Unit 5 Review Flashcards
Ways to receive new prescription?
Hand delivery (Paper copy), Fax, Verbally, Electronically
Ways to receive prescription refills?
Patient representive can call, Leave a message, In person, App
What do you put as the written date for a transferred prescription?
Original written date
What are the prescription requirements for a Non Controlled Prescription?
Date Written
Patient Name & date of birth
Name, Strength, dosage form, and quantity of medication
Directions for use
Prescribers Name, Address, license designation (MD, MO, PA)
Number of refills
Prescriber’s signature
What are the prescription requirements for a Controlled Prescription?
Date Written
Patient Name & date of birth
Medication dispensing info
Prescribers Name, Address, license designation (MD, MO, PA)
Prescribers DEA number
Patient’s full address
Prescriber’s signature on C-II must be handwritten or digitally verified
What info do you need from a new patient?
Name, Address, Telephone Number, Date of birth
Allergies
Medications currently taking
Health insurance
Disease states and conditions
What to verify on existing patient for new prescription?
DOB, Address, Telephone #, Health insurance, Allergies, Current medical conditions and medications
What are some common red flags with patients?
Ask to pay cash for controls
Demand certain brands
Drops of prescriptions for controls frequently
Comes from another city or town
Receive prescriptions from multiple doctors or pharmacies
What are some common prescription red flags?
Looks altered or forged, Large quanties, incomplete, Written by non local prescriber
What is PRN for refills?
Refill as needed until expired
What are the Scheduled drugs refill limits?
II = No refills allowed
III & IV = no more than five
V = No restrictions
What are the expiration dates for drugs of different classes?
Non controlled = 1 year
Class-II = no expiration
III - V six months from date written
What drugs require immediate cleaning of supplies?
Sulfa, Penicillin, Aspirin
What must a prescription label include?
Patients Name
Date pharmacy processed prescription
Pharmacy Name, Address, and telephone #
Prescription #
Medication Name, Strength, and dosage form
Quanity dispensed, Directions on use, Drug manufacturers name
Prescriber Name
Number of refills, Expiration date of medicine
Control medication warning against diversion
What are auxiliary labels used for?
Used as a warning to the patient how to take and store medication and its side effects
What drug classes are hazardous?
Chemotherapy agents, Immunosuppressants, Antivirals
What are the potential adverse effects when exposed to hazardous drugs?
Carcinogenicity (cancer-causing)
Teratogenicity or developmental toxicity (causing harm to unborn child)
Reproductive toxicity (interference with normal reproduction such as fertility)
Organ Toxicity at low doses (harming organs, such as heart, liver, lungs)
Genotoxicity (damaging the genetic information in a cell)
What is the NIOSH list?
A list of hazardous drugs, contains information about the specific risks associated with the medicine.
updated every few years
What is the USP chapter <800>
Contains standards for handling hazardous drugs in healthcare settings
Must be followed when handling any drug on NIOSH list, any hazardous ingredient
How often must a pharmacy do an assessment of risk?
at least once yearly
Carcinogenicity Hazard Drugs?
Arsenic trioxide (Trisenox)
Azathioprine (Imuran)
Busulfan (Myleran)
Cisplatin (Platinol)
Cyclophosphamide
Spironolactone
Tamoxifen (Nolvadex)
What safety equipment is needed for crushing or cutting hazardous medication?
Double gloves, respiratory protection, gown, ventilation
Teratogenicity Hazard Drugs?
Divalproex (Depakote)
Leflunomide (arava)
Liraglutide (Victoza)
Mycophenolic acid (Myfortic)
Mycophenolate mofetil (CellCept)
Thalidomide (Thalomid)
Reproductive Toxicity Hazard medications?
Bosentan (Tracleer)
Finasteride (Proscar)
Paroxetine (Paxil)
Tacrolimus (Prograf)
Organ Toxicity Hazard medications?
Leflunomide (Arava)
Teriflunomide (Aubagio)
Genotoxicity Hazard Medications?
Abacavir (Ziagen)
Dexrazoxane (Zinecard)
What does AOR stand for?
Assessment of risk
What 4 things does a plan for handling hazardous medications need?
Engineering Controls, PPE, Safe work practices, Disposal
What does USP <800> cover?
Standards for Address receiving, storing, compounding, dispensing, administering, and disposing of hazardous drugs.
What is the list called that keeps track of confusing medication names?
Confused Drug List
Sig also refers to?
Directions for prescription
When do prescriptions expire?
1 year for non-controls, no expiration for C-II, 6 months for other classes
How to clean counting tray for hazardous medications?
Apply rubbing alcohol to a clean disposable cloth then wiping it down.
What 2 drugs types are all high-alert medications?
Insulins, opioids
Specific drugs that are hazardous?
Dutasteride (Avodart), Finasteride (Proscar), Azathioprine (Imuran), Ganciclovir (Zirgan), Medroxyprogesterone (Depo-Provera), Conjugated estrogens (Prempro), Thalidomide (Thalomid), Chlorambucil (Leukeran), Cyclophosphamide (Cytoxan), Capecitabine (Xeloda), Exemestane (Aromasin), Fluorouracil (Carac), Hydroxyurea (Hydrea), Methotrexate (Trexall), Testosterone-containing products
Color of waste trashcans?
