Assisting the pharmacist

Question 1

in ambulatory pharmacy, what are PT responsible for? (8)

Answer 1

processing prescriptions/data entry, checking accuracy, refilling prescriptions, working with 3rd party/insurance, filling orders, customer service, administrative tasks, organization

Question 2

in a hospital, what is the PT responsible for? (7)

Answer 2

preparing IV admixtures, prepping meds, delivering meds to nursing floors, filling dispensing systems, communicating with doctors/nurses, administrative, unit-dosing meds

Question 3

what is an ambulatory setting pharmacy

Answer 3

patients can walk to get to the pharmacy

Question 4

what is the ambulatory pharmacy workflow

Answer 4

greeting patient > data entry > dispensing > verification > release

Question 5

all hard copies of prescriptions must be kept for ___ years

Answer 5

2

Question 6

what is included in the hard copy of a prescription (7)
patient - 4
prescriber - 5

Answer 6

patient name/phone/address/DOB
prescriber name/address/phone/signature/DEA
date prescription written
med strength/quantity/dose/dosage form
administration route
signa/directions
refill info

Question 7

controlled substances must be signed by ___ and not the PA/NP

Answer 7

physician

Question 8

C6 meds expire a year after written date
C2
C3-C4

Answer 8

C2 = filled only once (no refill)
C3-4 = 6 months after written

Question 9

true or false

PT can transfer meds from different pharmacies

Answer 9

false - only pharmacist

Question 10

NKA means

Answer 10

no known allergies written on prescriptions

Question 11

when looking for forged prescriptions, look for (5)

Answer 11

handwriting, signatures, quantities/refill looks altered, looks copied, different pen colors

Question 12

when transferring prescriptions from another pharmacy, we need (9)

Answer 12

patient name/address/phone/DOB/allergies/insurance
previous pharmacys phone
prescription # & drug

Question 12

when transferring prescriptions from another pharmacy, we need (9)

Answer 12

patient name/address/phone/DOB/allergies/insurance
previous pharmacys phone
prescription # & drug

(dose, strength, quantity, fill date, refills, directions, physicians name obtained by pharmacist)

Question 13

C3-C5 controlled substances can be transferred between pharmacies how many times

Answer 13

once

Question 14

what are therapeutic duplications

Answer 14

drugs in same drug class with same functions prescribed

Question 15

what are special considerations added to a patients profile (2)

Answer 15

anything restricting patient such as arthritis preventing opening of a bottle or language restriction

Question 16

what is medication therapy management (MTM) (4)

Answer 16

pharmacists review patients medication history to check for compliance with taking medication, therapeutic duplications, patient counseling , and inconsistencies in drug therapy

Question 17

who is medicare for? (4)

Answer 17

65+, youngers blind, widowed, disabled due to long-term illness

Question 18

what do each part of medicare cover? ABCD

Answer 18

A - hospital services/inpatient
B - doctors appointments/outpatient
C - medicare advantage plans
D - prescription drugs

Question 19

who is TRICARE for

Answer 19

servicemen and veterans

Question 20

for formularies, (list of drugs approved by insurance) what are 1st, 2nd, 3rd tier drugs?

Answer 20

1 - generic, copay lowest
2 - preferred brands
3 - non-formulary drugs, highest copay

Question 21

who is medicaid for? (4)

Answer 21

income below poverty level, blind, disabled, members of family with children only supported by one parent (and financially eligible)

Question 22

what are daw codes? What is 0-9?

Answer 22

-when doctor/patient prefers brand drugs over generic
0 = no instructions, generic okay
1 = no substitution by prescriber, brand necessary
2 = patient prefers brand
3 = pharmacist chose brand
4 = generic not in stock, substitution okay
5 = brand name dispensed at generic price
6 = override code
7 = brand dictated by law
8 = generic not available
9 = other

Question 23

what is the grace period allowed by insurance companies to refill

Answer 23

5-7 days

Question 24

step therapy

Answer 24

when insurance companies require patients to use first-line drug before others

Question 25

what are some reasons for claim reject? (7)

Answer 25

expired coverage, invalid PI, quantity exceeds limit, refill too soon, prescriber not covered, NDC not covered, PA required

Question 26

reimbursement in the ambulatory setting is done as ___ (2)

Answer 26

retrospective payment or fee for service

Question 27

what is WAC & AMP

Answer 27

wholesale acquisition cost = the price manufacture sells to the wholesaler average manufacturers price = price paid to manufacturers from wholesalers to distribute to pharmacies

Question 28

examples of health insurance fraud (5)

Answer 28

billing for services not rendered altering monetary amount on claims leaving important information off claim using another persons insurance card billing for duplicate payment

Question 29

READ what is on a pharmacy label (15)

Answer 29

patient name & address date of fill and refill original prescription date expiration date order number drug manufacturer & NDC name, dose, dosage strength dispense quantity signa/sig code # refills pharmacy name, address, phone initials of pharmacist verifying prescription initials of PT entered prescription into system auxiliary labels

Question 30

What 3 things does the NDC # tell? Which section must be the same for generic substitutions? Which section must be the same for it to be the same medication?

