aaliya's excpt notes

dea form 222

transferring or ordering controlled substances (c1 and c2)

dea form 106

loss or theft of controlled substances

dea form 41

request permission to destroy expired controlled substances

dea form 224

apply for registration to dispense controlled substances, renewed every 3 years

geometric dilution

mixing small amounts of active ingredient into large volume evenly

trituation

reducing particle size by grinding

levigation

using liquid to make a paste for mixing

spatulation

mixing with spatula on an ointment slab

beyond use date

compounding date

for non-aquous (capsules and ointment) prescriptions, what is the beyond use date?

6 months of earliest expiration date of any ingredient

beyond use date rule aqueous oral (suspension)

14 days refrigerated

beyond use date aqueous topical (cream, gel)

the beyond use date for a topical cream or gel is 30 days

label requirements to compound products

patient name, drug name and strength, beyond use date, storage instructions, “compounded by pharmacy” statemark, lot number

aseptic compounding technique

use laminar airflow work bench or biological safety cabinet, maintain first air and dont block airflow, use alcohol wipes and gloves, clean station back to front top to bottom and side to side

documentation for compounding

1) master formulation record MFR recipe

2) compounding record, what was made

3) SDS for each chemical

4) log books, document cleaning, calibration, batch, mf

which organization accredits hospital and healthcare organizations and enforces patient care

the joint comission

what is the confidential, voluntary, national reporting system, allows pharmacy techs and healthcare providers to report actual and potential medication errors, operated by ISMP

MERP, medication error reporting program

ASHP, american society of health system pharmacists

national professional organization that represents pharmacists, techs, students working in hospitals, and clinics

FDA

regulates drug safety, labeling, recalls, approoves new drugs and monitors quality

DEA

enforces controlled substances act, issues DEA numbers and audits confirmed drug handling

USP, US pharmacopeia

sets drug standards, purity, quality. publishes usp 795 and 979 and 800 for compounding

ISMP

monitors medication errors, maintains error-prone abbreviations and high alert drugs

OSHA

enforces workplace safety, PPE and SDS

BOP, state board of pharmacy

regulates pharmacy practice in state, issues licenses, inspectors, enforces state laws

HIPAA

health insurance portability and accountability act, protects patient protected health information, techs must maintain confidentiality

medicare modernization act, (MMA)

created medicare part D for prescription Drug coverage, led to more pharmacy involvement

combat methamphetamine epidemic act

restricts OTC sudafed purchases, 3.6 g per day, 9 g per month, 7 g mail order

Hatch-waxman act

drug price competition and patent term restrictions, allows approval of generic drugs, created ANDA process for new drug application

NABP, national association of boards of pharmacy

oversees pharmacy boards nation wide, administers license transfer

what prevents the distribution of mislabeled food and drugs

pure food and drug act

what gave the FDA the power to oversee the safety of drugs before marketing and enforce clinical trials

food, drug, and cosmetic act

what separates OTC and prescription only medications AND allowed for verbal RXs and refills

Durham Humphrey ammendment

Kefauver-Harris Ammendment

required drugs to be effective and safe, drug testing before approval from FDA

posion prevention packaging act

child safe medication packaging, exclude nitroglycerin

controlled substances act

created drug schedules, CI to CV, enforced by DEA

what required the NDC/ national drug code numbers?

drug listing act

NDC breakdown

manufacturer - drug - package size

OBRA, omnibus budget reconcilliation act

requires rph to offer counseling to medicaid patients, requires DUR

US pharmacopeia

sets standards for identity, strength, quality, and purity of medications food ingredients and dietary supplements

USP 795

nonsterile compounding

USP 797

sterile compounding

USP 800

how to handle hazardous drugs

DAW 0

no selection indicated

DAW 1

subsitution NOT ALLOWED

DAW 2

substitution allowed, pt selects brand name

DAW 3

substitution allowed, pharmacist selects brand name

DAW 4

subsitution allowed, generic not in stock

DAW 5

brand dispensed and priced as generic

DAW 6

override

DAW 7

subsitution NOT ALLOWED, brand name mandated by law

ISMP error prone abbreviations

U for unit/ 0

IU international unit/ IV

QD/ QID

QOD/ QD

trailing 0s

lack of leading 0, 0.5

SC/ SL

VACCINES- + EARLIEST AGE YOU CAN TAKE IT, NUMBER OF DOSES, HOW FAR APART DOSES ARE

CONVERSIONS WITH OUNCES

INSURANCE CLAIM REJECTS

-olol: what class, what organ, what does it treat

beta blockers, heart, bp, anxiety

-pril, class and indication

ace inhibitors, hypertension

-sartan

ARBs, blood pressure

-statin

HMG COA reductase inhibitors, high cholesterol

-cillin

antibiotic, bacterial infection

-mycin

macrolide antibiotic, respiratory and skin infection

-floxaccin

fluoroquinolone antibiotics, UTI, respiratory infection

-aycline

antifungal, fungal infection

-pam/ lam

benzodiazepine, anxiety, sleep disorder

-caine

local anaesthetic

-vir

antiviral, viral infection

-ine

stimulant, antihistamine, ADHD, allergies

-tidine

H2 blockers, acid reflux, GERD

-prazole

proton pump inhibitor, PPI, GERD

-nib

Tyrosine Kinase Inhibitors, often used in cancer therapy

ace inhibitors: what is the ending and what do they do

pril, reduce blood pressure by dilating

beta blockers

olol, lower blood pressure by slowing heart rate

calcium channel blocker ending and function

sartan, inhibit vessel constriction, lower bp

angiotensin II receptor blockers: ending, what do they do

sartan relax blood vessels, increase blood supply and oxygen to heart

potassium sparing diuretics

actone, increase fluid excreted by kidneys, lower bp

thiazide diuretic

thiazide, increase fluid and potassium release by kidneys

antilipidemics

statin, lower cholesterol

thrombolytics: ending, what to they do

ase, clot busters, break down clots

tetracyclines

cycline, broad spectrum antibiotic

aminoglycosides

mycin, broad spec anti

fluoroquinolones

floxacin, broad spectrum antibiotic

antiemetics

azine, prevent nausea and vomiting

PPI

prazole, GERD

H2 receptor antagonists, H2 blockers

tidine, decrease stomach acid prod

bronchdilators

terol, phylline, dilate bronchi

antihistamines

-ine, treat allergy symptoms

benzodiazepines

pam, lam, anxiety

tricyclic antidepressants

triptyline, depression, bpd, ocd

SSRIs

pram, ine, major depressive

local anaesthetic

caine, treat nerve impulse pain wo unconsciousness

ticosteroids

sone, lone, antiinflammatory

meglitinides and sulfonylureas: ending and what they do

ide, lower blood glucose by triggering insulin prod.

usp chapter <800>

addresses handling of hazardous medications

who creates a list of hazardous medications

NIOSH

who enforces the rcra and hazardous medication disposal

the EPA environmental protection agency enforces the rsource conservation and recovery act

who handles how hazardous medications are transported or shipped

the DOT, department of transportation

Categories of hazardous medications

P, D, and U

P listed - acutely hazardous, empty containers

D listed, toxic, ignitable, corrosive, and reactive.

U listed, toxic and related to chemotherapy

epinephrine, nicotine, and warfarin hazardous class

P listed

benzoyl alcohol, albuterol inhalers, silver sulfadiazine hazardous class

d listed

cyclophosphamide, mercury, and mitomycin hazardous class

U listed

disposal of hazardous waste needs how many witnesses in hospital setting

2 pharmacists or nurses