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Pharmaceutical Care Midterm > Lecture 4 - Processing an outpatient rx > Flashcards

Lecture 4 - Processing an outpatient rx Flashcards

1
Q

What are the pharmacy positions in an outpatient setting?

A

ancillary help
technicians
interns
pharmacists

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2
Q

Who are ancillary help and what is their purpose

A

unlicensed personnel

their job is to maintain stock and medical records, type labels, count and prepare dosage untits, and hand deliver completed prescriptions to patients

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3
Q

the pharmacist can supervise a maximum of ___ individuals at one time

A

4

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4
Q

can unlicensed personnel interpret or evaluate a prescription (ie: give instructions)

A

NO

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5
Q

What is the job of pharmacy interns?

A

they can perform ALL the duties of a pharmacist but must be supervised by a pharmacist at all times

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6
Q

what does HIPAA stand for

A

the health insurance portability and accountability act of 1996

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7
Q

what are some examples of “individually identifiable health information”

A

-the person’s past, present or future physical or mental health condition

-the provision of health care to the individual

-the past present or future PAYMENT for the provision of health care

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8
Q

what are some common ways to identify a person’s identity

A

name, address, DOB, SS#

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9
Q

what is the HIPAA term for places that provide treatment, payment, and operations in healthcare

A

a covered entity (pharmacy is one)

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10
Q

What is the FIRST STEP of the pharmacist patient care process

A

collect

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11
Q

what exactly are we collecting in this first step?

A

patient information (patient profile)
medication information (prescription order, evidemce based medicine_

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12
Q

when collecting information and pulling up a patient’s profile, what information should we be looking to update?

A

allergies, health, address, insurance

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13
Q

what are the 9 important things on a patient’s profile

A

name
address
DOB
phone number/email
gender
allergies
medications
chronic diseases/conditions
other relevant counseling information

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14
Q

does NKA mean that no allergies exist?

A

NO — IT MEANS WE DONT KNOW IF ANY ALLERGIES EXIST

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15
Q

patient profiles must be maintained for _____ years from the most recent entry

A

5

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16
Q

patient profiles must be reviewed for which 5 things

A

-DTP due to therapeutic duplication
-drug-drug interactions (includes OTC)
-incorrect drug dosage or duration
-drug-allergy interactions
-clinical abuse or misuse

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17
Q

what is some ADDITIONAL information that is good to collect from the patient

A

safety cap preference
delivery services
contact preference

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18
Q

any pharmacy in a group larger than ____ in NYS or ____ in NYC is required to have free written and oral translation services

A

8 in NYS
4 in NYC

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19
Q

What does LEP stand for

A

limited english proficiency

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20
Q

what are 4 ways to receive a prescription

A

in person on paper
verbal from prescriber
fax from prescriber’s office
electronically

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21
Q

name the 8 work stations/work flow in a community pharmacy

A

pickup/drop off counter
prescription entry
order evaluation
assemble/fill station
final verification
consultation counter
storage (bins)
immunization room

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22
Q

what do standing orders do?

A

they allow non-prescribing healthcare providers to prescribe under a set protocol for a set group or population

ex:

vaccinations
naloxone
pre and post exposure prophylaxis
COVID testing
paxlovid
public readiness and emergency preparedness act

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23
Q

what documentation is REQUIRED on a verbal prescription order

A

the date received
initials of who is receiving the call
FULL SIGNATURE (required for controlled substances)

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24
Q

though not required, what are some good habits to include on a verbal prescription order

A

-identify who you are speaking with to ensure it is authorized
-always verify and repeat back
-check patient profile and stock

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25
Q

what is the controlled substances act

A

federal law.
divided into 5 schedules based on

accepted medical use
abuse potential
likelihood of causing dependence when abused

STATE LAWS ON CONTROLLED SUBSTANCES CAN BE STRICTER THAN FEDERAL LAW

26
Q

from CV to C1, which is the one that has NO ACCEPTABLE MEDICAL USE and has a high potential for abuse

A

C1

27
Q

what must be on a controlled substance order to fill it

A

patient address and age

28
Q

the # of refills allowed for a controlled substance is dependent on…..

A

schedule

29
Q

If refills ARE allowed for that schedule of controls, what is the maximum amount of refills?