Answer 30

-manufacturer, product, package size (quanitity) -first section/labeler/manufacturer must be the same -second section/product code must be the same

Question 31

1 dram = ___ oz

Answer 31

1/8 oz

Question 32

which act ruled that caps must be chilproof

Answer 32

poison prevention packaging act of 1970

Question 33

what is DUR (6)

Answer 33

drug utilization review = alerts of therapeutic duplications, drug-disease contraindications, incorrect dosage, incorrect duration of treatment, drug allergies, drug misuse

Question 34

what are PT monthly (not daily) tasks in an ambulatory pharmacy

Answer 34

cycle counts (counting meds), checking expiration dates

Question 35

what is the 3040B program

Answer 35

federal law that reduces costs of medication by having drug manufacturers give discounts to hospital in return for using their medication

Question 36

the ___ alerts nurses as to when the medication needs to be administered

Answer 36

medication administration record - MAR

Question 37

what information must medication orders in hospitals contain? (9)

Answer 37

patient name, weight, height, allergies, DOB, medical conditions, medical #, hospital room #, nursing unit floor dosage form, strength of drug drug schedule preparation instructions route of administration directions for use For IVs: concentration & base solution

Question 38

CATH

Answer 38

cardiac catheterization lab

Question 39

CCU

Answer 39

coronary cardiac care unit

Question 40

ED or ER

Answer 40

emergency room

Question 41

ENDO

Answer 41

endoscopy

Question 42

L&D

Answer 42

labor and delivery

Question 43

MICU

Answer 43

medical intensive care unit

Question 44

NICU

Answer 44

neonatal intensive care unit

Question 45

OR

Answer 45

operating room

Question 46

PACU

Answer 46

post-anesthesia care unit

Question 47

PEDS

Answer 47

pediatrics

Question 48

SICU

Answer 48

surgical intensive care unit

Question 49

TCU

Answer 49

transitional care unit

Question 50

X-RAY

Answer 50

raidiology

Question 51

PT prepares enough of a scheduled order to last ___ (time)

Answer 51

24 hours

Question 52

what is CSP

Answer 52

compound sterile preparations/IV mixtures

Question 53

where is sterile medication compounded

Answer 53

sterile room

Question 54

what is central vs decentralized pharmacy

Answer 54

central = where center of pharmacy operations (compounding, med preparation, unit-dosed) occur decentralized = nursing unit med rooms with automated dispensing machines (where patient specific meds prepared)

Question 55

in a hospital pharmacy all medications must be ___

Answer 55

unit-dosed (blister packages)

Question 56

the PT will prepare med for a patient for the next ___ (time)

Answer 56

24 hours

Question 57

how does a day as a PT in a hospital look like/flow (4)

Answer 57

1. print labels for meds needed in the next 24 hours, fill meds, label meds, deliver it to decentralized pharmacy (nursing stations) after pharmacist verifies 2. filling meds in automated machines 3. fill STAT drugs (drugs needed to be prepared ASAP) 4. prepare CSPs

Question 58

prepped medications are delivered to ___ in a hospital by PTs

Answer 58

nursing unit

Question 59

PTs check the ___ to see if a patient has been discharged

Answer 59

cencus

Question 60

why is it good to use pharmacy automation?

Answer 60

improve efficiency and accuracy

Question 61

investigational new drugs (INDs) must be approved by the ___

Answer 61

FDA

Question 62

True or false Record keeping for all INDs is responsible by the PT

Answer 62

true

Question 63

for both hospitals and ambulatory pharmacies, all prescriptions start with the ___ putting in the order

Answer 63

physicians

Question 64

narrow therapeutic index (NTI) drugs (4)

Answer 64

drugs that cannot be substituted with generic drugs because small changes in dosages can result in adverse events or therapeutic failure e.g., carbamazepine, cyclosporine, digoxin, levothyroxine, lithium carbonate, phenytoin, warfarin

Question 65

therapeutic substitution

Answer 65

the substitution of a prescribed drug with another medication that produces the same therapeutic effect (usually from the same class)

Question 66

benzodiazepines

Answer 66

drug class prescribed to reduce anxiety and relax muscles (–pam) e.g., alprazolam (Xanax)

Question 67

anaphylaxis

Answer 67

life-threatening allergic reaction that requires immediate emergency care

Question 68

drug-disease interaction

Answer 68

when a medication taken for one disease causes or exacerbates a different disease