Non-Medication List Flashcards
4 Big Prescribers
Physicians, Dentists, Podiatrists, Veterinarian
Mid-Level Prescribers
Optometrist, Advanced Practice Registered Nurse (APRN), Physician Assistant, Pharmacists
What do the numbers on NDC stand for?
- First 5: Manufacturer
-Middle 4: Drug, strength, dosage form, formulation of product - Last 2: Package size (comes in bottles of 100, 500, etc)
CSS: Schedule I
No medical use, highest potential abuse, unsafe
CSS: Schedule II
Medical use, high abuse potential, highly addictive
CSS: Schedule III
Medical use, medium abuse and addiction potential
CSS: Schedule IV
Medical use, low abuse and addiction potential
CSS: Schedule V
Limited abuse potential and/or psychological dependence
Prescription Requirements (8)
- Patient name
- Patient address
- Prescriber
- Date written
- Drug name
- Directions
- Drug Quantity
Limitations on Rx Refills: C-II
Expire no later than 1 year from issue date with no refills
Limitations on Rx Refills: C-III, C-IV, C-V
Expire no later than 6 months from issue date, 5 refills max
Limitations on Rx Refills: Non-controlled
Unlimited refills, expires 1 year from written date
Requirements for Generic Substitutions
Requires the statement, “Generic for…”
Patient Counseling 3 Prime Questions
- What is this medication used for?
- How did your doctor tell you to take the medication?
- What did the doctor tell you to expect (side effects)?
Generic Substitution - Therapeutic Equivalence
- Product must be both pharmaceutically equivalent & bioequivalent
Pharmaceutical equivalence
- Active ingredient
- Dosage form
- Strength
- Route
- Labeling
Bioequivalence
- In vivo (human) results
- In vitro (lab) results
- Kinetics, dynamics, clinical effects
4 Identifiers of Insurance Cards
- ID number
- RxGRP
- RxBIN
- RxPCN
Medicaid
- State-funded program
- Low-income families, children, expecting mothers
- Covers many medical, dental, & Rx claims
- Most Rx; some OTC
Medicare
- Federally-funded program
- Elderly & disabled patients
- Part A: hospital
- Part B: outpatient, few needs (diabetic/medical supplies, oral anti-emetics for cancer, vaccines, like flu, pneumo, COVID)
- Part C: “advantage,” deductible coverage, increasing Rx coverage
- Part D: Rx coverage
Phone-In Prescriptions - Interruption
Repeat back individual pieces of info as they say it, by
interrupting
Phone-In Prescriptions - Echo-back
At the end, repeat back entire Rx in a logical sequence
Rules for Transferring - Non-controlled Rx
Can be transferred multiple times between pharmacies within refill authorization limits on Rx
Rules for Transferring - Controlled-III, IV, V Rx
- Cannot be a new Rx-pt must have filled it at least once
- One time transfer only
- Exception: receiving & sending pharmacies share a common database
Rules for Transferring - Controlled-II Rx
No refills allowed, no transfers
Receiving Transfers
Get pt’s prescription info, Orig Rx #, date issued, date first filled, original # of refills, refills remaining, transferring pharmacy name + info, transferring RPh, Receiving RPh and Intern (if applicable), Prescriber’s info
Transferring Out
- Name of pharmacy
- Address of pharmacy
- DEA # of pharmacy
- Pharmacist’s name
- Date of Transfer
- Student Pharmacist/Intern’s name
Institute of Safe Medication Practices (ISMP)
Private entity focused on increasing the safety of
healthcare practice through documentation of how/why med errors occur, communicating trends to healthcare community
Food and Drug Administration (FDA) MedWatch
- A gov’t agency interested in product failures & serious adverse effects for all types of meds, medical devices & foods, which publishes recalls issued by manufacturers
- Perform drug seizures
Recall
correction or removal & notification by company of a product which is a violation of law; voluntary, Classes I
(serious adverse effect), II (temporary or reversible effects), III (unlikely to cause serious adverse effects)
Seizure
FDA (adulterated or misbranded isolation of
drugs); DEA (illegal to possess or distribute) → both physically isolate the drugs
Enhancing Customer Service
- Establishing & meeting expectations
- Demonstrating empathy
- Communicating clearly & directly
- Identifying problems & creating solutions
- Building relationships
- Following up with patients
Over the Counter Triage
Symptoms
- Characteristics of Symptoms
- History of Symptoms
Onset
Location
- Aggravating Factors
Remitting Factors
- Medication Use (Rx & OTC)
Allergies
- Coexisting conditions
When to Refer
No relief after 1 week of OTC treatment
Worsening of symptoms
Severe bleeding/pain
Reactions to OTC meds