Hazardous waste = Black | Chemo Waste = Yellow | Non-Haz = Med waste blue/white | Biohaz waste = red/orange
Cleaning a hazard steps?
Step 1 - access a spill kit
Step 2 - Garb (put on) PPE
Step 3 - Clean up any broken glass and place it in a sharps container
Step 4 - Follow pharmacy policy for spill cleaning, deactivation, and decontamination.
Step 5 - Put used cleaning supplies and garbs in bag and double bag it. Close outer bag and label it as hazardous to ensure proper disposal.
Step 6 - Wash your hands
Step 7 - Check your stock to ensure there are enough spill kits for any future spills
Step 8 - Follow through on replacing the spilled med if needed
Step 9 - Complete a spill report if required by your pharmacy’s policy.
Types of Two-Pan balances?
Class III prescription balance - used to weigh small amounts of material
Counterbalance - Used to weigh large or bulk amounts of material.
Pharmaceutical weights - used when weighing ingredients on two-pan balances
- Use forceps when using weights to protect them from moisture and oil from hands
Procedure for weighing creams and ointments?
Place empty glassine paper on the digital scale, Tare scale, put ointment on paper, put in jar
Procedure for powder?
Same as cream or ointment. Use a weighing boat instead of glassine paper
What are the measurements for amber bottles?
Milliliters and ounces
What is OBRA 90?
A law that requires patients to receive counseling by the pharmacist or are offered phamacist counseling.
When is a notice of privacy required?
With each RX
What is a co-pay?
is the amount a person with health insurance is required to pay for a prescription.
Copay vs Coinsurance?
Co-payment is a set dollar amount vs Coinsurance is a percentage of the medications cost.
ScriptPro and Parata steps?
Select, count, and pour the med into the vial, label the vial,
Parata caps the vial with a lid
ScriptPro leaves the lid off
What does ADD mean?
Automated Dispensing Devices (ADDs)
What are the high alert medications?
Insulins, Opioids, Carbamazepine, Warfarin
Measures to avoid exposure to hazards?
Check NIOSH list to determine if spill is hazardous, then refer to SDS for additional information on hazards and handling spills.
What is a third party payer?
Company that pays healthcare providers for their services
What is adjucation?
Third party process of accepting or denying a submitted claim
What are the 3 goverment sponsored insurance programs?
Medicaid, Medicare, TRICARE
What does MCO stand for?
Managed care organization
What does HMO stand for?
Health maintenance organization (HMO)
What does PPO stand for?
Perferred provider organization (PPO)
What does PBM stand for?
Pharmacy benefits manager (PBM)
What is a Medicaid?
Joint federal and state program. For patients under the national poverty level. Provides coverage for children, pregnant women, the elderly, and patients with disabilities. Pharmacy has to contract with state to process claims. Prices must be the same or lower than what is charged for other patients.
What is Medicare
Managed by federal government. Coverage for patients over 65, disabled under 65, who had a kidney transplant, have kidney failure and on dialysis, Amyotrophic lateral sclerosis (ALS), has part A, B, C, D.
What are the enrollment time frames for medicare?
3 months before or after turning 65, younger than 65 and on due to disability can join 3 months before or 3 months after receiving disability for 25 months. Open enrollemnt is october 15 to december 7
What is part A for?
in patient Hospital care, nursing facility, hospice care, Inpatient medications
What is part B for?
Doctor services, outpatient hospital care, Physical therapy, DME, Home healthcare, some out patient medications, Diabetic testing supplies
What vaccines are covered under Part B?
Influenza, Pneumonia, Hepatitis B, Injury-related
What is medicare part c?
Medicare A, B, and D - Also called medicare advantage plan or medicare health plan, administered by private insurers
What is medicare Part D?
Sponsored by federal government and private administrator. Pays for cost on prescription
What is TRICARE?
Department of defense health insurance for military personnel and family. Uses DEERs system to track medical services
What is a Managed care organization?
Provides quality healthcare benefits to enrollees while keeping costs low. Provided to employees by employers. Two types HMO and PPO. Medicare and medicaid are also Managed care organizations
What is a Health maintenance organization?
Type of MCO - Restricted provided choice, in-network providers, referrals for specialist, doesn’t require claims to be submitted, lower costs
What is Preferred Provider Organization?
Type of MCO - Healthcare professionals treat for an agree upon rate, patient may choose provider, higher (premium deductibles copays Coinsurance), no need for specialist referrals, out of network care is a higher fee and separate deductible, out of network care may require direct payment and filing claims
What are the formulary tiers?
T1 = Generic drugs, T2 = Brand Names, T3 = Brand names not on formulary (may require PA), T4-6= High cost or speciality drugs
What is a Pharmacy Benefits manager?
Hired by third party payer to administer their prescription drug plan and acts as middle man between insurer and pharmacy.
What is the bin?
6 digit number that identifies insurance company
What is the PCN?
secondary identifier routes claims to correct insurance company. Used for insurances with a PBM. If no PBM no pcn
What is a dependent code?
Identifies which family member is using benefits
What is a group number?
Unique number assigned to an employer or organization who insures their employees, or a group of people
What is having 2 coverages called?
Dual-eligible
What is billed first between medicare and medicaid?
Medicare
