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Pharmacy Technician Duties
Answer phone and handle questions that do not require a pharmacist's expertise or judgement
receive written prescriptions or telephoned refill requests
Gather information needed to prepare prescriptions
Record information needed before prescriptions can be dispensed
Enter data into the pharmacy's computer system
notify the pharmacist of patient or prescriber questions, as well as medication warnings or interactions
Help the pharmacist prepare prescriptions by counting, pouring, labeling, or pricing medications
Keep pharmacy supplies stocked
place completed prescriptions in the pick up area
order and stock medications
prepare insurance claims and verify payments
help patients find otc meds and stock otc department
complete purchase transactions and log them when necessary
perform housekeeping duties
What a tech cannot do
receive oral prescriptions, refill authorizations, or changes to prescriptions
consult with prescribers about prescriptions
provide confidential patient information to other health professionals or insurance companies
checking medications before dispensing them.
consult with patients about medication use and other health issues
recommending otc medications
intake area
where patients leave prescriptions. keep clean and uncluttered. Scan rx in a timely manner to prevent delays
processing area
data entry occurs here. Keep free from distraction. also houses counting equipment.
processed rx area
completed prescriptions are stored until pick up
out window-
where patients pick up completed prescriptions. cash register is used. nearby counseling area.
other areas
administration area, clean room for sterile compounding, otc area, and consultation room
Pharmacy Security
pharmacy doors should always be closed. Unauthorized persons should not have access
Non pharmacy personnel should not be allowed to enter unless designated and approved to work in that area.
pharmacy should be locked any time a pharmacist is not on duty.
Receiving Staff Responsible for-
verify name, address, DOB as well as quantity of orders received
shipments must be inspected for damage and observations noted
products requiring special care, such as temperature conditions should be given priority
shipments should be inspected to ensure they exactly match the details written on the purchase order.
invoice should be signed and dated by whoever receives the shipment
expiration dates must be checked to ensure that they are compliant with pharmacy standards.
Any product on back order should be brought to the pharmacist's or management's attention to prevent any possible outages
Stocking Medications- Pay attention to
Expiration of new products
products inspected and anything unusual reported to pharmacist
report prescription patterns to members responsible for ordering/purchasing
stock should be examined for damaged or recalled products
as stock bottles are placed into inventory, label information should be noted.
Identifying expired products-
techs are responsible for checking dates prior to dispensing to determine whether the entire rx is likely to be used by the pt prior to expiration date.
Controlled Substances Act-
Regulates manufacture, importation, possession, use, and distribution of substances with abuse potential. Created five federal schedules of controlled substances. Scheduling determined by DEA. Techs responsible for knowing federal and state rules.
Schedule 1
High potential for abuse no accepted medical use in US unsafe for use under medical supervision LSD and Heroin
Schedule 2
Have current accepted medical use in US high potential for abuse or physical/psychological dependence morphine, methamphetamine, secobarbital
Schedule 3
Have abuse potential less than C1-2 Moderate or low physical dependence May lead to high psychological dependence morphine/opium combo products, central nervous system stimulants and depressants
Schedule 4
low potential for abuse limited risk for dependence compound/mixture containing limited amount of controlled substance with noncontrolled active ingredients (cough suppressants) difenoxin and dephenoxylate preparations
Form 222
used when ordering controls pen and paper middle copy forwarded to DEA record quantity, date received
How long must invoiced for controls be kept?
7 years
How often must inventory of controls be taken?
2 weeks at a minimum
How often must inventory of regular drugs be taken?
monthly
The records of which Schedule drugs must be kept separate?
C2
How many times can c3-4 meds be refilled?
Up to five times in 6 months if authorized
How many times can a c2 be refilled
it cannot be refilled
if the entire quantity is not available, how long do you have to dispense the entirety of a c2 prescription?
72 hours, otherwise the rx is considered to be expired
True/False, in an emergency, a c2 rx can be taken by phone
True. Must say Emergency on rx. Must be followed by written rx. Prescriber has 7 days to follow with a written prescription. Some states require written rx within 24 hours.
Information required in c2 books
dispensing date
name of product
quantity
name, signature, and address of purchaser
pharmacist signature
Methamphetamine Precursor Control Act
Customers required to show ID Must have: name, address, date/time, quantity
Daily limit for Sudafed
3.6gm
Monthly limit for Sudafed
9gm
DEA numbers
First letter will be A,B,M,F Second usually first letter of prescriber last name
Four steps to Check DEA numbers
add the first, third, and fifth digit add the second, fourth, and sixth digit and multiply by two add the result of the first two steps the last digit of the calculation should be the same as the seventh digit
Generic Substitution
substituting a lower cost generic when brand name is prescribed. Often mandated by third party.
What determines whether or not you can substitute a generic for brand?
Prescriber will either check "may substitute" or "DAW(dispense as written)"
HIPAA
Health Insurance Portability and Accountability Act 1996 Privacy is important
OBRA 90
federal law requiring pharmacists to keep records of all medications used by medicaid patients. Pharmacists required to counsel all medicaid patients. Generally interpreted to include all patients.
Consumer Product Safety Commission
requires child-resistant packaging on any substance that might cause serious injury to children. Nitro is an exception
FDA
responsible for approval of drugs deemed safe and effective for human use. Testing phases are required
State Boards of Pharmacy
regulate safe practices and requiring registration for those practicing pharmacy. Determine scope of practice for techs Inspections to determine compliance.
