2 - Hospital Pharmacy Practice & Drug Management Cycle

c. Hospital Pharmacy

[Hospital Pharmacy Practice]

Field involved in procurement, storage, compounding, packaging, distribution, dispensing of drug in the hospital setting
a. Pharmaceutical Care
b. Clinical Pharmacy
c. Hospital Pharmacy
d. Community Pharmacy

b. Pharmaceutical Care

[Hospital Pharmacy Practice]

Direct, responsible provision of medication-related care for the purpose of achieving definite outcomes that improve a patient's quality of life
a. Hospital Pharmacy Practice
b. Pharmaceutical Care
c. Drug Distribution
d. Clinical Monitoring

b. Quality of Life

[Hospital Pharmacy Practice]

The purpose of pharmaceutical care is to achieve definite outcomes that improve a patient's __________
a. Medication Adherence
b. Quality of Life
c. Length of Stay
d. Cost of Care

• Administrative

• Purchasing & inventory

• Compounding (paper tabs , TPN, other drugs)

• Pharmaceutical research

• Dispensing

  • medication order review

  • medication administration

  • therapeutic monitoring

• Drug distribution

• Information services (Patient , Medical Doctor)

[Hospital Pharmacy Practice]

Responsibilities of Hospital pharmacist [7]

SELECTION

↓

PROCUREMENT

↓

DISTRIBUTION

↓

USE

📌Mnemonic: “SPDU”

Drug Management Cycle [4]

b. Pharmacy & Therapeutic Committee (P&TC)

[Drug Management Cycle - Selection]

Committee responsible for the selection step of the drug management cycle
a. Drug Utilization Review Board
b. Pharmacy & Therapeutic Committee (P&TC)
c. Infection Control Committee
d. Medical Ethics Committee

b. Drug & Therapeutics

[Drug Management Cycle - Selection]

Other term for Pharmacy & Therapeutic Committee (P&TC)
a. Formulary Committee
b. Drug & Therapeutics
c. Medication Safety Committee
d. Clinical Review Board

c. Medical Doctor (MD)

[Drug Management Cycle - Selection]

Chairperson of the Pharmacy & Therapeutic Committee (P&TC)
a. Chief Pharmacist
b. Nurse Supervisor
c. Medical Doctor (MD)
d. Hospital Administrator

b. Chief Pharmacist

[Drug Management Cycle - Selection]

Secretary of the Pharmacy & Therapeutic Committee (P&TC)
a. Medical Doctor (MD)
b. Chief Pharmacist
c. Chief Nurse
d. Hospital Administrator

• Develop a formulary

• Drug utilization reviews

• Monitor Adverse drug events & medication errors (medication misadventures)

[Drug Management Cycle - Selection]

Function of the Pharmacy & Therapeutic Committee (P&TC) [3]

b. Formulary

[Drug Management Cycle - Selection]

Periodically updated list of pharmaceuticals to be carried by the pharmacy & prescribed by MDs
a. Pharmacopeia
b. Formulary
c. Drug Utilization Review
d. Essential Medicines List

a. Essentially drug list

[Drug Management Cycle - Selection]

Other term for formulary
a. Essentially drug list
b. Core list
c. National drug index
d. Complementary list

b. Philippine National Formulary (PNF)

[Drug Management Cycle - Selection]

National formulary used by all government hospitals in the Philippines
a. Philippine Drug Formulary
b. Philippine National Formulary (PNF)
c. Philippine Essential Medicines List
d. National Pharmacy Index

• Core list

• Complementary list

[Drug Management Cycle - Selection]

Components of the Philippine National Formulary include _______ [2]

b. Core list

[Drug Management Cycle - Selection]

Component of the Philippine National Formulary (PNF) needed by majority of population
a. Complementary list
b. Core list
c. Essential list
d. Specialist list

b. Complementary list

[Drug Management Cycle - Selection]

Component of the Philippine National Formulary (PNF) that:

• Provides alternatives

• For rare/exceptional disorders

• Requires specialist treatment
  

a. Core list
b. Complementary list
c. Essential list
d. Standard list

b. Complementary list

[Drug Management Cycle - Selection]

