Midterm Flashcards
What does Rx mean?
Stands for prescription
to take/recipe
What is a prescription?
A written, verbal, or electronically transmitted order issued by a practitioner for a drug or device to be dispensed for a patient by a pharmacist
What are the requirements for a written prescription?
Must be in ink, indelible pencil or typed
What must be on the label of a prescription prior to being dispensed or delivered?
Rx only
Caution: Federal law restricts this drug to use by or on the order of a licensed veterinarian
What is a prescription drug?
A pharmaceutical drug that legally requires a medical prescription to be dispensed
TF: Over the counter drugs do not require Rx
True
What is the difference between the brand name drug and the generic name drug?
Brand name- trade name or proprietary - holds a patent
Generic drug - non-proprietary (drug marketed chemical name without advertising)
What is a new prescription?
Original Rx written for the 1st time (may contain refills)
What is a refill prescription?
Second or subsequent set of doses upon doctor’s orders
What are the different types of prescriptions?
Written Verbal (except CII) Transfer (not controlled) Electronic (not CIIs) Fax
TF: Clinical pharmacists under collaborative practice can prescribe prescriptions
True
How do you verify a DEA number?
Add the 1st, 3rd, 5th digit
Add the 2nd, 4th, 6th digit and double it
Add the two totals together
The second digit is the last digit in DEA
What is the first letter of the DEA?
The type of registrant
What is the second letter of the DEA?
First letter of the provider’s last name
What is required on a prescription from the prescriber?
Prescriber name, address, DEA or NPI, Signature, phone number
What is needed for patient information on the prescription?
Name
Address (for controls, fax and electronic)
Date of birth for fax or electronic
What other things are required on a prescription?
Issue date
Name, strength, dosage form, quantity of drug
Instructions for use
Refills if any
How long is a non-controlled prescription valid for?
1 year
How long is a controlled drug (CIII-CV) valid for refills?
6 months
How long are refills valid for CII drugs?
None/ cannot have refills
When can the generic drug be administered for a prescription?
When “generic substitution permitted” is checked off
What needs to be labeled for Federal law on prescriptions?
Name and address of dispenser Serial or prescription number Date of filling Prescriber's name Patient's name Directions for use Cautionary statement
What must be on the pharmacy label for MS?
Pharmacy name and address Prescription number Prescriber name Directions Refill/Fill date Pharmacist identifier
What is not required for prescriptions?
Auxiliary labels
Physical description of drug
How is inspection done for physical exams?
By looking at the patient or the area of body that is being examined
How is palpation done?
By touching the part of the body that is being examined
How is percussion done?
By tapping your finger over a part of the body to determine if a compartment is filled with air, fluid, or solid material
How is auscultation done?
By listening to a part of the body through a stethoscope to determine if normal or abnormal sounds are present
How would you look at a patients appearance for a general assesment?
By looking at their hygiene, attire, skin color, presence of sores, signs of redness
What would you look for in a patient to observe their behavior?
Their facial expressions, level of consciousness, orientation, speech and demeanor
How would you observe a patients mobility?
Their posture, range of motion, gait and use of mobility aids
How would you measure a patient’s height?
Measure from heel to top of head in inches or cm
What is actual weight?
The measure of weight in kg or lb
How would you calculate ideal weight for males?
IBW=50+(2.3x (height in inches-60))
How would you measure ideal body weight for a female?
IBW=45.5 +(2.3 x(height in inches-60))
How would you measure adjusted body weight?
Ideal body weight in kg + (0.4 x (actual-ideal)
What is BMI?
Body mass index
Measure of how much fat in body
What is the units for BMI?
kg/m^2
How do you calculate BMI?
BMI=703 x (weight in pounds/ (height in inches)^2)
If a person has a BMI of less than 18.5, what would they be classified as?
Underweight
What is the normal BMI range?
18.5-24.9
What class of obesity does a person who has a BMI of 36 fall into?
Class II Obesity
What are vital signs?
Temperature Respiratory rate Pulse Blood pressure Blood oxygen saturation
What can vital signs do?
Identify the existence of an acute medical problem
What do vital signs measure?
The magnitude of an illness and how well the body is coping with the resultant physiologic stress
Where can you take body temperature?
Rectal Tympanic Temporal Oral Axillary
If a person has a temperature of 99.0 F in the armpit, do they have a fever?
No the normal range in the armpit is 94.9-99.6F
What is pulse?
