibilities of the Pharmacists include:

A

 The distribution and control of medicines on a 24-hour service, including dangerous and investigational
drug products.

 To ensure the availability of an adequate supply of medicines for the patients of the hospital.

 To ensure rational drug therapy and patient pharmaceutical care through the application of the “rule of right”

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5
Q

The pharmacists ensure rational drug therapy and patient pharmaceutical care through the application of the:

A

“rule of right”

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6
Q

Dispensing is the major activity of the pharmacy service as governed by the:

A

Generics Acts of 1988
Dangerous Drugs Act
Food, Drugs, Devices and Cosmetics Act
Pharmacy Law

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7
Q

It is used to describe the various methods by which the pharmacy service receives drug orders, prepares the
drug for distribution and in turn, distributes the drugs to the patients care areas.

A

Dispensing

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8
Q

 The consistent and repeated use of good dispensing procedure is vital in ensuring that errors are noticed and corrected at all stages of the dispensing process.

Before dispensing a drug product, the pharmacist must clearly understand which medicine is being requested.

A
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9
Q

Prescriptions must be legibly written; if not, ask the prescribing physician for clarification. Verbal order shall only be entered on emergency cases.

A
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10
Q

It shall only be entered on emergency cases.

A

Verbal order

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11
Q

Dispensing Process

A
  1. Receive and Validate Prescription
  2. Understand and Interpret Prescription
  3. Prepare Items for Dispensing
  4. Record Issuance in the stock card
  5. Issue Medicine to patient with clear
    instructions and advise
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12
Q

 Check if the prescription is appropriate for the age, weight and sex of the patient.

 Check if the medications prescribed are appropriate in form, dosage and strength.

 Confirm name of patient since there might be a risk of mixing-up prescriptions as there are people with
similar names.

A
  1. Receive and Validate Prescription
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13
Q

 The pharmacist must read the label of a drug product at least three times and compare it with the prescription before withdrawal from stock bottle, shelf or drawer.

 If the prescription is not complete, contact the prescriber and ask him/her to complete the prescription before dispensing.

A
  1. Understand and Interpret Prescription
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14
Q

The pharmacist must read the label of a drug product at least ____ and compare it with the prescription before withdrawal from stock bottle, shelf or drawer.

A

three times

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15
Q

Who to contact in case of incomplete prescription

A

Prescriber

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16
Q

Label in Prescription for external use

A

Red Label

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17
Q

Every prescription for internal and oral use shall bear this label

A

White Label

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18
Q

Prescription for external use, shall bear
a red label in black ink indicating the components of such prescription and the word ____ at the bottom of the label.

A

“For external use only”

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19
Q

For ____, the pharmacist must affix to the box, bottle or other package another label or red paper upon which shall be printed in large letters the word “POISON” and a vignette representing a _____ before delivering it to the purchaser.

A

poisonous substances

skull and bones

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20
Q

Every prescription for internal and oral use shall bear a white label. Prescription for external use, shall bear a red label in black ink indicating the components of
such prescription and the word “For external use only” at the bottom of the label.

What section and RA

A

Section 31
R.A. 5921- Pharmacy Law

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21
Q

For poisonous substances, the pharmacist must affix to the box, bottle or other package another label or
red paper upon which shall be printed in large letters the word“POISON” and a vignette representing a skull and bones before delivering it to the purchaser.

What section and RA

A

section 34
R.A. 5921- Pharmacy Law

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22
Q

It must be affixed to the drug containers to remind other health personnel to take
extra caution in handling, delivery and administering the medications concerned.

A

Auxiliary Labels

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23
Q

Auxiliary labels are used for:

A

high alert drugs
chemotherapeutics
parenteral admixtures

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24
Q

In this AO, in dispensing unit dose products which are no longer in their original containers but have been transferred to small bottles, cans, boxes, plastic and/or paper envelopes and the like, the pharmacist shall place
legibly on the label the following information.

A

A.O. No. 63 s. 1989 Labeling Requirements

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25
Q

Labeling Requirements:

A

 Name of the Patient
 Generic Name of the Drug
 Brand name, if any
 Manufacturer
 Dosage Strength
 Expiration Date
 Direction for use
 Name of the Pharmacist

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26
Q

Labels must be printed clearly. In addition, the pharmacist must fully explain to the patients and/or relatives the written instructions for them to understand.

A
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27
Q

 Read the label of the container and check it with the prescription.

A

Pick the Right Medicine from the Shelf

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28
Q

 For capsules/tablets in container, hands must never be in direct contact with the medicine. Counting can be done with a clean piece of paper and spatula, tablet counter, lid of the container in
use or other clean surface.

 Labels should be rechecked for the drug name and strength.

A

Measure/Count Quantity from the Stock Container

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29
Q

 Tablets and capsules should be packed in a ___

 Liquids require ___. Never mix two
liquids together.

