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Hospital Pharmacy > midterm > Flashcards

midterm Flashcards

1
Q

what is the mission of pharmacists

A

to help people make the best use of medication

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2
Q

name 4 elements of care as it relates to pharmacy services in a hospital

A

-monitoring medication use
-optimizing medication therapy
-medication delivery
-preparing, packaging, and labeling medications

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3
Q

name 4 considerations of medication storage and preparation areas

A

-sanitation
-temperature
-light
-moisture

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4
Q

name 4 things to consider when putting together a formulary

A

-meet on a regular basis

-review medications for safety

-P&T committee responsible for developing and maintaining written criteria for drug selection

-formulary requests for specific populations should be addressed (pediatric, geriatric)

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5
Q

medication acquisition - 4 things to consider

A

-competitive bidding
-group purchasing
-medication shortages
-cost-effective patient services

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6
Q

4 reasons for drug shortages

A

-manufacturing/quality problems

-shortage of API

-supply and demand

-natural disasters

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7
Q

pharmacy’s role in drug shortages - 4 key points

A

-inventory system should be designed to detect low inventory levels and alert staff

-work with suppliers and collaborate with physicians for alternatives

-staff should check reliable sources (ASHP and FDA have websites)

-strategies for identifying alternate therapies

-campaign for awareness

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8
Q

4 components of medication therapy monitoring

A

-therapeutic appropriateness of the med regimen

-therapeutic duplication or omissions

-appropriate dose/route/frequency

-patient adherence

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9
Q

antimicrobial stewardship

A

-policies to reduce transmission of infections

-educate health professionals/patients/public about the topic

-proper antimicrobial utilization

-multidiciplinary groups and committees

-pharmacists should monitor patient’s lab reports to check for resistance

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10
Q

4 aspects of the joint commission

A

-evaluates and accredits more than 22,000 HC orgs in US

-global driver of quality improvement since 1951

-independent and non profit

-GOLD SEAL OF APPROVAL awarded after successful accreditation survey - establishes continuous improvement in patient care

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11
Q

4 aspects of the joint commission accreditation survey

A

-all surveys unannounced

-surveyors are highly trained experts in their respective fields

-surveyors trace a pt experience to see if their care meets organization’s standards

-pharmacy falls under medication management standards

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12
Q

4 examples of medication management

A

-storage and handling

-preparing and dispensing

-sterile compounding

-anti-coagulation

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13
Q

4 examples of high alert medications

A

controlled substances

look alike sound alike

insulin

meds with narrow therapeutic range

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14
Q

NIOSH classification for hazardous drugs

A

carcinogenity

teratogenicity

genotoxicity

organ toxicity

AT LOW DOSES

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15
Q

4 error prevention strategies for look alike sound alikes

A

-minimize verbal orders

-tall man lettering

-meds should be separated from each other and not stored side by side

-med bins should be labeled with look alike sound alike sticker

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16
Q

4 asp goals

A

-reduce toxicity

-optimize patient outcomes

-limit unnecessary antibiotic use

-promote appropriate selection of antibiotics

17
Q

4 times the laminar flow hood should be cleaned

A

-beginning of each shift

-before each batch

-after spills

-end of shift

18
Q

sterility tests of the laminar flow hood should be conducted according to….

A

USP797/USP800
to determine colony forming units of bacterial/fungal growth

19
Q

4 general principles of compounding

A

-personnel are trained and documented

-ingredients purchased from reliable sources and stored properly

-all equipment cleaned and properly maintained

-only authorized personnel allowed

20
Q

purpose of USP 795

A

-non sterile compounding

-provide compounders with good compounding practices for the preparation

dispensing

and administration of non sterile compounded formulations

21
Q

engineering/facility design 4 considerations

A

-air quality (affects microbial contamination)

-temp 20 degrees c or cooler

-only authorized personnel and materials (for compounding and cleaning) permitted in buffer area

-viable air sampling every 6 months

22
Q

4 personnel standards

A

-well trained and routinely monitored

-aseptic technique

-#1 source of microbial contamination is personnel

-special attention given to garbing

23
Q

sterile compounding involves creating medication….

A

-in a controlled environment

-free from viruses

-free from bacteria

-free from fungal grwoth

will be administered IV injusion, injection, intraocular, or intrathecal

24
Q

why do we need standards for sterile compounding

A

-med may be sup-potent

-uper potent

-contaminated

-could expose pt to death

25
Q

4 points on history of USP

A

-found in 1820

-mission is to improve global health through public standards that ensure quality, safety, and benefit of medication

-NO ROLE IN ENFORCEMENT

-gov agencies responsible for enforcement

-standards used by manufacturers and regulatory agencies

26
Q

impact of drug shortages on hospital

A

-higher hospital expenses

-increased labor costs

-worsen pt health outcomes

27
Q

4 reasons for recalls

A

-microbial contamination

-pH failure

-dissolution failure

-deviation from good manufacturing processes

28
Q

4 criteria for formulary

A

-need
-effectiveness
-risks (ADR, abuse potential)
-acquisition cost
-monitoring parameters

29
Q

how often is hospital formulary reviewed

A

annually

30
Q

4 benefits of 340b

A

-providers can stretch their limited resources to better serve vulnerable communities

-hospitals use 340b to provide free care for uninsured, FREE VACCINES,

-money saved allows hospitals to use that money to spend on their uninsured pts

-mental health services

31
Q

drug procurement

A

-process of acquiring supplies through purchase from manufacturer, distributor, or contracted supplier

-helps ensure availability of right meds in right quantities at reasonable prices

-timely delivery to avoid OOS

-drugs have recognized standards of quality

32
Q

4 advantages of GPO contracts

A

-reduction of duplicate purchasing efforts among institutions

-reduction of contract labor costs for institutions

-standardization of products

-long periods of price protection

33
Q

wholesale acquisition cost

A

-manufacturer list price when sold to wholesalers

-most expensive – is suggested retail price without any discounts

-set by manufacturer and sold to wholesaler

-price pharmacy pays is based on listed WAC

34
Q
A

Hospital Pharmacy (1 decks)

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