PSD Exam 1

Community Pharmacy Workflow Steps

1. Pharmacy receives → 2. Data Entry → 3. Pre-check → 4. Dispensing → 5. Final check → 6. Patient receives

Pharmacy receives the prescription

Includes written Rx in person, fax, electronic/e-prescription, telephone from prescriber's office, voice mail, or transfer Rx from another pharmacy.

Data Entry

Involves patient info, interpreting & assessing prescription data, and entering information into the computer.

Pre-check

Completed by a pharmacist at some pharmacy locations to verify data entry and check for safety & appropriateness before dispensing.

Dispensing

Involves printing the Rx label, locating & selecting medication, safety scan to verify meds, and counting, packaging & labeling the meds.

Final check

Verification completed by pharmacist to check for appropriateness/safety and assess for accuracy of medication prescribed.

Patient receives the prescription

Any pharmacy staff member may release Rx to patient and must verify the correct patient is receiving the prescription.

Required components of a written outpatient prescription

Date, prescriber info, patient info, medication info, DAW rules, and manual signature for paper Rx.

Controlled substances requirements

DEA# required and quantity to dispense must be written numerically and alphabetically.

Required components of an outpatient prescription label

Pharmacy info, full name of patient, name of prescriber, Rx# / prescription serial number, date dispensed, drug name and strength, drug distributor/manufacturer, quantity dispensed, and Rx directions.

DEA# validity check

DEA# consists of 2 letters followed by 7 numbers; the first letter indicates the type of practitioner and the second letter is the first initial of the prescriber's last name.

Initial filling timeframe for prescriptions

Noncontrolled and C-V controlled drugs = 6 months; Opioid analgesics (CII-CIV) = 14 days from the date prescription was written.

Refill timeframe for prescriptions

C-II controlled drugs = ZERO refills; C-III and C-IV = 6 months; Noncontrolled and C-V = 1 year from the date prescription was written.

Schedule I drugs

Includes heroin, LSD, ecstasy, and marijuana.

Schedule II drugs

Includes oxycodone, hydrocodone, morphine, methylphenidate, and dextroamphetamine.

Schedule III drugs

Includes testosterone and certain analgesics with codeine (e.g., Tylenol with codeine).

Schedule IV drugs

Includes lorazepam, alprazolam, tramadol, and zolpidem.

Schedule V drugs

Includes pregabalin and certain cough syrups with codeine.

PPCP steps

Collect → Assess → Plan → Implement → Follow-up.

PPCP purpose

Used for patient evaluation and problem solving through a patient-centered approach.

Collect in PPCP

Pharmacists collect necessary subjective & objective information about the patient.

Assess in PPCP

Pharmacist assesses collected info and analyzes clinical effects of therapy in context of overall health goals.

Plan in PPCP

Pharmacist develops an individualized patient-centered care plan in collaboration with other healthcare professionals.

Implement in PPCP

Pharmacist implements the care plan in collaboration with other healthcare professionals.

Follow-up in PPCP

Pharmacist monitors and evaluates the effectiveness of the care plan and modifies it as needed.

Importance of documenting interventions

Essential for tracking patient care and ensuring continuity and quality of care.

PPCP

Framework for pharmacists' patient care activities.

SOAP Note

Structured documentation of patient encounters.

Subjective Data

Information from patient's personal experiences.

Objective Data

Information obtained through direct measurement.

Assessment

Identifying and prioritizing patient problems.

Plan

Recommendations for treatment and follow-up.

Follow-up

Monitoring therapy effectiveness and safety.

Drug-Related Problem (DRP)

Issues affecting optimal patient drug therapy outcomes.

BMI Calculation

Weight in pounds divided by height squared.

IBW Calculation

Ideal weight based on height and gender.

CrCl Calculation

Estimates kidney function using age and weight.

Adverse Drug Reaction

Harmful response to medication.

Drug Interaction

Effects of one drug altered by another.