A

sealed plastic dispensing bag

clean bottles and caps

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30
Q

Steps in Preparing Items for Dispensing

A

• Write the Label
• Pick the Right Medicine from the Shelf
• Measure/Count Quantity from the Stock Container
• Pack and Label Medicine
• Check Dispensed Medicine against prescription and stock container

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31
Q

Services in Drug Distribution System

A

Out-Patient Services
In-Patient Services

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32
Q

 The ____ is usually in an uncontrolled environment where vital signs are not routinely recorded between clinic visits, and medications may sometimes be taken erratically by the patient.

A

ambulatory patient

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33
Q

 It becomes apparent that the medication-related problems of ambulatory patients may often differ from those typified by hospitalized patients.

 The ambulatory patient may often be responsible for his/her own health care.

A

Out-Patient Drug Distribution System

34
Q

 In addition, with regard to prescribed drugs, it is possible that the patient may be taking over-the-counter medications obtained from outside pharmacies or other retail outlets or medications obtained from family members or friends.

Therefore, it is likely that no single health professional may be completely aware of the patient’s total medication regimen.

A
35
Q

Face with these potential problems, the hospital pharmacist should, in addition to properly dispensing prescription, provide extended pharmaceutical services like ____. This type of service will guide the patient in the proper use of medication and a better understanding of the medication he/she is taking.

A

drug counseling

36
Q

There are three (3) equally suitable provisions for the out-patient area:

A

 A separate out-patient pharmacy
 A combined in-patient and out-patient unit service provided from the same window
 A combined in-patient and out-patient unit with service provided from separate windows

37
Q

The most important consideration should be for the out-patient pharmacy to be near to the out-patient clinics and the general public.

If the clinics are distantly removed from the in-patients area, it is necessary for the out-patient pharmacy to be isolated from the in-patient pharmacy.

A

This will require planning for transporting drugs/medicines and
supplies from the main pharmacy, to the outpatient pharmacy or it may require separate ordering for the outpatient pharmacy.

It will also require additional manpower to provide an efficient and effective pharmaceutical care.

38
Q

A special counseling area or room may be used and reserved initially for those patients having the potential for certain medication-related problems such as
patients taking multiple medications or having certain diseases.

A

Patient Counseling

39
Q

The pharmacist is intimately involved with medications, it is logical that educational services may be provided to patients receiving potentially dangerous medications, those prescribed on confusing schedules or administered by unusual means.

A

Patient Education

40
Q

The pharmacist may develop medication profiles for out-patients. This will enable the pharmacist to evaluate patient’s entire drug regimen which will be particular value for the routinely-seen patient in the out-patient pharmacy.

Potential drug interactions may be detected by the pharmacist and reported to the prescribing physician.

A

Developing Patient Medication Profiles

41
Q

The pharmacist may provide general drug information which will assist patients in gaining a better understanding of their medications and how to take them.

A

Providing Drug Information

42
Q

The ____ is usually confined in a specific section where environment is controlled, vital signs are routinely recorded, and medications are scheduled and administered by trained professionals.

 The pharmacist focuses in providing medications on a ___ basis.

A

hospitalized patient

24-hour

43
Q

Methods in In-patient Drug Distribution System

A
  1. Individual Prescription Order System
  2. Floor Stock/Ward Stock System
  3. Combination of Individual Prescription Order and Floor Stock System
  4. Unit Dose Drug Distribution System (UDDDS)
44
Q

 All medicines are retained in the pharmacy service until receipt of the physician’s initial order. The nurse remains responsible for most aspects of the preparation of the unit doses;
 A one day supply of medications good for one day are dispensed;

A

Individual Prescription Order System

45
Q

 This system facilitates a convenient method for instituting patient drug charges and it provides individualized patient service;
 Safest and most economical method;
 Use by small and/or private hospitals.

A

Individual Prescription Order System

46
Q

They remain responsible for most aspects of the preparation of the unit doses;

A

Nurses

47
Q

Advantages of Individual Prescription Order System

A

 Allows the pharmacist to directly review medication orders.
 Provides interaction among pharmacists, physicians, nurses,
and patients.
 Provides proper charges and bill of all medications issued to
patients.
 Provides an efficient inventory control.

48
Q

Disadvantages of Individual Prescription Order System

A

 Possible delay in obtaining the required medication.
 Increased personnel requirements of the Pharmacy Service, which is necessary for the individual prescription
dispensing function.

49
Q

 A bulk supply of each drug product is stored in the nursing station in advance. The nurse is totally responsible for all aspects of the unit dose preparation as
well as administration and refill of used item from the pharmacy.

A

Floor Stock / Ward Stock System

50
Q

 Issuance of medicines must be controlled quantities for emergency use in treatment areas (OR, RR, DR, ICU)

 Used most often in government hospitals in which charges are not made to the patient.

A

Floor Stock / Ward Stock System

51
Q

Types of Floor Stock Drugs

A

• Charge Floor Stock Drugs
• Non Charge Floor Stock Drugs

52
Q

Are those medications that are stocked on the nursing station at all times and
are charged to the patient’s account after they have been administered.