Component of the Philippine National Formulary (PNF) that is for rare/exceptional disorders

a. Core list
b. Complementary list
c. Essential list
d. Standard list

b. Complementary list

[Drug Management Cycle - Selection]

Component of the Philippine National Formulary (PNF) that requires specialist treatment

a. Core list
b. Complementary list
c. Essential list
d. Standard list

b. Formulary Manual

[Drug Management Cycle - Selection]

Document that contains information about drugs listed in the formulary (RPh)
a. Standard Treatment Guidelines
b. Formulary Manual
c. Philippine National Formulary
d. Drug Utilization Review

b. Route

[Drug Management Cycle - Selection]

Information included in the formulary manual aside from MOA, ADRs, and duration
a. Cost
b. Route
c. Manufacturer
d. Storage condition

b. Standard Treatment Guidelines

[Drug Management Cycle - Selection]

Document that describes how illnesses are managed (MD)
a. Formulary Manual
b. Standard Treatment Guidelines
c. Philippine National Formulary
d. Drug Utilization Review

b. GINA

[Drug Management Cycle - Selection]

Standard treatment guideline for asthma
a. GOLD
b. GINA
c. JNC
d. PSMID

b. GOLD

[Drug Management Cycle - Selection]

Standard treatment guideline for COPD
a. GINA
b. GOLD
c. ACC/AHA
d. PSMID

b. GOLD

[Drug Management Cycle - Selection]

Standard treatment guideline for hypertension
a. GINA
b. GOLD
c. JNC/ACC/AHA
d. PSMID

d. PSMID

[Drug Management Cycle - Selection]

Standard treatment guideline for infectious diseases
a. GINA
b. GOLD
c. JNC/ACC/AHA
d. PSMID

b. Sentimental Events

[Drug Management Cycle - Selection]

• Any unexpected event in a hospital resulting in serious injury/death

• Unrelated to patient's illness
  

a. Adverse Drug Events
b. Sentimental Events
c. Medication Error
d. Near Miss

• Pharmaceutical Alternatives

• Pharmaceutical Equivalence

• Therapeutic Alternatives

• Therapeutic Equivalence

Types of Drug Substitution [4]

b. Pharmaceutical Alternatives

[Drug Management Cycle - Selection]

Type of drug substitution:

• Drugs have the same API, but different salt, ester, or complex
  a. Pharmaceutical Equivalence
  b. Pharmaceutical Alternatives
  c. Therapeutic Alternatives
  d. Therapeutic Equivalence

• Losartan Sodium (Na) vs. Losartan Potassium (K)

• Metoprolol succinate (OD) vs. Metoprolol tartrate (TID)

• Vitamin B Complex Tablet and Vitamin B Complex Capsule

[Drug Management Cycle - Selection]

Example of pharmaceutical alternatives [3]

b. Pharmaceutical Equivalence

[Drug Management Cycle - Selection]

Type of drug substitution where drugs have the same API, salts, ester, complexes, dosage, or forms
a. Pharmaceutical Alternatives
b. Pharmaceutical Equivalence
c. Therapeutic Alternatives
d. Therapeutic Equivalence

e. Both b and c

• Ibuprofen & Alaxan

• Biogesic & Tylenol

[Drug Management Cycle - Selection]

Example of pharmaceutical equivalence :

a. Losartan Na/K
b. Ibuprofen & Alaxan
c. Biogesic & Tylenol
d. Losartan vs. Irbesartan

e. Both b and c

c. Therapeutic Alternatives

[Drug Management Cycle - Selection]

Type of drug substitution involving different API but same drug class
a. Pharmaceutical Alternatives
b. Pharmaceutical Equivalence
c. Therapeutic Alternatives
d. Therapeutic Equivalence

d. Losartan vs. Irbesartan

[Drug Management Cycle - Selection]

Example of therapeutic alternatives cited under drug substitution
a. Ibuprofen & Alaxan
b. Biogesic & Tylenol
c. Losartan Na/K
d. Losartan vs. Irbesartan

a. Do not substitute

[Drug Management Cycle - Selection]

