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daily limit of pseudoephedrine
3.6 grams
Category D pregnancy risk
Positive evidence of human fetal risk. Use only if no other choice
Medwatch
This is the FDA reporting service for adverse effects that occur from use of approved drugs.
Yellow book
CDC's standard resource on travel information
USP 795
guidelines for non-sterile preparations
what are controlled release meds do
med is released over extended amount of time to avoid concentrations in digestive tract/provides longer duration of action
OBRA 87
The federal law that was set to improve the life and care of those living in long term care by eliminating/making sure the patients are not taking any unnecessary medications
DEA form 106
report of theft or loss of controlled substances
DEA form 41
request permission to destroy exp C-2
DEA form 224
Apply for a DEA registration number (to disp control)
DEA form 222
Order form for CI and CII substances. Must be kept for 2 years.
Medicare part A
hospital insurance
Medicare part B
-physicians services
-diabetic services
-specialty meds
-medical equipment
Medicare part C
provides supplemental coverage allow patients to participate in HMO/PPO for extra cost
Medicate part D
Prescription drug coverage (insulin, vaccines..)
DAW 0
no product selection indicated, generic ok, pt ok
DAW 1
substitution not allowed by prescriber, fill exactly as written
DAW 2
substitution ok, but pt request that brand be disp'd
DAW 3
substitution ok, but pharmacy fills brand even though generic is available
DAW 4
Substitution allowed - generic drug not in stock
DAW 5
substitution allowed but pharmacy uses the brand
DAW 6
override
DAW 7
substitution not ok, brand mandated by state
DAW 8
substitution ok, brand disp'd because generic is not manufactured
DAW 9
other
Drug Utilization Review (DUR)
(pharmacist's job) reviewing the patient's profile with medication to ensure safety
How many hours of CE are technicians required to complete? How often?
20 hours every 2 years
Adjudication
submitting 3rd party insurance claim for payment
How are legend and controlled prescriptions filed?
legend are filed together, c-ii are filed separately, and c-iii to c-iv are filed together
ad
right ear
as
left ear
au
both ears
bu
buccal
im
intramuscular
it
intrathecal (into the spine)
od
right eye
os
left eye
ou
both eyes
po
by mouth
pr
rectal
pv
vaginally
sub q
subcutaneous
sl
sublingual (under the tongue)
ac
before meals
bid
twice daily
hs
at bedtime
pc
after meals
prn
as needed
qh
every hours
qid
four times daily
tid
three times daily
aaa
apply to affected area
gtts
drops
ha
headache
qs
quantity sufficient
ung
ointment
Patience Adherence
pt taking meds exactly as directed and going to all doctor appointments and labs
Why do hospital pharmacies only give a 24 hour supply?
reduces stealing, any qty after 24 hours would clutter the upper floor, its best to wait for pt's tests and results to come in
the basic layout of the pharmacy
intake area, processing area, processed rxs area, out window
first in first out
method for stocking medications, earlier exp date goes in the front
common refrigerator vaccines
hepatitis B vaccine (all age groups)
influenza vaccine (6 months/older)
DTAP vaccine, tetinus, pertussis (11-18 y/o)
common freezer vaccines
measles, mumps, rubella, varicella (MMRV)
zoster
USP 800
handling hazardous drugs
Who releases medication recalls?
the FDA
Class 1 medication recall
serious adverse effects or death, customer level
Class 2 medication recall
temporary adverse effect or a small chance of an adverse effect
Class 3 medication recall
problem not likely to cause adverse effects
Department of transportation (DOT)
regulates how medication waste should be shipped
P-listed
acutely hazardous waste (epinephrine, nicotine, warfarin)
D-listed
toxic, ignitable, corrosive (benzoyl alcohol, albuterol inhaler)
U-listed
toxic (chemotherapy)
What is on a patient profile
(basic demographic info) name, address, DOB, phone#, email
types of drug interactions
drug-drug
drug-age
drug-health condition
NKDA
no known drug allergies to all drugs
NKA
no known allergies to anything
Trissel's Handbook on Injectable Drugs
Provides information on the stability and compatibility of injectable drugs
post
after, behind
peri
around, surrounding
how to dispose of antibiotics
mixed with coffee grounds or soaked in water
how to dispose of warfarin
hazardous, so meant to be placed in a specific bin for professional disposal
how to dispose of chemotherapy
yellow sharps container
how to dispose of fentanyl patches
flush down toilet
USP
United States Pharmacopeia: info about product, med quality standards, and info about legend + OTC
Pink book
provides info about vaccines and diseases
The Merck Index
lists chemical attributes of chemicals, meds, and biologicals
barbiturates
central nervous center depressant, used to treat seizures and anxiety
medicaid
health care coverage for low income children, adults, elderly, and people with disabilities
National Formulary (NF)
list of officially recognized names of drugs that have an established usefulness
how often is the national formulary updated
every 5 years
PDR (Physician's Desk Reference)
The most widely used refernces for drugs in current use.
What Act created the FDA
Pure Food and Drug Act of 1906
Pure Food and Drug Act of 1906
prevented the adulteration and mislabeling of foods and pharmaceuticals
The Joint Commission
Independent non-profit organization, sets healthcare quality standards and protects patients and visitors, conducts inspections of healthcare facilities.
tort
act that causes harm/injury to a person intentionally or negligently
Harrison Narcotic Act of 1914
curb the recreational use of opium, established that opiums cannot be purchased without an rxs
Federal Food, Drug, and Cosmetic Act of 1938
created because the pure food and drug act was not worded strictly enough, emphasized adulteration and misbranding
Durham-Humphrey Amendment of 1951
required all rx drugs to be labeled "caution: federal law prohibits dispensing without an prescription", created the distinction between legend and OTC
Kefauver-Harris Amendment of 1962
ensured that drugs be proven safe and effective, gave FDA authority to approve manufacturers marketing
Controlled Substances Act of 1970
enforced by the DEA, created the drug classes I-V
Poison Prevention Packaging Act of 1970
Requires use of child-resistant containers for prescription and nonprescription drugs