T3: Midterm Objectives Flashcards
1
Q
Explain the components of medication assessment (CO 4).
A
- Appropriateness
- Safety
- Effectiveness
- Adherence
2
Q
What is appropriateness?
A
- Current/valid interactions
- Duplicate therapy
3
Q
What is safety?
A
- ADR
- High dose
- Allergic reaction
4
Q
What is effectiveness?
A
- Does it work
- Therupeutical desirabe?
5
Q
What is adherence?
A
- Cost
- Complexity
- Other barriers
6
Q
Identify common causes of drug related problems (CO 7).
A
- Unnecessary drug therapy
- Needs additional therapy
- Ineffective drug
- Dose too high
- Dose too low
- ADR
- Nonadherence
7
Q
Categories of DRP: appropriateness?
A
- Unnecessary (duplicate) drug therapy
- Needs additional drug therapy
8
Q
Categories of DRP: Safety?
A
- Adverse drug reaction
- Dosage too high
9
Q
Categories of DRP: Effectiveness?
A
- Ineffective drug
- Dosage too low
10
Q
Categories of DRP: Adherence?
A
Non adherence
11
Q
What is unnecessary drug therapy?
A
- Duplicate therapy
- No indication
- Non-drug therapy is more appropriate
12
Q
What is needs additional therapy?
A
- Untreated conditions
- Preventative treatment
- Synergistic therapy
13
Q
What is ineffective drug?
A
- Contraindication
- Not indicated for condition
- More effective drugs available
- Dosage form is not appropriate
14
Q
What is dosage too low?
A
- Ineffective does
- Inappropriate frequency, duration
15
Q
What is ADR?
A
- Unsafe
- Undesirable effect
- Drug interactions
- Allergic reactions
- Inappropriate tapering
16
Q
What is dose too high?
A
- Toxicity
- Drug interaction
- Needs additional monitoring
- Inappropraite frequency, duration
17
Q
What is non adherence?
A
Cost, forgetfulness, admistration, complexity, availabity, lack of understanding
18
Q
Prioritize drug related problems (CO 7).
A
- Urgency: which problem should be addressed first
- Responsibility: Which prblem can be resolved by practioner and patient direcly
- Synergy: Problems that require intervention by someone else
19
Q
Stating drug related problems
A
- Description of patients medical conditions or clincal state
- Drug therapy involved
- Specific association between the drug therapy and patient’s codition
20
Q
Core elements of MTM
A
- Medication therapy review
- Personal med record
- Medication related action plan
- Intervention and referall
- Documentation and follow up
21
Q
What is MTR?
A
- Uses the PPCP
- Comprehensive or targeted to an actual/potential DRP
22
Q
What is personal med record?
A
COmprehensize med list
23
Q
What is med related action plan?
A
- Patient centered and collaborative
- Pharamcists scope of practice
- Include follow up
24
Q
What is intervention and referral?
A
- Consulting
- Addressing DRPs
- Refer
25
What is Documentation and follow up?
1. Evalves
2. Communication
3. Outcomes
26
Describe the Plan, Implement, and Follow Up steps in the Pharmacist’s Patient Care Process (PPCP) (CO 4). - You should also be able to describe the Assess step.
1. Assess: prioritize and identify problems
2. Plan: patient-centered, individualized, collaborative
Goals of therapy, DRPs, interventions neccesary, follow up to track outcome
3. Implement: put the plan into action, collaborate with patient and healthcare professionals
4. Follow up: How are thing, is it effective, what changes need to be made
27
Develop an individualized patient-centered care plan using SMART goals (CO 4, 7).
Specifc: What is the goal
Measurable: How will we know when the goal is reached
Achievable: Is it in your power to accomplish it?
Realistic: Can it be done?
Timely: When do we want to accomplish it?
28
Utilize appropriate PPCP documentation (CO 4).
1. Each med condition has a care plan
2. Each plan should be documented separately
29
What should a DRP plan include?
1. Indiction
2. Summary of signs
3. Goals
4. Med instructions
5. Non pharm interventions
6. Follow up
30
Implement a care plan using patient-centered communication (CO 4, 7).
1. Document all communication (coordination of care)
2. Schedule follow up
3. Address medications and HRP
4. Modify therapy
5. Educate and self-manage training
31
Evaluate the effectiveness of a patient-centered care plan (CO 7).
1. Medication apprpriateness, effectiveness, and safety
2. Patient adherence: health data, biometric, patient feedback
3. Outcomes of care
32
What is medication use process?
multistep process in which drug travels from the pharmacy to patient
33
What are the steps of medication use process?
1. Prescribing
2. Transcribing/Documentation
3. Dispensing
4. Adminsitering
5. Monitoring
34
What is prescribing?
1. Evaluate the patient
2. Establish need for meds
3. Select right med
4. Determine interactions and allergies
5. Precibe med
35
What is Transcribing/Documentation?
1. Transcribe
2. Transmit to pharmacy
36
What is dispensing?
