Pharm Tech Exam Combo

What is DEA 222 used for?

Purchasing and returning of outdated CII drugs.

What does the blue copy of DEA 222 represent?

The purchaser keeps it for 2 years.

What does the green copy of DEA 222 represent?

The seller sends it to the local DEA.

What does the brown copy of DEA 222 represent?

The seller keeps it on file.

What is DEA 106 used for?

To report lost or stolen controlled substances.

When is DEA 106 required to be filed?

When 5% of yearly product sold is missing.

How many tablets missing from a yearly supply of 1000 would require filing DEA 106?

50 tablets.

DEA 41

Used to document the destruction of controlled substances

DEA 224

needed for a pharmacy to dispense controlled substances

DEA 363

needed to operate a controlled substance treatment program or compound controlled substances

DEA 225

needed to manufacture or distribute controlled substances

Approved Drug Products with Therapeutic Equivalence Evaluations (Orange Book)

compares therapeutic equivalency using an alphabetical rating system

What does "A" rated in the Orange Book mean?

products can be substituted because they are bioequivalent

What does "B" rated in the Orange Book mean?

products can be substituted because they are not bioequivalent

What does USP/NF stand for?

United States Pharmacopeia/National Formulary

What does the USP/NF contain?

monographs of recognized drugs and drug characteristics

USPDI US pharmacopoeia dispensing information

Volume I:Drug info for healthcare provider

Volume II: Drug info for patients

Volume III: Therapeutic equivalency information and pharmacy law

USP 797

Guidelines for sterile compounding

Drug Facts and Comparisons

Contains a comprehensive listing of drugs and comparative drugs. These drugs are organized by therapeutic class and provide general information with a list of monographs. Also contains listing of drug manufacturers, addresses and phone numbers. Updated monthly

Drug Topics Red Book

Gives a listing of drugs by pricing, strengths, sizes, manufacturers, brands, and generics

Mosby's Complete Drug Reference

Lists generic drugs in alphabetical order. Contains additional drug information

Physician's Desk Reference (PDR)

containes packet insert drug information for physicians and is published anually

American Drug Index

Drugs are listed alphabetically and provide brand,generic and the chemical names of the drugs. Gives alist of manufacturers, strengths and dosage forms of the drugs listed.

The Handbook of Injectable Drugs

References the compatibility of various parenteral drugs

Safety Data Sheet

include safety information about products compiled by the manufacturer, including hazardous ingredients, safe use and handling procedures, proper disposal guidelines, precautions to reduce the risk of accidental harm or overexposure, and more.

Pure food and drugs act of 1906

prohibit the interstate transportation or sale of adulterated or misbranded food or drugs

What does Adulterated mean?

Consists of any filthy, decomposed, putrid susbtance

Perpared, packed, or help under unsanitary conditions

Perpared in containers composed of any poisonous or deleterious substance

Containing unsafe color additives

Recognized in an official compendium but differing in strength, quality, or purity of the drugs

What does Misbranding mean?

False labeling

No label

Label lacks Name, place of business of the manufacturer/packer/distributor, lack accurate quantity of contents.

No Warning if the product is habit forming

No labeled direction for use and no warning against certain pathological conditions

Products that are dangerous to health under the labeled dosage

No ingredient/alcohol content if have alcohol

Failed to bear the established name of the drug

Durham-Humphrey Act of 1951

Amendment of FDCA 1938

Require all products to have adequate directions for use

Don't need to have adequate directions for use if the drug/products must be dispense with a prescription (not over-the-counter)

Separated drugs into Legend and Nonlegend (over the counter)

Allows verbal prescriptions over the phone

Allows refills to be called in from a doctors' office

Food, Drugs, and Cosmetic Act of 1938 (FDCA)

Created the US Food and Drug Administration (FDA)

Required all new drug applications be filed with the FDA

Clearly defined Adulteration and misbranding

Kefauver-Harris Amendment of 1962

Requires all medication in the US to be pure, safe, and effective

Comprehensive drugs abuse prevention and control act of 1970

Established "Controlled substance" rating

Created the Drug Enforcement Agency (DEA)

Separated the controlled substance into 5 Schedule based on potential for abuse and accepted medical use in the US

Prescription monitoring programs. the federal National All Schedules Prescription Electronic Reporting Act in 2005

The Act establish an electronic system for practitioner monitoring of the dispensing of controlled substances in SCH 2, 3, 4. The act would require specific information to be reported. But the act was never enacted at the federal level. But many states have enacted similar legislation.

