excpt day 2

Basic quantity formula

Dose per administration × administrations/day × number of days

Days-supply formula

Quantity dispensed ÷ quantity used per day

1 tablet BID × 10 days. Quantity?

20 tablets

1 tablet TID × 10 days. Quantity?

30 tablets

1 tablet QID × 7 days. Quantity?

28 tablets

2 tablets BID × 14 days. Quantity?

56 tablets

1½ tablets daily × 30 days. Quantity?

45 tablets

#90, take 1½ tablets daily. Days supply?

60

#120, take 2 tablets BID. Days supply?

30

#90, take 1 tablet TID. Days supply?

30

#60, take ½ tablet BID. Days supply?

60

5 mL BID × 10 days. Quantity?

100mL

5 mL TID × 10 days. Quantity?

150mL

10 mL BID × 7 days. Quantity?

140mL

2.5 mL TID × 10 days. Quantity?

75mL

Ordered 250 mg; stock 125 mg/5 mL. Give?

10mL

Ordered 500 mg; stock 250 mg/5 mL. Give?

10mL

Ordered 375 mg; stock 125 mg/5 mL. Give?

15mL

Ordered 200 mg; stock 100 mg/5 mL. Give?

10mL

Ordered 150 mg; stock 50 mg/5 mL. Give?

15mL

General liquid-dose formula

Desired dose ÷ dose on hand × volume on hand

25 mg/mL; need 100 mg. Volume?

4mL

50 mg/mL; need 125 mg. Volume?

2.5mL

20 mg/mL; need 60 mg. Volume?

3mL

U-100 insulin: 10 mL vial contains?

1000 units

1,000 insulin units ÷ 20 units/day

50 days

1,000 units ÷ 25 units/day

40 days

1,000 units ÷ 40 units/day

25 days

Patient uses 30 units BID. Total daily dose?

60 units/day

1,000 units ÷ 50 units/day

20 days

Three 3-mL U-100 insulin pens contain how many total units?

900 units

Five 3-mL U-100 pens contain how many total units?

1500 units

Five pens = 1,500 units; patient uses 50 units/day. Mathematical days supply

30 days

1% w/v means

1 g per 100 mL

2% w/v means

2 g per 100 mL

5% w/v means

5 g per 100 mL

500 mL of 2% w/v contains how much drug?

10g

200 mL of 5% w/v contains how much drug?

10g

250 mL of 4% w/v contains how much drug?

10g

Ratio strength 1:100 means

1 g in 100 mL

Basic dilution equation

C₁V₁ = C₂V₂

Need 100 mL of 5% solution from 10%. How much 10% stock?

50mL

Need 200 mL of 5% from 20%. Stock volume?

50mL

1 kg = ? g

1000

1 kg = ? mg

1000000

1kg = ? lb

2.2

154 lb ≈ ? kg

70

Patient weighs 44 lb. Approximate kg?

20

IV contains 1,000 mL and runs at 125 mL/hr. Duration?

8 hours

500 mL runs at 100 mL/hr. Duration?

5 hours

General DEA registration-number format

Two letters followed by seven digits, with the last digit serving as a check digit.

DEA number validation: Step 1

Add the 1st, 3rd, and 5th numeric digits.

DEA number validation: Step 2

Add the 2nd, 4th, and 6th numeric digits and multiply that sum by 2.

DEA number validation: Step 3

Add the results of Steps 1 and 2.

How is the DEA check digit verified?

The last digit of the calculated total should match the final digit of the DEA number.

What is a PDMP?

Prescription Drug Monitoring Program.

Purpose of a PDMP

Electronic monitoring of controlled-substance prescribing/dispensing to help identify misuse, diversion, unsafe prescribing patterns, or multiple-provider use.

Diversion

Redirection of a legally produced controlled substance into illegal or unauthorized use.

Perpetual inventory

Continuously updated record of inventory quantities after each receipt, dispensing, transfer, or other transaction.

Why maintain perpetual controlled-substance inventory?

To identify discrepancies and support accountability/diversion detection.

What should happen when controlled inventory received does not match the invoice/order?

Stop and investigate the discrepancy according to pharmacy procedure, involving the pharmacist/PIC.

Who has ultimate responsibility for controlled-substance compliance in a pharmacy?

The pharmacy and pharmacist/PIC under applicable law; technicians perform delegated tasks under supervision.

Emergency Schedule II oral prescription concept

Federal law permits an emergency oral C-II prescription in limited circumstances, followed by required prescriber documentation.

What determines whether a controlled prescription may be transferred?

The schedule, federal law, state law, and applicable electronic-prescription rules.

Hardcopy controlled-substance prescription filing

Must comply with federal and state filing/retrievability requirements.

Inventory transfer between pharmacies

Controlled-substance transfers require appropriate documentation and must follow DEA/federal requirements.

Controlled substances awaiting disposal

Must remain secured and handled under applicable DEA disposal procedures.

Core elements checked when reviewing prescription completeness

Patient, prescriber, drug, strength, dosage form, directions, quantity, date, required authorization/signature and other legally required information.

What should happen if required prescription information is missing?

Obtain clarification through the appropriate pharmacist/prescriber process before dispensing.

Patient profile should include

Demographics, allergies, medical conditions, prescription/OTC medication history and insurance information.

Why include OTC drugs and supplements in a patient profile?

They can contribute to drug interactions, contraindications, duplication, and adverse effects.

NPI

National Provider Identifier.

Purpose of an NPI

Standard unique identifier for covered healthcare providers in electronic healthcare transactions.

Prescription origin types listed by NHA

Written, verbal/telephone, facsimile, and electronic.

Prescriptive authority

Legal authority granted to a healthcare professional to prescribe within the person's scope of practice.

Can every prescriber prescribe every drug for every condition?

No; authority depends on profession, state law, scope of practice, controlled-substance registration and other requirements.

What is a DUR?

Drug Utilization Review.

Purpose of DUR

Identify potential medication-related problems such as duplication, interactions, excessive dose, inappropriate therapy or adherence concerns.

Prospective DUR

Review occurring before a prescription is dispensed.

Retrospective DUR

Review of medication use after dispensing to identify patterns or problems.

Why does ISMP publish an error-prone abbreviation list?

To reduce medication errors caused by misinterpretation.

Why avoid trailing zeros? Example: 5.0 mg

The decimal may be missed and interpreted as 50 mg.

Safer notation for five milligrams

5 mg, not 5.0 mg.

Why use a leading zero?

To prevent .5 from being misread as 5.

Safer notation for half a milligram

0.5 mg, not .5 mg.

Why is “IU” considered error-prone?