T1 - Final Exam - Lectures Flashcards
What is professionalism?
The conduct, aims, or qualities that characterize or mark a profession
What is altruism?
Make an unselfish commitment to serve the best interest of the patient above your own
What are the core competencies required for all health professionals?
- Deliver patient-centered care
- Work as part of an interdisciplinary team
- Practice evidence-based medicine
- Apply quality improvement approaches
- Use information technology
What are the roles of a pharmacist?
- Interpretation, evaluation and implementation of medical orders
- Dispensing of prescription drug orders
- Participation in drug and device selection
- Drug administration
- Drug regimen review
- Telepharmacy within and across state lines
- Drug or drug-related research
- Provision of patient counseling
- Provision of those acts or services necessary to provide pharmacist care in all areas of patient care, including primary care and collaborative pharmacy practice
- Responsibility for compounding and labeling of drugs and devices, proper and safe storage of drugs and devices, and maintenance of required records
- Continually optimizing patient safety and quality of services through effective use of emerging technologies and competency-based training
What is the scope of practice of a pharmacist?
- Each state has their own Board of Pharmacy -> different rules and regulations
- Variances in training and certifications (residency training, specialty certifications)
- Practice site specific rules and regulations
- Professional experience
What are the responsibilities bestowed on pharmacists?
- Dispensing of drugs
- Patient records
- Prospective drug use review
- Patient counseling
- Confidentiality
What are the 5 rights of dispensing?
- Patient
- Drug
- Time
- Dose
- Route
What are the classifications of med errors?
- Stage in the medication use process
- Types of errors
- Mistakes made when planning actions vs errors in the execution
- Level of severity
What is medical review therapy?
A systematic process of collecting patient-specific information, assessing medication therapies to identify medication-related problems, developing a prioritized list of medication-related problems, and creating a plan to resolve them
What is personal medication record?
A comprehensive record of the patient’s medications
What is medication-related action plan?
A patient-centric document containing a list of actions for the patient to use in tracking progress for self-management
What is the intervention and/or referral?
The pharmacist refers the patient to a physician or other healthcare professional
What is the patient care process?
Collect, Assess, Plan, Implement, Follow-up
Describe how the pharmacy profession is expanding
Pharmacy is ever evolving
Technology is continuously improving
Medication development will always continue
Everyone wants to get paid
You are your biggest advocate
How is technology improving medical care?
Digital medications
Online prescribing
Remote and continuous patient monitoring
Universal electronic medical records (EMR)
Pharmacy informatics
Mobile medical applications
What are examples of digital medicines?
- Abilify MyCite
- In-Pen
- ProAir Digihaler
What is the benefits of online prescribing and filling?
- Convenient
- Medications mailed straight to the door
What is remote and continuous patient monitoring?
May be used in conjunction with Telehealth services or independent
What is pharmacy informatics?
the scientific field that focuses on medication-related data and knowledge within the continuum of healthcare systems
What is pharmacogenomics?
the study of how genes affect a person’s response to drugs
What is the goal for pharmacogenomics?
To tailor medication therapies
What is specialty pharmacy?
Aspect of pharmacy practice that deals with specialty pharmaceuticals
What is biologics?
Medicines made from living organisms through highly complex manufacturing processes
What is biosimilars?
A biologic that is “similar” to another biologic medicine (reference product) that is already licensed by the FDA
What are the methods of advocating for pharmacy?
Set achievable goals
Send letters to your congressional leaders
Invite members of congress to your pharmacy practice
Share how your pharmacy is part of the healthcare ecosystem
Attend community events
Get to know your state representatives
Connect with other pharmacists
How can one advocate for pharmacy?
- Participation in professional associations
- Communicate with politicians
What is subjective information?
Based on personal opinions, interpretations, points of view, emotions and judgement
What is objective information?
Fact-based, measurable, and observable
What kind of info would you collect for the PPCP?
- Medication
- Medical history
- Relevant health data
- Patient lifestyle, health
What does it mean to assess?
Identify and prioritize problems and achieve optimal care
What things would you assess?
- Each medication for appropriateness, effectiveness, safety, and patient adherence
- Health and functional status, risk factors, health data, cultural factors, health literacy, and access to medications or other aspects of care
- Immunization status and the need for preventive care and other health care services, where appropriate
What is plan according to the PPCP?
Individualized, in collaboration with other health care professionals and the patient/caregiver that is evidence-based and cost-effective
What should a care plan include?
- Address medication-related problems and therapy
- Set goals of therapy
- Patient education
- Support continual care, Follow-up
What is implement according to the PPCP?
Collaborative effort between the pharmacist, other health care members, and the patient/caregiver
What are the pharmacist’s responsibilities?
- Addresses medication and health-related problems
- Initiates, modifies, discontinues, or administers medication therapy
- Patient education
- Contributes to coordination of care
- Schedules follow-up care
What is follow up in the PPCP?
Look at the efficacy of the care plan and make modifications as needed in collaboration with other health care professionals and the patient/caregiver
What factors would need continual monitoring?
- Medication effectiveness
- Clinical endpoints
- Outcomes of care
What is a drug-related problem?
An event or circumstance involving drug therapy that actually or potentially interferes with desired health outcomes
What are the 3 types of DRP?
- Patient behavior or self-medication problem
- Physician prescribing problem
- Pharmacy dispensing problem
What is the difference between an unavoidable and avoidable problem?
Unavoidable is 1st time
What is the purpose of a SOAP note?
