Exam 1 : IPC II

What vaccines may be appropriate for a pregnant woman?

1. TDAP every pregnancy, ideally during gestational weeks 27 to 36

2. Inactivated influenza vaccine

3. COVID-19 vaccine

4. Bivalent abrysvo during gestational weeks 32 to 26 in RSV season

What vaccines are live?

- MMR

- Varicella

- Rotovirus

- MMRV

- Live attenuated influenza

- Yellow Fever

- Oral Typhoid Capsule

What vaccines are recombinant?

- Flu

- COVID-19

- RSV

- HEP A / HEP B

- Zoster

- Human Pap

- Typhoid Vaccine Injection

What are special considerations for live vaccines?

People with weakened immune systems, such as those with HIV/AIDS, may not be able to receive live vaccines

People with certain malignancies, such as leukemia or lymphoma, may not be able to receive live vaccines

People receiving chemotherapy or radiation may not be able to receive live vaccines

People with long-term health problems should consult with their health care provider before receiving live vaccines

Pregnant women should not receive the LAIV vaccine

Children with asthma or who have had a wheezing episode within the past 12 months should not receive the LAIV vaccine

People who have taken influenza antiviral medications within the previous 48 hours should not receive the LAIV vaccine

What are the roles of adjuvants in vaccines?

Increases immune response

what are necessary elements for a drug to be considered a non-prescription?

- Monograph or NDA

- Must prove safety and efficacy

- Non-prescription "drug facts" Label

what are necessary elements for a drug to be considered a dietary supplement?

a product taken by mouth that contains a dietary ingredient intended to supplement the diet

* They do not have a monograph

* Do not require submission of a new drug application

* Dietary supplements can not prevent, treat or relive a disease or medical condition

what are necessary elements for a drug to be considered a homeopathic product?

" Regulated by FDA

- "Treat" a self limiting, self diagnosable condition

- FDA has NOT reviewed any homeopathic products not currently / never were included in DESI or OTC Drug Review

- Governed by the Homeopathic Pharmacopoeia of the United States (HPUS)

Dilution factor

What are regulations pertaining to NDA's?

1. Premarket approval required

2. Clinical development (trials) required

3. Approved labeling is unique

4. Marketing exclusivity for 18 months

What are regulations pertaining to OTC Drug Monographs?

1. Premarket approval NOT required

2. Clinical studies not necessary

3. Monograph (labeling) is the same for all products with the same ingredient

4. No marketing exclusivity

What are regulations pertaining to Both NDA and Monograph?

1. Standards for safety and efficacy

2. GMP (Good Manufacturing Practices) inspections

3. Advertising regulations through Federal Trade Commission

What are possible disruptions to the medication use process?

1. Solving Third Party Rejections

2. Staffing limitations

3. Phone calls

4. Rush Hour

5. Stock issue

6. MTM

7. Immunizations

8. Consultation

9. Metrics

What is meant by self care therapeutics & pharmacist - assisted self care?

- non prescription recommendations

1. Nonprescription medications

2. Medical devices

3. CAM

- Non-pharmacologic recommendations

1. Dietary

2. Lifestyle

3. General wellness

What would be the first question you should ask during a self care consultation?

Who is the patient that we are going to be treating for this self care consultation?

What is the medication use process

The sequence of industrial, administrative, or other processes through which a piece of work passes from initiation to completion

What are advantages of telepharmacy for patients?

1. Expands access

2. Improves adherence

3. Decreases hospital readmission

4. Improves experience

5. Decrease risk; helped "flatten the curve" during COVID-19 pandemic

What are advantages of telepharmacy for pharmacies?

1. Decrease in operating costs

2. Increase in operational efficiency

3. Free up RPh for clinical role

4. Ability to work remotely

5. Decrease infection risk; helped "flatten the curve" during COVID-19 pandemic

What is Telehealth?

- administrative meetings

- Provider training

- Continuing medical education

- Clinical services

What is telepharmacy?

- Remote delivery of pharmaceutical care and services using technology

- Inpatient and outpatient facilities

- Follows federal and state regulations

What is telepharmacy services?

1. Inpatient remote order-entry review

2. Outpatient remote dispensing

3. Intravenous (IV) admixture verification

4. Patient counseling and monitoring

Inpatient remote order-entry review

RPh at remote location : reviews medication orders before hospital staff administers drug

Advantages:

- Real- time medication order review / verification

- Extension of the in-house pharmacy

- 24/7 coverage

- fill-in/ supplement during peak hours

Patient counseling and monitoring

Pharmacist counsels patient via a live interactive video session or other telecommunications

Advantages:

- allows pharmacist to counsel patients

+ Specialty counseling : EX diabetes, HIV/AIDS

+ Discharge counseling

What are benefits of digital health technologies

- improve patient care

- Increase efficiency

- Gives patients more control over their health

How do you prepare and conduct a successful virtual encounter?

1. Prepare

+ Ask patient to gather all their meds, have a notepad and pen

+ Practice using the equipment

+ Find a quiet place for the encounter

2. Beginning the encounter

+ Ensure privacy, comfort, distraction free

+ Introduce all participants

+ Document

3. Conducting

+ Ensure all participants can be seen and heard

+ Maintain eye contact

4. Closing the encounter

+ Summarize the encounter verbally

+ Determine a follow-up plan

+ Document the encounter, in writing

What patients may benefit from Aidia?

Individuals that need reminders to take medication on time ( device will remind by phone or text to alert patient if late to take dose)

What patients may benefit from Truthbrush?

- allows sharing data with dentist

- helps shows parents where they children can focus more on brushing

What patients may benefit from Endeavor Rx and EndeavorOTC?

Individuals with ADHD in children 9-17 years old

What patients may benefit from perifit Care+?

Individuals that need help to strengthen pelvic muscles & reduce bladder leakage

What are general rules of digital health tools that are safe to recommend?

- safe to recommend an app developed / adopted by the CDC for patients

- Safe to use an app developed / adopted btw the DCD to look up information yourself

- Safe to recommend an FDA- authorized app or digital device

- Safe to recommend not using a digital tool for an intervention that a guideline does not recommend

Ex: earwax cleaning tools