Standard Setting Organizations
Joint Commission National Commission for Quality Assurance (NCQA) United States Pharmacopeia (USP)
Manufacturer Drug Package Labeling must have
brand or trade name
generic name
medication's strength (amount of active ingred)
legend statement- (rx only)
storage requirements
package quantity
dosage form
Manufacturer's name
controlled substance mark
lot number
expiration date
NDC
First five digits of NDC indicate
Manufacturer
Second four digits of NDC indicate
name, strength, dosage form
Last two digits of NDC indicate
package size
Common use of Analgesic
treatment of mild to moderate pain
Generic Analgesics
acetaminophen acetylsalicylic acid acetaminophen/hydrocodone combo acetaminophen/oxycodone combo
Brand Name Analgesics
Tylenol Aspirin Vicodin Percocet
Common use of Antibiotics
treatment of bacterial infections
Generic Antibiotics
amoxicillin azithromycin ciprofloxacin clarithromycin levofloxacin
Brand name Antiobiotics
Amoxil Zithromax Cipro Biaxin XL Levaquin
Anticoagulant common use
prevent/inhibit clotting of blood
Anticoagulant generics
Enoxaparin sodium Heparin Sodium Warfarin Sodium
Anticoagulant Brand Names
Lovenox Heparin Coumadin
Anticonvulsant Common Use
treatment of seizures
Anticonvulsant generics
Clonazepam Phenobarbital Sodium Gabapentin Phenytoin Sodium
Anticonvulsant Brand Names
Klonopin Dilantin Neurontin Dilantin
Common interactions: Blood thinners
interact with other meds or foods to increase bleeding or increase the medication effectiveness. Diet can be a factor in the effectiveness of warfarin
Common interactions: Heart Meds
other drugs can affect metabolism of these meds small changes can result in significant effects which can cause toxicity or lack of efficiency
Common interactions: Antibiotics
rashes and diarrhea are the most common can cause photosensitivity can alter metabolism of other medications
Common interactions: Diuretics
changes in serum potassium and sodium levels directly associated with these medications can cause serious side effects
Common Interactions: Herbal Products
Can affect potency of prescribed medications and should be noted in patients profile.
Capsules
gelatin containers filled with medications. Considered easier to swallow.
Tablets
solid dosage forms vary greatly in size, color, shape, weight, etc Sometimes scored to facilitate breaking sometimes coated to delay absorption
Buccal Tablets
placed in buccal pouch between cheek and gums to dissolve
Sublingual Tablets
placed under tongue and dissolve rapidly
Chewable Tablets
chew before swallowing, only those marked as chewable should be chewed
Effervescent Tablets
mixtures of acids and sodium bicarbonate plus active ingredients. Should not be chewed or swallowed. Should be dissolved in water.
Enteric-coated tablets
coated to prevent dissolving in stomach. Move to small intestine.
Toches and lozenges
held in the mouth while they dissolve. Keep medication in contact with mouth and throat.
pills
originally made from powdered raw materials mixed with sticky liquid
LA
long acting
SA
Sustained Action
SR
Sustained-Release
CR
Controlled- Release
XR/XL
Extended-Release
TR
Timed-Release
Solutions
solid ingredients are dissolved in liquid (usually water)
Suspension
medication particles are suspended in liquid. Medication is not dissolved. In order to help the medication stay suspended, an agent is added to make the preparation thick. Can settle. Need to be shaken.
Reconstitution of Powders to liquids
adding a specific amount of distilled water. Deteriorate rapidly as liquids. Generally effective for 10-14 days. need to be refrigerated.
Elixirs
clear hydroalcoholic (water/alcohol) orally used often contain flavoring substances
Fluid extracts and tinctures
alcoholic or hydroalcoholic solutions of volatile substances contain enough alcohol to necessitate tight containers to prevent evaporation
Syrups
concentrated solutions of sugar in water with active ingredients. May contain alcohol
Emulsions
mixtures of oil and water. Separate over time. Must be shaken.
Ointments
greasy preparations petroleum jelly base good for areas that need protection leave heavy coatings
cream
water/oil/other substances not as much protection as ointments more appealing (less greasy/absorbed by skin)
Lotions
like creams, but more liquid applied easier over larger areas
liniments
mixtures of various substances in oil, alcoholic solutions of soap, or emulsions intended for external application. often used with heat-producing products
gels
semi-solid suspensions of very small particles usually water based
collodions
liquids that dry as flexible films on skin wart/corn/callus removers
transdermal patches
stick to skin with adhesives, long lasting 12 hours to several days nitro for angina or estrogens for hormone replacement
suppositories
cylindrical, egg, or pear shaped some for insertion into rectum or vagina. local effects or to be absorbed
vaginal tablets
inserted into vagina remind patients to remove wrapper
otic
for the ear usually in dropper bottles
opthalmic
for the eyes must be sterile
Aerosols
sprayable products using pressurized gas and valve systems commonly used for skin application or inhalation into lungs or nasal passages
Chewing Gum
absorbed through mucus membranes nicotine gum
Parenteral Medications
sterile preparations injected with syringes insulin