Rule regarding Rx drugs under therapeutic alternatives
a. Do not substitute
b. May substitute freely
c. Substitute with physician approval only
d. Substitute only in emergencies

d. Therapeutic Equivalence

[Drug Management Cycle - Selection]

Type of drug substitution:

• Pharmaceutical equivalent plus bioequivalent

• Same clinical profile

a. Pharmaceutical Alternatives
b. Pharmaceutical Equivalence
c. Therapeutic Alternatives
d. Therapeutic Equivalence

b. Bioequivalent and same clinical profile

[Drug Management Cycle - Selection]

Under therapeutic equivalence, what must be proven only by research
a. Same dosage form
b. Bioequivalent and same clinical profile
c. Same API
d. Same salt form

c. Inventory Management

[Drug Management Cycle - Procurement]

Heart of the drug supply system

a. Distribution
b. Selection
c. Inventory Management
d. Formulary System

• Cycle stock

• Safety stock

[Drug Management Cycle - Procurement]

Types of Stock [2]

c. Cycle Stock

[Drug Management Cycle - Procurement]

Type of Stock:

• Regular/periodic quantity of stock

a. Safety Stock
b. Buffer Stock
c. Cycle Stock
d. Reserve Stock

b. Safety Stock

[Drug Management Cycle - Procurement]

Type of Stock:

• "Buffer" that protects against fluctuations in demand

a. Cycle Stock
b. Safety Stock
c. Reserve Stock
d. Periodic Stock

b. ABC Analysis

[Drug Management Cycle - Procurement]

Inventory analysis method based on the Pareto principle (80/20 rule)
a. VEN Analysis
b. ABC Analysis
c. FIFO Analysis
d. FSN Analysis

• Category A

• Category B

• Category C

[Drug Management Cycle - Procurement]

Category in ABC analysis include ____ [3]

c. Category A

[Drug Management Cycle - Procurement]

Category in ABC analysis:

• 20% stock

• 70 - 80% consumption

a. Category B
b. Category C
c. Category A
d. Category D

a. Category B

[Drug Management Cycle - Procurement]

Category in ABC analysis:

• 30% stock

• 15 - 20% consumption

a. Category B
b. Category C
c. Category A
d. Category D

b. Category C

[Drug Management Cycle - Procurement]

Category in ABC analysis:

• 50% stock

• 5 - 10% consumption

a. Category B
b. Category C
c. Category A
d. Category D

b. Category C

[Drug Management Cycle - Procurement]

Category in ABC analysis:

• Requiring tight control every day

a. Category B
b. Category C
c. Category A
d. Category D

b. Category C

[Category in ABC analysis]

Requiring moderate control every week

a. Category B
b. Category C
c. Category A
d. Category D

b. Category C

[Category in ABC analysis]

With no need to monitor closely
a. Category B
b. Category C
c. Category A
d. Category D

a. VEN analysis

[Drug Management Cycle - Procurement]

VED Analysis is also known as ______
a. VEN analysis
b. ABC analysis
c. FSN analysis
d. HML analysis

b. VED Analysis

[Drug Management Cycle - Procurement]

Based on how critical items are to operations

a. ABC Analysis
b. VED Analysis
c. FIFO Analysis
d. FSN Analysis

• Vital

• Essential

• Desirable (Non-essential)

[Drug Management Cycle - Procurement]

Category in VED analysis [3]

c. Vital

[Drug Management Cycle - Procurement]

Category in VED analysis where without it, the hospital cannot function
a. Essential
b. Desirable
c. Vital
d. Non-essential

c. Vital

[Drug Management Cycle - Procurement]

• Epinephrine

• Norepinephrine

• IV fluids

• Amiodarone

• Insulin

• Dextrose

Are example of _____ item in VED analysis

a. Essential
b. Desirable
c. Vital
d. Non-essential

b. Essential

[Drug Management Cycle - Procurement]

Category in VED analysis where without it, it may affect the quality of services
a. Vital
b. Essential
c. Desirable
d. Non-essential

a. Essential

[Drug Management Cycle - Procurement]