The heart rate
Beats per minute
What is the range for a normal heart rate?
60-100 BPM
What is respiratory rate?
12-20 BPM
Breaths per minute
What does oxygen saturation signify?
The percent of blood oxygen content and oxygen delivery
What is the normal range for oxygen saturation?
95-100%
What is the normal blood pressure?
Less than 120/80 mmHg
What vital sign usually offers no relevant information for the routine exam?
Respiratory rate
Where can you take pulse?
Any place where there is a large artery
What is the review of systems?
Inventory of body systems obtained by asking a series of questions to identify signs or symptoms the patient may be experiencing or has experienced
What is required for payments?
Review of Systems
What are the three types of ROS?
Problem pertinent
Extended
Complete
What does problem perinent ros ask about?
Asks about the system directly related to the problem identified by the history of physical illness
What does extended ros ask about?
About the system directly related to the problem identified in the HPI and a limited number of additional systems
What does complete ROS ask about?
The systems directly related to the problems identified in the HPI plus all additional organ systems
What is blood pressure?
The pressure exerted against the arterial wall
What is blood pressure measured in?
mmHg
What is the systolic?
Peak value
Pressure during cardiac contraction
What is diastolic?
Nadir value
Pressure during filling of the chambers
What is considered a high blood pressure stage 1?
130-139
What is considered hypertensive crisis?
Higher than 180
What is a normal blood pressure?
Less than 120 for systolic and less than 80 for diastolic
What are the different types of arterial hypertension?
Essential hypertension Secondary hypertension Resistant hypertension Masked hypertension White coat hypertension
What do you need for manual blood pressure checking?
Stethoscope
Sphyngmomanometer
When should a patient come back for a follow up if the blood pressure was normal?
2 years
When should a patient come back if the blood pressure is elevated
1 year
What should you tell the patient if they have stage 1 hypertension?
Confirm with a second reading within 2 months
What should you tell the patient if they have stage 2 hypertension?
TO evaluate again within 1 month
If BP is above 160/110 to check back in a week
What should you tell the patient if they have hypertensive crisis?
Seek medical attention immediately
What does a polysaccharide vaccine do?
Stimulate T-cell independent immunity
Stimulate B cells without assistance of helper T cell
Short lived immunity
No booster effect
Not consistently immunogenic in children younger than 2
Do polysaccharide vaccines have a booster effect?
No
Do polysaccharide vaccines have short or long term immunity?
short term immunity
Which vaccine stimulates T cell independent immunity?
Polysaccharide vaccine
What vaccine stimulates T cell dependent immunity and involves helper T cells?
Conjugate polysaccharide vaccine
What vaccine produces immunologic memory and results in a booster effect when exposed later?
Conjugate polysaccharide vaccin
How many days early can a patient receive a live vaccine?
4 days early (need 30 days usually in between but can come from 26-30 days later)
When should a patient get a Tdap vaccine when they are pregnant?
Until she is 20 weeks pregnant but usually 27-36 weeks pregnant
If a patient has HIV, should they get a vaccine?
Yes
A patient had a severe allergic reaction to the same vaccine before, should they be given the vaccine?
No
How many varicella doses should a child get to go to school?
2 doses (do not need to start over dosing if they miss the second dose just continue and get the second one?
What vaccines should an immunocompromised patient not recieve?
Live attenuated
What opportunities are their for pharmacists to provide drug information?
Direct patient care Managed care organizations Insurance industry Scientific writing and medical community Pharmaceutical industry
What 3 skills do you need to provide accurate drug information?
Investigation (ask questions)
Evaluation (think critically)
Communication (speak with confidence and compassion)
What are the 3 C’s of successful communication?
Character (trust)
Chemistry (compassion/ communication)
Competence (respond with confidence )
What are tertiary resources?
They are filtered and summarized by the author
Easy to use and access
Lexicomp, Medscape, Textbooks, Review articles
What are secondary resources?
Indexes and abstracts
Databases
Pubmed, GoogleScholar, AccessPharmacy
What resource literature is the most up to date and recent?
Primary resources
Medical journals
What drug information resources requires skillful discernment and is accessed by professionals?
Primary (trials, study, cases)
What drug information resource is a search engine and requires proper searching skills?
Secondary (pubmed)
What drug information resource is the most commonly used and easily accessible?
Tertiary (textbooks, review articles, package inserts)