A

5 (less than a 6 month supply)

30
Q

what are the ONLY things that a RPH can add or change to a controlled substance prescription without authorization?

A

patient address
patient sex
patient age

31
Q

what are the 5 things that can NEVER be added to a controlled substance prescription

A

patient name
practicioner signature
date written
drug name
quantity

32
Q

collect + assess =

A

implement

33
Q

a pharmacist’s responsibility is to ensure….

A

the safe and efficacious use of every medication

34
Q

can we ever assume things in the pharmacy?

A

NOOO

35
Q

What is used to minimize medication errors when it comes to pulling stock bottles?

A

“tall letters”
NDC
bar codes

36
Q

what 4 things on a prescription label should be the BIGGEST FONT and a minimum of 12 pt

A

patient name
drug name
drug strength
directions for use

37
Q

NAME THE 9 REQUIREMENTS ON A LABEL

A
  1. name and address of the owner of the pharmacy in which it was dispensed
  2. name of the prescriber
  3. name of the patient
  4. patient’s address
  5. directions for use
  6. date compounded
  7. rx number
  8. name and strength of the drug
  9. if generic, the name of the manufacturer
38
Q

is refill and quantity required to be on a prescription label by NY law?

A

NO

39
Q

which is better….

morning and evening or

two times a day

A

morning and evening

40
Q

which is better….

with breakfast or….

30 minutes before breakfast

A

30 minutes before breakfast

41
Q

which is better

2 times a day or…

two times a day

A

2 times a day

42
Q

which is better…

mL or teaspoon

A

mL

43
Q

what are auxiliary labels?

A

provide additional information to the patient such as….

if the product is a new generic drug for the same med dispensed previously

storage

what to avoid taking

possible side effects

expiration

44
Q

where should auxiliary labels be placed?

A

DIRECTLY ONTO THE RX CONTAINER

45
Q

are auxiliary labels required by law

A

no

46
Q

What is the purpose of DUR

A

to identify DTP’s

47
Q

can we rely on the system to tell us about DUR

A

NO – THEY MUST BE EVALUATED BASED ON CLINICAL AND LEGAL JUDGMENT

documentation is vital

48
Q

what does TPR stand for

A

third party claims

49
Q

what does the NYS PMP require dr’s to do

A

dr’s have to check the PMP registry before writing a prescription for a controlled substance, schedules 2-4 for a pt

50
Q

the PMP includes all controlled substances that were dispensed and reported by the pharmacy for the past ________

A

6 months

51
Q

all NYS pharmacies are required to submit their controlled substance dispesing data to…..

A

the Bureau of Narcotic Enformcement

52
Q

the PMP registry displays the ____ and ____ but does not specify the ____

A

displays the drug and strength but does not specify the dosage form

52
Q

FDA requires med guides when….

A

-its necessary to prevent serious adverse effects
-pt should be informed of a known serious side effect
-pt adherence to directions for usage of a product are essential to its effectiveness

53
Q

what are CvI’s

A

NON CONTROLLED

54
Q

If a pharmacist must cancel an RX, what must they include?

A

RPH initials, date, RX#, and manufacture if generic

for non controls (CVI) ^^^^

for controls…..

RPH SIGNATURE, date, rx#, manufacture if generic

55
Q

when a prescription is cancelled and filed away, how long is it stored for?

A

FIVE YEARS

56
Q

under ORBA, what must pharmacist or pharmacy intern do?

A

the pharmacist/pharmacy intern MUST PROVIDE COUNSELING

-before dispensing a new med to a new pt of the pharmacy

-before filling a new script for an exisiing pt of the pharmacy

-if the dose, strength, route of administration, or directions for use has changed for an exisitng presciption previouslt dispensed to an exisiing patient

57
Q

any time a patient has a prescription refilled, what must be done?

A

an OFFER to provide counseling

58
Q

a daily log is printed every day which reports all new and refilled prescriptions dispensed. What must the pharmacist do with this?

A

sign it, and it must be kept for 5 years

59
Q

are we required to fill every prescription?

A

NO

60
Q

PC

A

after meals

61
Q
A

Pharmaceutical Care Midterm (5 decks)

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