Self-Care and Nonprescription Therapy + Legal and Regulatory Issues Flashcards
What are examples of Self-Care?
- Non-pharmacological
- Behind the Counter medications
- OTC medications
- Statewide protocol
What is self-care?
The independent act of preventing, diagnosing, and treating one’s illness without seeking professional advice
What are the 7 pillars of self-care?
- Health Literacy
- Self awareness of physical and mental condition
- Physical activity
- Healthy eating
- Risk avoidance or mitigation
- Good hygiene
- Rational and responsible use of products, services, diagnostics, and medications
Define the community pharmacist contributions.
- 8 in 10 adults use them as a first response to minor ailments
- Over-the-counter medicines provide $102 billion in value to the U.S. healthcare system annually.
What is the preferred first line of treatment that both physicians and consumers agree on?
OTC
3/4 of all primary care physicians will recommend an OTC medicine before an Rx.
2/3 or consumers perfer taking an OTC medicine when available versus an Rx.
Pharmacists’ Patient Care Process
C stands for…
Collect
* The pharmacist assures the collection of the necessary subjective and objective information about the patient in order to understand the relevant medical/medication history and clinical status of the patient.
Pharmacists’ Patient Care Process
A stands for…
Assess
* The pharmacist assesses the information collected and analyzes the clinical effects of the patient’s therapy in the context of the patient’s overall health goals in order to identify and priotitize problems and achieve optimal care.
Pharmacists’ Patient Care Process
P stands for…
Plan
* The pharmacist develops an individualized patient-centered care plan, in collaboration with other health care professionals and the patient or caregiver that is evidence-based and cost-effective.
Pharmacists’ Patient Care Process
I stands for..
Implement
* The pharmacist implements the care plan in collaboration with other health care professionals and the patient or caregiver
F stands for…
Follow-up: Monitor and Evaluate
* The pharmacist monitors and evaluates the effectiveness of the care plan and modifies the plan in collaboration with other health care professionals and the patient or caregiver as needed.
What does SCHOLAR-MAC stand for?
- S–> Symptoms
- C–> Characteristics
- H–> History
- O–> Onset
- L–> Location
- A–> Aggravating factors
- R–> Remitting factors
- M–> Medications
- A–> Allergies
- C–> Conditions
What does QUEST stand for?
- Qu–> Quickly and accurately assess the patient
- E–> Establish the patient is appropriate candidate for self care
- S–> Suggest appropriate self care strategies
- T–> Talk with the patient
What are the open ended questions for the patient assessment?
- What symptoms are you experiencing?
- When did your symptoms start?
- What have you tried to treat this already?
Step 1 of pt assessment= open ended questions
What questions do you ask for the patient evaluation?
- Pt history? Allergies?
- What have they tried?
What is the difference between Rx and OTC?
RX
* Medication focused
* Pt seeks medical attention
* Physician develops treatments plan (RPH might be involved)
* Pt brings RX to pharmacy
* RPh counseling
OTC Process
* Problem focused
* Pt seeks medical attention
* Pharmacist triages patient (self-care or referral)
* RPH develops treatment plan and counsels on OTCs.
What medications are considered analgesics?
- Advil/ibuprofen (max recommended dosing is 1.2 g/day
- Tylenol (acetaminophen)–> max recommended dosing is 4g/day–> recommended duration of use is 7 days
- Voltaren (Diclofenac)
- Aspirin
- Aleve (Naproxen)
What medications are good for GI/GERD?
- Antiacids (Milk of Magnesia, Magnesium carbonate)
- H2RAs (Pepcid or Famotidine)
- PPIs (Prilosec/Omeprazole)
- Pepto-Bismol (Bismuth subsalicylate)
- Alginic acid (Gaviscon)
What are medications that are good for cough and cold?
- Cough syrups (Delsym/Dextromethorophan)
- DayQuil/NyQuil
- Psuedoephedrine (Sudafed)–> If pt complains of sinus pressure or stuffed nose
- Cough and cold suppressents
- Dry cough= dextromorophan
- Wet cough= guaifenesin
What medications are used for allergies?
- Afrin (oxymetazoline)–> safe in pregnancy, caution: only use 3 days due to risk of rebound congestion
- Claritin (loratidine)
- Zyrtec (cetirizine)
- Nasal Sprays (Flonase, Nasonex)–> good for seasonal allergies or for runny or stuffy nose
What are common vitamins?
Vitamins A, D, E, K
Vitamins B, C
Multivitamins
Describe the 2005 Combat Methamphetamine Epidemic Act.
- Banned OTC sales of cold medicines with pseudophedrine, which is commonly used to make methamphetamine
- Behind the counter medication
- Need photo identification to purchase products as the consumer
- Pharmacy must keep personal information about purchasers for at least 2 years in written or electronic logbook and list the name of the products, quantity sold, names, and addresses of purchasers, and the dates and times of the sales
What are the psuedoephedrine federal limits?
- 3.6 g/day
- 9 g/month
What are the psuedoephedrine state limits?
- 3.6 g/day
- 7.2 g/month
What are behind the counter medications that need indentification?
- Pseudoephedrine
- Ephedrine
- Phenylpropranolamine
What are the OTC medications that need identification?
Dextromethorphan
What vaccines can the pharmacist administer?
COVID-19, influenza, HPV, Hep A/B, Shingles, and Travel vaccines
- collaborative practice agreement
- Authority per individual pharmacist
Who can administer vaccines in the pharmacy?
Pharmacists, pharm interns, pharm techs
* Can administer under another health care provider
What age ranges exist for pharmacist administered vaccines?
- Ages 3 and over for COVID-19 and flu per the PREP Act, until the end of 2024
- Can give immunizations to 13 yo and older without Rx
- Can give immunizations to 8-13 yo with an Rx (except fly shots- can do without Rx)
What tests can pharmacists give?
Administration and evaluation of diagnostic tests allowed in 47 states
Tests
* CLIA-waived tests
* COVID-19
* Influenza
* Strep
* UTI
Authority can be via pharmacist’s own license, via a CPA, or through the provisions of a state standing order.
* Birth control
* Smoking cessation
* Naloxone
W
Can RPH prescribe Birth Control?
Yes, it was passed in September 2023. Pharmacists can prescribe birth control that is self administered only.
* Combined oral pill
* Progestin only oral pill
* Vaginal ring
* Patch
* SubQ shot
* Emergency contaception (Plan B)
What are the requirements for birth control?
- Patients must be 18 years or older
- Pateitns complete a self-screener to check potenital risk factors
- Appointment should be in a confidential area
- Assess bp every six months
- Pharmacists can provide the initial prescription for up to 6 months
- Patients must meet with MD, PA, or APRN within 12 months on recieving prescription.
- Standing order from Dr. Lindsey Weaver in place for 2 years
- Keep appointment documentation for 7 years
Does PUP prescribe birth control?
Yes
