Pharmacy Chapter 9 and 11

USP 795

non-sterile compounding standards

Good Manufacturing Practices (GMP)

Federal guidelines that must be followed by all entities that prepare and package medication or medical devices

Beyond Use Date (BUD)

a repackaged non-sterile solid or liquid dose, 1 year from repackage date or manufacturer container whichever is earlier

Expiration Date

assigned by manufacturer (month and year) expires on the last day of the month

Central Pharmacy

where all drugs are housed (main pharmacy in the hospital)

Satellite Pharmacy

smaller specialty pharmacies that supply for different departments

Discharge

Pharmacies where patients can get their meds when they leave the hospital.

Standard Operating Procedures (SOPs)

Manuel that contains policies that outline rules and procedures of facility.

Pharmacy and Therapeutics Committee

Made of pharmacists, physicians, and other healthcare workers that make up the approved list (formulary/non-formulary)

NKA

No known allergies

NKDA

No known drug allergies

Who are the patients in the hospital?

The pharmacy technicians

Centers for Medicaid and Medicare (CMS)

regulate and administer medicare, medicaid, CHIP, and HIPPA Standards.

Department of Health and Human Services (HHS)

protects health of American people, helps with proventative care, disasterous preparedness, and covering areas such as infection and diseases.

Department of Public Health (DPH)

inspects hospital and hospital pharmacies to make sure their in compliances (state-regulated)

Medication order

A prescription written for administration in a hospital or institutional setting

Computerized Physcian Work Entry (CPOE)

Medication that is sent electronically to pharmacy

Stat Order

medication orders that need to be filled within 5-13 minutes.

ASAP order

done as soon as possible but not as urgent as STAT (within an hour)

Standing order

writtn protocols for drugs for treatment that is to be used in specific situations.

Electronic Medication Administration Record (e-MAR)

automatically documents adminstration of meds into patient EHR (electronic health record)

Computerized Adverse Drug Event Monitoring (CADM)

system that detects/monitors adverse drug events

Automated Dispensing System (ADS)

Computerized cabinets and integrated systems that control inventory on nursing floors, in emergency departments, and in surgical suites and other patient care areas

Unit Dose (UD)

Individualized packaged doses used in institutional practice settings

Period Automatic Replenishment

sets levels of medication kept on hospital floors

Aseptic Technique

method used to make the environment, the worker, and the patient as germ-free as possible

Horizantal/Vertical Air Flow Hood

Use HEPA filter to collect contaminents, non-hazardous medication making in these hoods

Biological Safety Cabinent (BSC)

Has 2 HEPA filters, normally enclosed, used to prepare hazardous medications

ISO Classes

rating system on how clean a room is (1-9) higher = dirtier, lower = cleaner

Crash Carts

a cart full of emergency medications used during a code stored on nursing units for easy access

Mortars/pestles

a tool consisting of a bowl-like container to crush and grind ingredients (ex glass and porcelein)

Non-aqueous formulations

should be assigned a BUD sooner of 6 months or earliest expiration dates

Scales

Differ in range from Class III and Class II

Class III scale or Class A

A torison balance, uses a counter balance to determine the weight of the substance (commonly used for weighing drugs and other pharmaceutical substances required in prescription compounding)

Class II

electrical scale

Excipients

inert substances added to a drug to form a suitable consistency for dosing

Graduated cylinder readings

when reading calibrations of a beaker or graduated cycliner, must read at eye level and bottom of liquid line aka meniscus

Solvent

vehicle used to dissolve something

Solute

the ingredient or agent dissolved in the solvent

Solution

result of the final mixture of the solute and solvent

Reconstitution

mixing a diluent into a preweighed powder to form a solution or suspension

Suspensions

Shake Well

Opthalmic

For the eye

Otic

For the ear

Ointment/Cream

For external use, For topical use

Suppositories

For recral use; for vaginal use

Patches

apply to skin

Trituate

to crush something into fine powder

Geometric dilution

a compounding technique to evenly distribute a small amount of one ingredient with a larger amount of another ingredient

Punch method

The body is punched, attached to the cap and then weighted down to make sure each capsule is filled with the same amount

What’s on a Formulation Record (FR)?

• The recipe for the drug preparation that must be followed.

• It should be created before compounding a preparation for the first time.

Compounding Record (CR)

ingredients, their quantities, equipment used, and the procedure for preparing the medication. (Also include SDS Sheets, expiration dates, and date prepared)

DAW Codes

Ranging from (0,1,2,3)

DAW 0

No product selection indicated

DAW 1

Substitution not allowed by provider

DAW 2

Substitution allowed; patient requested

DAW 3

Substitution allowed; pharmacy requested product