- Continuity of care
- Professional liability
- Regulatory policy
- Payment
- Standardize medical records
What are the components of a SOAP note?
Subjective, objective, assessment, plan
What is found in the subjective section?
- Patient or caregiver reported info
- Experiences, personal views, or feelings
- Not directly observed or measured
What are the components of Subjective?
- Chief complaints
- History of Present illness
- History - medical, surgical, family, surgical
- ROS
- Current medications
- Allergies
What is chief complaint?
Reason the patient is seeing a healthcare provider or presenting for treatment
What is OLDCARTS?
- Onset: When did the CC begin?
- Location: Where is the CC located?
- Duration: How long has the CC been going on for?
- Characterization: How does the patient describe the CC?
- Alleviating and Aggravating factors: What make the CC better? Worse?
- Radiation: Does the CC move or stay in one location?
- Temporal factor: Is the CC worse/better at a certain time of day?
- Severity: Using a measurable scale, how does the patient rate the CC?
What is comprises the history section in Subjective?
- Medical: Current or past medical conditions
- Surgical: Procedure as well as year and surgeon
- Family: First degree relatives
- Social: HEADSS:
Home and Environment
Education, Employment, Eating
Activities
Drugs
Sexuality
Suicide/Depression
What is ROS?
Designed to identify symptoms not mentioned by the patient
What is Scholarmac?
- Symptoms
- Characteristics of symptoms
- History of symptoms
- Onset
- Location
- Aggravating factors
- Remitting factors
- Medications
- Allergies
- Conditions
What is the Objective section?
Data directly measured or observed by healthcare professionals
What kind of data is found in objective?
- Vital Signs
- Physical exam findings
- Lab Data
- Imaging results
- Diagnostic data
- Documentations of other clinicians
What are examples of vital signs?
BP, HR, RR, O2, Temp
What are example PEFs?
- Skin
- HEENT: head, ear, eye, neck, throat
- Pulmonary
- CV: cardiovascular
- MS/Ext: Multiple sclerosis
- Mental Status
What are example lab data?
- Blood
- Urine
- Fecal
- Culture
What are examples of imaging results?
- X-ray
- CT
- MRI
- Ultrasound
What are examples of diagnostic data?
- Angiograms
- Scopes
- Stress test
- Pulmonary function test
What are examples of documentation provided by other clinicians?
- Notes
- Diagnoses
- Meds
- Allergies
What is the Assessment section?
Synthesis of subjective and objective information to come up with a diagnosis or DRP using critical thinking
What are examples of a DRP
- Needs a drug
- Not receiving the optimal drug
- Dose is not optimal
- Adverse drug reaction
- Drug interaction
What is the Plan section?
Steps taken to treat the patient or specific recommendations to address a problem
What comprises the plan section?
- Medication: drug, dosage, duration
- Efficacy
- Toxicity
- Counseling Points
- Follow-up
- Treatment alternatives
What is A&P?
Assessment and plan using formats and presentation order will vary by writer and care setting
What are the main formats of A&P?
Problem-based: broken down by disease states in order of priority
System-based: broken down by body systems
What need to be signed on the SOAP note?
- Signature
- Credentials after name
What is anything that can be used to heal patients, plants, animals or minerals
Materia medica
What factor impacted the change in disease patterns between the Prehistoric and Neolithic Periods?
- Higher density population
- High density human & animal populations
- Cross-species transmission of infectious disease
- Relationship to animals
According to the Sumerians what was the organ that was central to life?
Liver
What is an embrocation?
Liniments
What are electuaries?
Mix of herbs in sugar water or honey
What were Babylonian vehicles for medications?
Alcohol, beer, wine, oil, fats (milk), wax
What are example dosage forms used in Ancient Babylon?
- Poultices and plasters
- Ointments and salves
- Lotions
- Tablets
- Powders
- Enemas
- Suppositories
- Pessaries
9.Inhalations / fumigations
What is Greek word for drug or poison?
Pharmakon
What is the Greek word for storekeeper?
Apothecaries
What is the Greek word for drug stores?
Apotheca
Which Greek symbol is usually incorrectly utilized to represent physicians?
The caduceus
Which Greek medical symbol should be utilized instead?
Rod of asclepius
What was Hippocrates’ practice philosophy based on?
4 humors when they are in balance that is homeostasis
How do you apply Hippocrates philosophy practice?
Imbalances can be compensated by drugs or bleeding
Where did the Rx symbol come from?
- Emperor Nero
- Recipo, the sign of Jupiter
What are the3 regulations of European Medieval Pharmacy?
- Separation of pharmaceutical profession from medical profession
- Official supervision of pharmaceutical practice
- Obligation by oath to prepare drugs reliably and in a uniform, suitable quality
What system of delivery of medicine in Colonial America would be most similar to modern day community pharmacies?
- Doctor Shop
- Apothecary shop
- General store
- Wholesale Druggist
What is the first and most commonly used biologic?
- Eli Lilly and Company: insulin
- HK Mulford Company: anti-toxin, rabies, tetanus, anti-streptococcus
What antibiotic was discovered by Alexander Fleming in 1928?
Penecillin
What was the first national pharmacy association in the United States?
APhA
What pharmacy organization is targeted toward hospital pharmacists and regulate pharmacy residency programs?
American Society of Health System Pharmacist (ASHP)
What pharmacy organization oversees the examinations required to become a registered pharmacist?
National Association of Boards of Pharmacy (NABP)
What is the only religious pharmacy organization?
Christian Pharmacists Fellowship International (CPFI)