Poison prevention packaging act of 1970

to reduce accidental poisoning in children.

Requires that most OTC and legend drugs be packaged in child-resistant containers --> can't be opened by 80% of children <5 yrs old but can be opened by 90% of adults.

Occupational safety and health act (OSHA) of 1970

Created the Occupational Safety and Health Administration (OSHA)

OSHA ensures a safe and healthful workplace for all employees

Ensures job safety and health standards for employees

Maintain a reporting system for job-related injuries and illness, reduce hazards in the workplace, and conduct audits to ensure compliance with the Act

Address Air contaminants, flammable, and combustible liquids, eye and skin protection, and hazard communication standards.

Requires the MSDS to be use

Drug listing act of 1972

Establish the NDC (National Drug Code) number

5 - 4 - 2

First 5: the manufacturer

2nd 4: the drug product

Final 2: package size and packaging

Orphan Drug Act of 1982

Provides tax incentives and exclusive licensing of products for manufacturers to develop and market orphan medication

Orphan medication

medications for treatment of diseases or conditions of which there are fewer than 200,000 cases in the world.

Drug Price Competition and Patent term restoration act of 1984

encouraged the creation of both generic and new medications

streamlining the process for generic drug approval and by extending patent licenses.

Prescription Drug marketing act of 1987

prohibits the re-importation of a drug into the US by anyone except the manufacturer.

prohibits the sale or distribution of samples to anyone other than those licensed to prescribe them

Required labels to appear on all medication for animals

Omnibus Budget Reconciliation act of 1987 (OBRA 87)

Revision to Medicare and Medicaid Conditions of participation regarding long term care facilities and pharmacy.

Anabolic Steroid control act of 1990

Harsher penalties for the abuse of anabolic steroids and their misuse by Athletes

Omnibus Budget Reconciliation Act of 1990 (OBRA-90)

Required manufacturers to provide the lowest prices to any customer or medicaid patient by rebating each state Medicaid agency the difference between its average price and the lowest price

Offer to counsel is made to every patient and drug utilization review is performed for every patient --> failure to do so may result in loss of medicaid funding

Authorizes government-sponsored demonstration project relating to the provision of pharmaceutical care

FDA Safe Medical devices Act of 1990

Requires that all medical devices be tracked

Records be maintained for durable medical equipment such as infusion pumps

American with Disabilities Act (ADA) of 1990

Prevent discrimination against potential employees who may possess a disability.

Must make a reasonable accommodation for the potential employee.

Resources Conservation and Recovery Act

From the Environmental Protection Agency (EPA)

federal guidelines regarding the disposal of hazardous waste

FDA modernization Act

Replace the Federal Drug legend "Federal Law prohibits the dispensing of this medication without a prescription" with the Rx abbreviation.

An update of the Humphrey Act

Dietary Supplement Heath and Education Act (DSHEA) of 1994

Guideline to prevent Adulteration of Herbal products and Dietary supplements

Must be labeled as Dietary supplements

identifies all ingredients and quantities of the ingredient in the label

Packaging that identifies the plant and plant part that derives the ingredients

Meet the quality, purity and compositional specification

HIPAA of 1996

improve portability and continuity of health coverage in the group and individual markets

Combat waste, fraud, and abuse in health insurance and delivery

Promote use of medical saving accounts

Improve access to long term care services and coverage

Simplify the administration of health insurance

Maintain patient confidentiality

Isotretinoin safety and risk management act of 2004

Isotretionoin (Accutane) is a medication used to treat acne that cause sever birth defect and psychiatric effects

The act helps control the use of Accutane

Anabolic Steroid Control act of 2004

An update to the Same Act of 1990.

New definition of anabolic steroid

SCH 3 medications

Eliminate requirement to prove muscle growth.

Increase the number of anabolic steroids to 59 substances

Also implement requirement for handling and recording of the use of anabolic steroids substances

Any willing provider Law

allows any pharmacy to participate in a prescription drug benefit plan as long as the pharmacy agrees to the terms and conditions of the plan

Freedom of choice law

allows a member of a prescription drug plan to select any pharmacy as long as the pharmacy agrees to the terms and conditions of the plan

Freedom of choice with regard to long term care

Long term care residents may choose an outside pharmacy for their medication if the pharmaceutical service is not provided under their contract.