Pharmacokinetics

Study of drug absorption, distribution, metabolism, excretion.

Tertiary Literature

Summarized information from original research.

Secondary Literature

Indexes and abstracts of primary research.

Primary Literature

Original research articles and case reports.

Drug Monograph

Comprehensive summary of a drug's information.

Boxed Warning

Severe safety information about a drug.

REMS

Risk Evaluation and Mitigation Strategies for drugs.

Pharmacology

Mechanism of action and drug effects.

Indications and Use

Approved uses of a medication.

Dosing Adjustments

Modifications based on patient-specific factors.

Overdose Toxicology

Information on overdose effects and treatment.

Background Information

Patient details needed for drug information requests.

Drug Identification

Determining the identity of a medication.

Product Availability

Information on whether a drug is in stock.

Poisoning

Toxic effects from harmful substances.

Literature Hierarchy

Ranking of information sources by reliability.

Effective Drug Information Skills

Essential skills for pharmacists in patient care.

Special populations

Groups needing dose adjustments due to specific conditions.

Administration

Guidelines on how to take a drug properly.

Overdose

Excessive drug intake leading to harmful effects.

Contraindications

Conditions under which a drug should not be used.

Warnings and precautions

Advisories for patients requiring special monitoring.

Pregnancy considerations

Drug safety information for pregnant individuals.

Lactation considerations

Drug safety information for breastfeeding individuals.

Adverse reactions

Negative effects categorized by organ systems.

Drug Interactions

Effects when two or more drugs are combined.

Monitoring parameters

Tests needed to ensure drug efficacy and safety.

Dosage forms

Different forms and strengths of drug preparations.

Stability/Storage

Conditions for proper drug storage and handling.

Patient education

Information provided to patients about their medications.

REMS Information

Safety program ensuring medication benefits outweigh risks.

DailyMed

Online database for FDA-approved drug information.

Facts and Comparisons

Resource for comparing drug products and active ingredients.

Lexi-Drugs

Quick reference database for drug information.

Martindale

International drug reference with detailed monographs.

AHFS-DI

Comprehensive drug monographs for healthcare professionals.

Excipient

Inactive substance in drug formulations for stability.

NDC

Unique identifier for human drug products in the US.

Proprietary name

Brand name assigned to a specific drug product.

Nonproprietary name

Generic name or active ingredient of a drug.

Pharmaceutical equivalence

Same active ingredient and dosage form in drugs.

Therapeutic equivalence

Drugs with same clinical effect and safety profile.

ASHP Drug Shortage Database

Resource for current drug shortage information.

FDA Orange Book

Resource for FDA approval and market availability.

Discontinued Drug Products

Information found in FDA Orange Book and Micromedex.

Physical Characteristics

Identifying drugs via appearance and inscription codes.

Generic Drug Name

Used to find manufacturer and foreign brand names.

Inactive Ingredients

Excipients like sugar and dyes listed in DailyMed.

Prescription Status

Determines if a drug is Rx-only or OTC.

Controlled Substance

Drug classification found in DailyMed and Facts & Comparisons.

Therapeutic Equivalence Code

Indicates FDA's AB rating for drug equivalence.

Pharmaceutical Equivalence

Drugs must share active ingredient, form, route, strength.

Orphan Drug

For rare diseases; info found in FDA database.

AWP

Average Wholesale Price; cost reference in Micromedex.

Prescription Transfer Requirements

Includes pharmacy details and prescription duplicates.

Rx# / Serial Number

Unique identifier for each prescription transfer.

Patient Information

Includes full name, address, and date of birth.

Prescriber Information

Includes prescriber's full name, address, and DEA#.

Transfer Prescription Notation

Word 'transfer' must appear on transferred Rx.

Refill Communication Format

Number of refills communicated in 1+X format.

Controlled Substance Transfer Law

Only refills for Schedule III-V can be transferred.