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What is legally required on a non-controlled prescription?
Date
Patient’s name
Prescriber’s signature
Drug name
Strength
Quantity
SIG
Refill amount
May substitute or not (DAW - Dispense As Written)
For how long are non-controlled prescriptions valid?
1 year
In Missouri, for how long are CV (Schedule 5) prescriptions valid?
1 year
In Missouri, for how long are CIV - CII (Schedule 4 - Schedule 2) prescriptions valid?
6 months
What additional criteria are legally required on a prescription for controlled mediacations?
Patient’s address
Prescriber’s address
Dosage form
Prescriber’s DEA Number
What does a DEA Number consist of?
2 letters followed by 7 numbers
What is the formula to determine if a DEA Number is valid?
1st letter is level of practitioner
2nd letter is first letter of prescriber’s last name
(1st number + 3rd number + 5th number) + 2(2nd number + 4th number + 6th number) = x ; digit in the one’s place of x matches 7th number
What should the first letter in a DEA number for a top-level practitioner be? (MD, DO)
A, B, or FWhat should the first letter in a DEA number for a mid-level practitioner be? (APRN, PA)
What should the first letter in a DEA number for a mid-level practitioner be? (APRN, PA)
M
In general, do medical orders or retail prescriptions contain more information?
medical orders (in the hospital)
The (institutional) medical order must have the following things:
-the date
-the pt's name
-the pt's location
(-the pt's DOB)
-the medication name
-the strength/dose
-the directions/dosing schedule
-the specific dosage form/route of administration
-the doctor's signature
-whether the medication may be substituted (DAW)
(there may be additional information such as the patient's current diet, date/time to D/C the med, height and weight of the pt)
Refills would not be used on a hospital order.
A DEA number is not required on hospital orders, even for controlled medications.
In the hospital, many medications must be diluted into a(n) _____ before administration.
diluent
What is a TPN?
Total Parenteral Nutrition - an IV administered nutrition (containing fats, protein, carbs/sugars, and micronutrients like vitamins and minerals) that is the only source of nutrition a patient is receiving and bypasses the digestive system
Instead of giving a set dosage instruction for a specific amount of medication (a SIG), a hospital medical order gives a(n) _____.
Dosage schedule (which may be done for an indefinite amount of time)
What is a unit dose in the hospital?
A unit dose is a patient-specific medication that is labelled and taken to patient floors by the pharmacy, typically at scheduled times.
True/False
Medications that are used to refill a medication dispensing machine (ex: Pyxis or Omnicell) are patient-specific.
False, these may be used at any time for any patient who gets an order for the medication. They are the general medication stock on a hospital floor. Unit doses are patient specific.
What are the things that are required to be on a unit dose medication?
-the patient's name
-the patient's location (room and/or bed number)
-the patientt's hospital identification number
-the attending physician (the physician in charge)
What is the "cart fill" in hospital pharmacy?
This is a task done by a technician that involves taking all unit dose medications to their respective patient floors at scheduled times. They will also take back any unused unit doses.
Example policy:
https://www.utoledo.edu/policies/utmc/pharmacy_hsc/pdfs/3364-133-99.pdf
*Pictured is the floor-specific bins*
True/False
A medical order for a controlled prescription requires the prescriber's DEA number.
What is an IV piggyback?
If a medication has a half-life of 6 hours, how long would it take a drug to reach 25% of it's peak level once it has been administered?
12 hours
At 0 hours: 100%
At 6 hours: 50%
at 12 hours: 25%
A medical order for 200 mg of Minocin IV is given.
Minocin comes in a solution of 20 mg/mL.
How many mL would need to be used to make the 200mg dose?
20mg/1mL = 200mg/x
==>
x = 200mg/(20mg/mL)
("mg" cancels)
x = 10mL
When medications interact and increase the effects of one another, this is called ___.
synergy/synergism
When medications interact and decrease the effects of one another, this is called ___.
antagonism
Drug duplication or therapeutic duplication refers to...
taking two or more medications for the same indication or purpose without a clear distinction of when one agent should be administered over another
In order to get medical records from a hospital (including your own), they must come from ...
the medical records department
In order to get YOUR OWN medical records from an outpatient pharmacy you must ...
present to the pharmacy with your ID
The main law that protects health information and patient privacy is ...
HIPAA (Health Insurance Portability and Accountability Act)
In general, do institutional or outpatient patient profiles contain more information?
institutional (hospital) patient profiles
Note 
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