Meds for common conditions is an example of _____ item in VED analysis

a. Essential
b. Desirable
c. Vital
d. Non-essential

c. Desirable (Non-essential)

[Drug Management Cycle - Procurement]

Category in VED analysis where unavailability will not interfere with functioning

a. Vital
b. Essential
c. Desirable (Non-essential)
d. Critical

c. Desirable (Non-essential)

[Drug Management Cycle - Procurement]

Pneumococcal vaccine is an example of a _____ item under VED analysis
a. Vital
b. Essential
c. Desirable (Non-essential)
d. Critical

• Floor stock

• Individual Inpatient Prescription System

• Combination of Floor stock and IPS

• Unit Dose DDS

[Drug Management Cycle - Distribution]

Drug Distribution System [3]

b. Floor Stock

[Drug Management Cycle - Distribution]

Drug Distribution System:

• This is where meds are available on patient area (nurse stations)

a. Individual Inpatient Prescription System
b. Floor Stock
c. Combination of Floor Stock & IPS
d. Unit Dose System

• Emergency situations (nurse stations)

• Prevents delay in administration

• Reduces transcription

[Drug Management Cycle - Distribution]

Advantage of floor stock system [3]

• Medication errors

• Pilferage (theft)

• Additional jobs to nurses

[Drug Management Cycle - Distribution]

Disadvantage of floor stock system [3]

b. Individual Inpatient Prescription System

[Drug Management Cycle - Distribution]

Drug distribution system where meds are available only in the pharmacy
a. Floor Stock
b. Individual Inpatient Prescription System
c. Combination of Floor Stock & IPS
d. Automated Dispensing System

• Increase medication errors

• Controlled inventory

• Increase interaction between RPh , Healthcare Teams and Patients

[Drug Management Cycle - Distribution]

Advantage of Individual Inpatient Prescription System [3]

• Delayed administration

• Excessive documentation

[Drug Management Cycle - Distribution]

Disadvantage of Individual Inpatient Prescription System [2]

c. Combination of Floor Stock & Individual Inpatient Prescription System (IPS)

[Drug Management Cycle - Distribution]

Drug distribution system where:

• Emergency meds & essential supplies go to nurse station

• Non-emergency meds go to pharmacy

With the use of PNEUMATIC TUBES

a. Floor Stock
b. Individual Inpatient Prescription System
c. Combination of Floor Stock & Individual Inpatient Prescription System (IPS)
d. Unit Dose System

b. Pneumatic tubes

[Drug Management Cycle - Distribution]

Method used to transport meds between pharmacy and nurse station in the Combination of Floor Stock & IPS system
a. Manual courier
b. Pneumatic tubes
c. Automated cart
d. Dumbwaiter

c. Unit Dose DDS

[Drug Management Cycle - Distribution]

Drug distribution system where drugs are placed in single packaging per dose
a. Floor Stock
b. Individual Inpatient Prescription System
c. Unit Dose DDS
d. Combination of Floor Stock & IPS

d. Unit Dose DDS

[Drug Management Cycle - Distribution]

Drug distribution system considered the "safest"
a. Floor Stock
b. Individual Inpatient Prescription System
c. Combination of Floor Stock & IPS
d. Unit Dose DDS

b. 24 hrs

[Drug Management Cycle - Distribution]

Timeframe within which unit dose DDS drugs are ready to be administered
a. 12 hrs
b. 24 hrs
c. 48 hrs
d. 6 hrs

b. Drug Utilization Review

[Drug Management Cycle - Use]

This is the evaluation of drug use before, during, and after dispensing time
a. Formulary System
b. Drug Utilization Review
c. Pharmaceutical Care
d. Sentinel Event Review

Determine pattern of drug use including:

• Adverse drug events (ADE) and Medication errors

• Interactions

[Drug Management Cycle - Use]

Goal of drug utilization review [2]

b. Drug Utilization Review

[Drug Management Cycle - Use]

This informs Selection process (Formulary) in the drug management cycle

a. Formulary System
b. Drug Utilization Review
c. Pharmaceutical Care
d. Sentinel Event Review