However the long term care facility may refuse admission to a resident if the resident refuses to use the drug distribution system already in place

The facility may have additional policies that the outside pharmacy must agree to

Prescription Drug Equity Law

prohibit a prescription drug plan from requiring mail order prescription drug coverage without also providing non-mail order coverage

Medicare Drug improvement and modernization act of 2003

Provide voluntary prescription drug benefit to medicare beneficiaries

Part B and Part D prescription plan

Add preventive medical benefits to senior citizens

Combat Methamphetamine epidemic Act of 2005

Place Ephedrine, pseudoephedrine, and Phenyl-propanolamine in the Controlled Substances in Schedule

Impose sale and production restrictions

Medicaid Tamper0resistant Prescription Act

2008

Special Prescription pad for any prescription that are paid by Medicaid (any portion)

Prevent unauthorized copying of the prescription form and modification of the prescription

Prevent counterfeit prescription forms

USP <797>

designed to cut down on infection transmitted to patients through pharmaceutical products and better protect staff working in pharmacies

Contain procedural training and quality assurance requirements for preparing sterile products

ATF stands for what regulatory agency? What is its responsibilities?

Bureau of Alcohol, Tobacco and FireArms

Set regulations regarding the purchase of tax-free alcohol (use in hospitals and clinics)

CMS stands for what regulatory agency? What is its responsibilities?

Centers for Medicare and Medicaid Services

Oversees medicare and medicaid

DEA stands for what regulatory agency? What is its responsibilities?

Drug Enforcement Agency

Enforces compliance with the Controlled Substance Act

It places medications into the appropriate schedule, monitor records, and reports of controlled substances, registering pharmacies, issuing Form 222 and 41, and monitor the destruction of controlled substances

DEA is overseas by Department of Justice

FDA stands for what regulatory agency? What is its responsibilities?

Food and Drugs administration

Ensure that all pharmaceutical products are pure, safe, and effective

Institutional Review Board stands for what regulatory agency? What is its responsibilities?

A board, committee, or other group designated by an institution to approve biomedical research in accordance with the FDA

TJC stands for what regulatory agency? What is its responsibilities?

The Joint Commission

address quality of patient care and patient safety.

establish standard and accredits health care providers (places): hospital, home health care agencies, long term care pharmacies...

NABP stands for what regulatory agency? What is its responsibilities?

National Association of The Boards of Pharmacy

Composed of all State Boards of Pharmacy.

No regulatory authority but meets to discuss current trends and issues in pharmacy that affect the practice of pharmacy

BOP stands for what regulatory agency? What is its responsibilities?

State Boards of Pharmacy

Regulatory state agency that oversees the practice of pharmacy in a given state

USP stands for what regulatory agency? What is its responsibilities?

United States Pharmacopeia

official public standards-setting authority for all prescription and oTC medicines and other health care products manufactured or sold in the US

Set standards for food ingredients and dietary supplements

-mycin

antibiotic; macrolides

-cycline

antibiotic; tetracyclines

-floxacin

antibiotic; fluoroquinolones

ceph-, cef-

antibiotic; cephalosporins

-cillin

antibiotic; penicillins

-cyclovir

antiviral; anti-herpetics

-pril

antihypertensive, ACE inhibitor

-sartan

antihypertensive; Angiotensin II Receptor blockers (ARB's)

-osin

antihypertensive, Benign Prostatic Hyperplasia (BPH); a 1-receptor blockers

-olol

antihypertensive;

cardioselective b-receptor blockers

nonselective b-receptors blockers

ISA

Mixed a & b receptor blockers

-dipine

antihypertensive, calcium channel blockers (CCB's)

-statin

Antihyperlipidemia; HMG-CoA Reductase Inhibitors

-glitazone

antidiabetic; thiazolidinedione

-glinide

antidiabetic; meglitinides

-dronate

osteoporosis; bisphosphonates

-tidine

Antiulcer H2 Receptor Antagonist

-prazole

Anti-Ulcer; Proton pump inhibitors (PPI's)

-triptan

Anti-migraine

-pam, -lam

anti anxiety/hypnotics, Benzodiazepines (BZD's)

-pramine

antidepressants, Tricyclic Antidepressants (TCA’s)

-triptyline

antidepressants, Tricyclic Antidepressants (TCA’s

-ine

antidepressants; selective serotonin reuptake inhibitors (SSRI'S)

-one

anti-inflammatory; corticosteroids

-steride

Benign prostatic hyperplasia (BPH)

-nacin

overactive bladder and incontinence; anticholinergics

-fil

erectile dysfunction

-terol

pulmonary, asthma & COPD

-mide, -nide

antihypertensive; diuretics