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N596 Adv Pharm APN > Wk 1: Principles of Prescribing > Flashcards

Wk 1: Principles of Prescribing Flashcards

1
Q

Prescriber is responsible to consider the following when prescribing:

A 
Does pt need the drug?
Education
Financial concerns
Individual variations in response
Pregnancy / nursing concerns
Obtain THOROUGH history
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2
Q

FDA created in 1906, required _______, and only prescribing meds listed in ___________

A

accurate labeling, and only prescribing USP or National Formulary

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3
Q

Durham Humphrey Amendment ________

A

1951: Mandated the Provider-Patient relationship for prescription drugs

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4
Q

Kefauver-Harris Amendment _________

A

1962: Drugs must be safe and effective, ADEs must be reported

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5
Q

Prescription is a method of communication to the pharmacist for a specific ______, specific ______, specific _______, and ________.

A

Method of communication to a pharmacist, for a specific medication, specific patient, specific time, instructions on how to use it

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6
Q

Controlled substances require a ________ for prescribing

A

DEA number

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7
Q

FDA site for reporting adverse drug events

A

Medwatch

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8
Q

Factors that cause confusion / error in prescription handoff include:

A

Large number of drugs
Numerous forms
Similar sounding names
Varying dosing regimens and usage

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9
Q

Percentage of prescriptions not filled, per Annals of Medicine, most commonly for these types of meds

A

31%, dermatology, GI, BP meds

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10
Q

Increased likelihood to fill Rx

A

Older adult
No copay
Frequent provider interaction

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11
Q

Eight components of a prescription:

A 
Date
Pt Name / Address / DOB
Rx Name / Strength / Dosage form
Signa (instructions on how to take it)
Dispensing information (how much to dispense)
Renewal information (Refills)
Prescriber name / info
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12
Q

DEA: Controlled substances cannot be dispensed beyond ____ from date prescribed

A

6 months

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13
Q

Schedule II substances can be prescribed ______

A

1 month at a time with NO refills

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14
Q

St Johns Wort is metabolized by CYP___ and may compete for metabolism of ________ leading to ______.

A

CYP3A4; alprazolam; worsening fatigue

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15
Q

Esomeprazole increases ______, and can decrease _______ of _______

A

gastric pH; absorption of ketoconazole, iron pills, vit b12

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16
Q

________ abbreviations should not be used on prescriptions

A

Latin

17
Q

Teaspoon = ____ mL; Tablespoon = ______mL; Ounce = _____ mL; Ounce = ______ g

A

Teaspoon = 5mL; Tablespoon = 15mL; Ounce = 30mL; Ounce = 28.35g

18
Q

Controlled substances have refill limits per ______ and _______

A

Schedule and state law

19
Q

All Controlled Substances require ________

A

DEA Number

20
Q

Schedule ___ require FULL signature

A

Schedule II

21
Q

Controlled Substances Act of 1970 provides a ____________

A

Legal framework for controlled substances

22
Q

Drug abuse potential defined by…

A

Pharmacologic properties
chemical structure
CNS effects

23
Q

Narcotic is a ______ term to denote controlled substance

A

Legal

24
Q

Controlled Substance Scheduling criteria is based on

A

Dependence liability
Potential for abuse
Approved clinical use

25
Q

Schedule I drugs:

A

No therapeutic value, high potential for abuse

APPLICATION TO DEA REQUIRED

26
Q

Schedule II drugs:

A

Medical use, but high potential for abuse
Includes Cocaine
Must be WRITTEN prescription on paper (can be done by phone in emergencies but must have written Rx in 72 hours)
30 days max / 100 dosage units max
3-5 day supply sometimes
NO REFILLS

27
Q

Schedule III drugs:

A 
Medical use, less potential for abuse
Anabolic steroids
Testosterone/estrogen
Buprenorphine
Paregoric
REFILL OK
5 REFILLS in 6 MONTHS
28
Q

Schedule IV drugs:

A 
Medical use, less potential for abuse
Benzodiazepines
Barbiturates
Sleep aids (Ambien)
REFILL OK
5 REFILLS in 6 MONTHS
29
Q

Schedule V drugs:

A

No Prescription required;
18 years old with ID required
Pregabalin / Lyrica

30
Q

Product Package Insert (PPI or PI) written by _____ and provides _______.

A

Product Package Insert (PPI or PI)
Provides FDA approved safety & efficacy information
Written by drug manufacturer
Includes BLACK BOX WARNING

31
Q

The international drug directory is called __________

A

Index Nominum and Martindale

32
Q

Natural Product Resources include:

A

Natural Medicines Comprehensive Database*
The Review of Natural Products
Natural Standard*
PDR for Herbal Medicines*
Complete German Commission E Monographs * Electronic options available
Pharmacist’s Letter herbal supplement

33
Q

Prescribers typically give a _______ supply if on stable therapy

A

12 month

34
Q

4 “S” rule for prescribing

A

Smart (Always ask about pregnancy possibility)
Safe (clear)
Sensible
Secure

N596 Adv Pharm APN (5 decks)

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