A

Charge Floor Stock Drugs

53
Q

Are group of medications that are placed at the nursing station for use of all patients on the pavilion and for which there may be no direct charge to the patient’s account.

A

Non-Charge Floor Stock Drugs

54
Q

Making use of plastic or metal card prepared on patient’s admission.

A

Charge Plate

55
Q

The pharmacist fills pre-labeled envelopes with specific drugs and places a predetermined quantity on the nursing unit.

When the drug is administered to the patient, the nurse places the patient’s name and room number on the envelope and places it in her “out” basket.

This is later picked up by the messenger service and is delivered to the pharmacy where it is priced and forwarded to the accounting office.

A

Envelope System

56
Q

 The night shift nurse checks the medicine closet, utility room and drug refrigerator inventory of supplies against a master list provided by the pharmacy through the nursing station.

A

Drug Basket Method

57
Q

The nurse places a check mark on the number required for each drug on the requisition for floor stock supplies.

Where there is an empty container, she places it in the drug basket.

Once the procedure is completed, the drug basket containing the empty containers and the requisition for floor stock supplies is then sent to the pharmacy service.

A

Drug Basket Method

58
Q

 Utilizes a specially constructed stainless steel truck;

 (60 inches high, 48 inches wide, 25 ½ inches deep, 8 inches balloon tires)

 Two mobile units are put into operation in order to permit one unit to be use while the other is being serviced.

A

Mobile Dispensing Unit

59
Q

 Under this system, the primary means of dispensing is the use of Individual Prescription Order System but utilizes or combined with limited number.

Floor Stock items (common non-prescription medicines like Paracetamol and other drug products such rubbing alcohol, disinfectants).

A

Combination of Individual Prescription Order and Floor Stock System

60
Q

 Most commonly used in hospitals for unit-dose dispensing and individually charge patients for drugs.

A

Combination of Individual Prescription Order and Floor Stock System

61
Q

 Is a pharmacy-coordinated method of dispensing and controlling medications in organized healthcare settings
depending on the specific needs of the hospital.

A

Unit Dose Drug Distribution System (UDDDS)

62
Q

 It can be used for medications administered by any route, the most common are oral, parenterals and respiratory routes.

Though most pharmaceuticals could be purchased in a pre-packaged, unit-dose medications, other drug products can
still be purchased in bulk supplies of tablets and capsules.

These can be repacked in unit doses at the central pharmacy.

A

Unit Dose Drug Distribution System (UDDDS)

63
Q

UDDDS Flow of Unit-Dose Dispensing

A

 Physician’s medications order is sent to the pharmacy.
 Pharmacist verify the orders and place drugs in unit-dose carts.
 For accuracy, the pharmacist must check each drawer before the carts are transported to the wards.
 A medication administration recording form is placed on top of the
cart. The nurse uses this form to check and then affix his/her signature on the time of each medication administration.
 The next day, the carts are retrieved from the wards and the pharmacist fills with unit doses for the next 24 hours.

64
Q

UDDDS Basic Aspects of Unit Dose System:

 Medicines are contained in ___ packages.
 They are dispensed in as “____” form as possible.
 Less than ___ supply of doses is delivered to or available anytime at the patient area.

A

single unit

ready-to-administer

24-hour

65
Q

Where all drug products are stocked and distributed to patients taken directly from the Central Pharmacy.

A

Centralized

66
Q

Where the drug products are distributed to patients taken from satellite pharmacies.

A

Decentralized

67
Q

refill doses, packaging and IV additive preparations.

A

Centralized (Central Pharmacy)

68
Q

only for starter and emergency
doses.

A

Decentralized (Satellite Pharmacy)

69
Q

Where the generic name is not indicated

A

Violative Prescriptions

70
Q

Where the generic name is not legible and a brand names which is legible is indicated

A

Violative

71
Q

Where the brand name is indicated and instructions added (such as the phrase“no substitution”) which tend to obstruct, hinder or prevent proper generic dispensing).

A

Violative

72
Q

Violative prescriptions shall not be filled. The pharmacist shall advise the prescriber on the problems to be able to get the proper prescription.

A
73
Q

 Where the brand name precedes the generic name

A

Erroneous

74
Q

 Where the generic name is the one in parenthesis;

A

Erroneous

75
Q

 Where the brand name is not in parenthesis.

A

Erroneous

76
Q

 Where more than one product is prescribed on one prescription form.

A

Erroneous

77
Q

Erroneous prescriptions shall not be filled. Such prescriptions shall be kept and reported by the pharmacist to the authorizedvofficial for appropriate action.

A
78
Q

 When only the generic name is written but is not legible;

 When the generic name does not correspond to the brand
name;

 When both the generic name and the brand name are not
legible;

 When the drug product is not registered with the FDA.

A

Impossible

79
Q

Impossible prescriptions shall not be filled. The pharmacist shall advise the prescriber of the problems to be able to get the proper prescription.

A
80
Q

The nurse uses this form to check and then affix his/her signature on the time of each medication administration.

A

Medication Administration Recording Form