Patient Safety

Question 1

NDC stands for?

Answer 1

National Drug Codes

Question 2

how many digits is the NDC of a drug

Answer 2

10

Question 3

how many segments in an NDC

Answer 3

3

Question 4

what does each segment of NDC mean

Answer 4

first: manufacturer, second: drug formulation, third: package size

Question 5

bar code scanning

Answer 5

help prevent medication errors

Question 6

what are LASA medications

Answer 6

lookalike-soundalike drugs

Question 7

which Institute came up with LASA?

Answer 7

Institute for Safe Medication Practices (ISMP)

Question 8

what does LASA prevent?

Answer 8

choosing the wrong medication

Question 9

Tall-Man Lettering

Answer 9

uses capital letters on part of a drug name

Question 10

how many types of Tall Man lettering are there?

Answer 10

2

Question 11

the first type of tall man lettering is recommended by what?

Answer 11

the FDA

Question 12

who recommends the second type of tall man lettering

Answer 12

Institute for Safe Medication Practices (ISMP)

Question 13

what does leading and trailing zeroes prevent?

Answer 13

dosage errors

Question 14

what is a lead zero

Answer 14

used before the decimal

Question 15

what is a trailing zero?

Answer 15

used after a decimal

Question 16

when does a trailing zero not be applied

Answer 16

to whole numbers

Question 17

ISMP Error Prone Abbreviations

Answer 17

list of abbreviations that are misinterpreted and should be avoided

Question 18

spacing dose and units

Answer 18

space between the number and the unit should be added

Question 19

drug name and dose

Answer 19

should never be ran together as it can be mistaken

Question 20

should abbreviated drug names be used

Answer 20

no

Question 21

which act introduced the DURs in 1990?

Answer 21

Omnibus Budget Reconciliation Act (OBRA)

Question 22

what does a DUR stand for?

Answer 22

Drug Utilization Reviews

Question 23

what does a DUR increase?

Answer 23

adherence and compliance

Question 24

what is a DUR?

Answer 24

a review of the patient profile, where past medications are checked by the RPh

Question 25

what protocol must be followed while preparing for a DUR?

Answer 25

identifying a target therapeutic goal

Question 26

what are the 3 kinds of DUR?

Answer 26

prospective, concurrent, and retrospective

Question 27

what does the prospective DUR do?

Answer 27

it attempts to identify potential errors beforehand such as drug-drug interactions, drug-disease interactions, changes in dosing, over/underuse of medication.

Question 28

when does a prospective DUR occur?

Answer 28

before dispensing

Question 29

when does a concurrent DUR occur?

Answer 29

at the same time as being dispensed

Question 30

what are problems identified in a concurrent DUR?

Answer 30

inapproprate dose changes, abuse, potential of drug-disease interaction, and drug to drug interaction

Question 31

what is a disadvantage of a concurrent DUR?

Answer 31

the pharmacist might not have complete patient data causing multiple reviews that are time-consuming and expensive

Question 32

what does a retrospective DUR examine?

Answer 32

the impact of medication after being dispensed

Question 33

what is a con of retrospective DUR?

Answer 33

harm or death may already have occurred to the patient

Question 34

what does PIL stand for

Answer 34

patient information leaflet

Question 35

what is a PIL

Answer 35

document that answers basic questions of a drug like trade/generic name, drug indication, mechanism, clinical pharmacology, side effects, rare adverse effects, warning, and dosing times

Question 36

do all meds require PIL ?

Answer 36

yes

Question 37

what is a MedGuide?

Answer 37

document that contains specific risks of certain medications

Question 38

what are some examples of drugs that require a medguide?

Answer 38

isotretinoin, NSAIDs, antidepressants, fentanyl, metformin, amphetamine, immunosuppressants

Question 39

what is the name of the FDA's reporting system for an adverse reaction?

Answer 39

MedWatch, founded in 1993

Question 40

adverse reactions are?

Answer 40

unexpected reactions

Question 41

which two categories are not covered by MedWatch?

Answer 41

vaccines and vet stuff

Question 42

what is the reporting system for vaccines?

Answer 42

VAERS: Vaccine Adverse Event Reporting System

Question 43

benefits of MedWatch?

Answer 43

it can detect unexpected reactions for which FDA issues an alert notice to professionals and the public

Question 44

what is the Beer's Criteria?

Answer 44

an important list of meds with caution for elders. these meds have added risk

Question 45

why elders?

Answer 45

they metabolize drugs to a lesser extent causing drug to accumulate

Question 46

what are the 4 objectives with Beer's Criteria?

Answer 46

1. Deprescribing meds that are no longer necessary 2. Reducing polypharmacy as much as possible 3. Reducing drug-drug and drug-disease interactions 4. Increasing risk benefit ratio of med to patient

Question 47

what events are sentinel events?

Answer 47

events that cause death or permanent/temporary harm in the healthcare (to patients, staff, or both)

Question 48

are sentinel events common

Answer 48

no, but constitute medical emergencies that may involve law enforcement

Question 49

what are examples of sentinel events?

Answer 49

- patient committing suicide - unexpected death of an infant brought to full term - infant discharged to the wrong person or family - rape/assault of a patient/staff

Question 50

all sentinel events must be recorded for?

Answer 50

analysis

Question 51

root cause analysis, RCA

Answer 51

analyzing the cause of the incident and implement preventive measures

Question 52

polypharmacy

Answer 52

patient taking at least 5 medications at the same time

Question 53

who does polypharmacy affect the most?

Answer 53

elders

Question 54

prescription cascade

Answer 54

side effect of a medicine is assumed as a new problem, requiring additional medication

Question 55

what does polypharmacy increase?

Answer 55

risk of med error, drug-disease interaction, and loss of compliance

Question 56

compliance

Answer 56

patient following medical advice

Question 57

is compliance same as adherence?

Answer 57

yes

Question 58

concordance

Answer 58

patient and doctor relationship where they work together for the treatment

Question 59

placebo

Answer 59

what a patient believes about the medication positive mental states about a drug can impact how the drug affects the patient

Question 60

nocebo

Answer 60

patients have negative expectations of a drug

Question 61

crash cart medication

Answer 61

crash cart contains equipment and meds that needed for the first 30 minutes of a medical emergency

Question 62

how often is the crash cart maintained

Answer 62

monthly

Question 63

what is the crash cart maintenance checked for

Answer 63

batteries and expired medications

Question 64

auxiliary labels

Answer 64

caution labels for safe administration, use, and storage