1. Review order
2. Confirm transcription
3. Contact prescribe for discrepancied
4. Prepar medicine
5. Distribute medicine
37
What is administering?
1. Review order
2. Review warnings
3. Evaulate patient
4. Confirm transcription
38
What is monitoring?
1. Assess patinet
2. Report and document results
39
What is the purpose of medication use process?
1. Provide safe and effective medication management
2. You are responsible for patient safety
3. Safeguard for you and patient
40
What is the role of Pharm tech?
1. Support pharmacist with order fulfillment
2. Manage all tasks not requiring a pharmacist’s direct participation or judgment
3. Free time for the pharmacist to preform professional responsibilities
4. Certification and CE may be required
41
What is the role of pharm clerk?
1. Coduct sales transactions
2. Resonds to quesitons about general merchandise
3. Dircet customers to the correct department
4. May assist with accepting new prescriptions, triaging customer inquireies, and helping to answer general questions
42
Explain the steps in the dispensing process (CO 1).
1. Drop off
2. Order entry
3. DUR
4. Filling
5. Final verification
6. Patient counceling
43
What is drop off?
1. Recive prescription
2. Obtain any necessary info
3. Provide an estimated ready time
44
What is order entry?
1. Scan hard copy Rx and file original
2. Type Rx info into system
45
What is DUR?
Review Rx accuracy, appropriateness, and DRPs
46
What is filling?
1. Counting out all the needed tablets and label bottle
2. Pick up the appropriate medicationa and scan the bottle and label
47
What is final verification?
Verify all aspects of the Rx are accurate
48
What is patient counceling?
Make sure you are giving the right prescription to right patient, IHS open ended questions
49
3Cs of drop off?
1. Character: practice ethically and legally, ensure all required parts of a prescription are present
2. Chemistry: Build rapport by excellent customer service, let the patient know what to expect
3. Competence: verify and update patient info, ensure that the medication is in stock
50
3 Cs of order entry?
1. Chracter: Be through
2. Chemistry: Proactive in contacting prescriber, let patient know of delays
3. Competence: Check for appropriateness, double check work
51
3 Cs of DUR?
1. Character: Be ceratin before moving fast
2. Chemistry: Respectfully communicate DRPs
3. Competence: Cosult drug resources, Consider all aspects of appropriateness
52
3 Cs of filling?
1. Character: follow procedures, don’t cut corners to save time
2. Chemistry: Build rapport with techs and prais work
3. Competence: Always scan, dowuble check work, avoid overrides
53
3 Cs of final verification?
1. Character: send back errors to be corrects
2. Chemistry: communicate errors with kindness, use as training opportunities
3. Competence: always open every bottle, eliminate distract
54
3 Cs of patient counseling
1. Character: correct errors, educate patient with humility
2. Chemistry: communicate genuine care and concern for the patient
3. Comeptence: verify patient and med info, ask open ended questions
55
UNits in a mL of insulin?
100, 300, 500
56
mL in pen?
3mL
57
pens in boxes
5
58
How much in Humalog and Humulin vial?
3mL or 10 mL, 100u/mL
59
How much 10mL other insulins?
100u/mL
60
How much in Humulin R?
500u/mL
61
Identify the goal of medication reconciliation (CO 7, 8).
Avoid medication erros such as omissions, duplications, dosing errors, or drug interactions
62
Explain the 5 steps of medication reconciliation (CO 7).
1.PReparation: review patient records and develop interview questions
2. Verification: conduct med history
3. Reconcilliation: Compare med lists and make clinical decisions
4. Documentation: Document changes and update med recs
5. Communication: Communicate changes/discrepancies and new med list to patient and appropriate caregivers
63
What is preparation in med rec?
1. Review chart thoroughly
2. Are allergies listed (Always ask if they have allergies)
3. Decide what questions you want to ask
64
What is verification in med rec?
1. Verify ID
2. HIPAA compliance
3. Open ended questions
4. OTCs?
5. Adherence?
6. Confirm patient’s current pharamacy
65
What is reconciliation in med rec?
1. Compare med lists and check for:
1. Omissions
2. Commissions
3. Dosing errors
4. Discontinued meds
5. DDI
6. Drug disease interactions
7. Duplications
2. Use clinical judgement to assess:
1. Appropriateness
2. Safety
3. Effectiveness
4. Adherence
66
What is documentation in med rec?
1. Update med list in chart
2. Document any recent or recommend changes in the chart
67
What is communication in med rec?
1. Communicate discrepancies
2. Communicate any med changes
3. Provide the patient and team with updated list
68
Describe when medication reconciliation is most beneficial (CO 7).
1. Admission: 24-48 hours of admission
2. Internal tranfer points: tranfers within facility, most difficult places to implement
3. Discharge: communicate med changes
1. Transitions of care: any change in setting, service, practitioner, or level of care
69
Discuss the 3 C’s of a successful medication reconciliation (CO 7).
Character: thoroughness vs incompleteness
Chemistry: good communication
Competence: good med history, asking good questions
