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FDA (food and drug administration)
-approve new drugs to be sold in the US -process New Drug Applications (NDA) -regulate package inserts -regulate drug advertising -issue recalls -federal agency
DEA (Drug Enforcement Agency)
-federal agency -enforce the CSA ( controlled substances act) -track controlled substances manufactured and sold -investigates all violations involving controlled substances -set the DEA Sch. Definitions -issue DEA numbers
BOP (Board of Pharmacy) (each state)
-regulate licensing of pharmacists -regulate licensing of pharmacy technicians -set state laws/ requirements -outline the operating guidelines in the pharmacy -investigate violations of the operating guidelines -determine state regulated controlled substances -state agency
Joint Commission on Accreditation of Healthcare Organizations
-watches over healthcare organizations -third party auditors/ regulators for insurance providers
DEA Schedule I
-no accepted medical use -extremely high potential for abuse -high potential for psychological and physical dependency -ex. weed
DEA Schedule II
-does have medical use -high potential for abuse -relative potential for psychological and physical dependency -ex. oxycodone
DEA Schedule III
-does have medical use -moderate abuse potential exits -ex. vicodin and tylenol w/ codeine
DEA Schedule IV
-abuse potential exists -ex. ambien
DEA Schedule V
-lowest abuse potential -ex. cough medicine w/ codeine or anti-diarrheas
DEA Form 222
-must be used whenever Sch I or II drugs are bought
DEA number verification
-add the 1st
sig
-tells pharm techs how to dispense it -also printed on the prescription it is dispensed in but translated into regular words for the patient
Expiration dates: DEA Sch II
no expiration
Expiration dates: DEA Sch III thru V
6 months
Expiration dates: Legend Drugs
12 months
Refills: DEA Schedule II
no refills allowed
Refills: DEA Schedule III thru V
-up to 5
Refills: Legend Drugs
up to 12 months worth
DEA Controlled Drug Prescriptions must contain at least:
-date of prescription issue -patient's name and address -practitioner's name
Schedule II drug prescription:
-must be manually signed by the practitioner. no exceptions -may not be faxed or called in
FDA Recall Class I
would be used in a case where there is a probability that the use of or exposure to a violative product will cause serious adverse health consequences or death
FDA Recall Class II
would be used in a case where use of a violative product may cause temporary health problems and the probability of serious adverse health consequence is remote
FDA Recall Class III
may be used in a situation in which use of a violative product is not likely to cause adverse health consequence
FDA Market Withdrawal
appropriate when a product has a minor violation that would be not subject to FDA legal action. the manufacture must remove the product from distribution markets or correct the violation. "a product removed from the market due to tampering
FDA Medical Device Safety Alert
used only for medical apparatus equipment. this is when a medical device may present an unreasonable risk of substantial harm. in some cases
NDA Process: Initial Development: Pre Clinical
pre-clinical (animal) testing
NDA Process: Initial Development: Investigational New Drug Review (IND)
-review of pre-clinical trial results -determination of safety to use on humans -authorization to ship across state lines
NDA Process: New Drug Clinical Trials: Phase I
-involves 25-100 volunteers -safety tolerated dosage determined -identification of major side effects -emphasis on safety and maximum tolerated dosages
NDA Process: New Drug Clinical Trials: Phase II
-involves 100-300 volunteers -emphasis on the drug effect against what it's designed to treat -effets compared with similar patients receiving different treatments
NDA Process: New Drug Clinical Trials: Phase III
-involves 300-3000 volunteers -emphasis on the drugs overall effect -effects compared with patients taking placebos -study of different population and different dosages -testing the drug in combination with other drugs -final phase before presenting to FDA for approval
NDA Process: New Drug Post Approval Trials: Phase IV
-ongoing/post approval trials -health-care professionals to report any adverse findings -lasts eternally
NDA Process Time
-can usually take 12-15 years -patent only last 20 years from the time the application for patent was filled
Federal Food and Drug Act of 1906
-known as the Pure Food and Drug Act -provided authority for federal inspection of meat products and prohibited the sale of adulterated foods -required that "secret elixirs" containing ingredients like: cocaine
Narcotic Tax Act of 1914
-known as the Harrison Narcotic Act -provided authority for the IRS to collect taxes on Opiates thru tax stamps -required that any entity which produced
Federal Food
Drug and Cosmetic Act of 1938
The Durham-Humphrey Amendment of 1951
-created a distinction between "OTC" and "Legend Drugs" -required legend drugs to carry the statement: "Caution: Federal law prohibits dispensing without a prescription." -emphasis on this act was to insure safety through qualified medical supervision
The Kefauver-Harris Amendment of 1962
-known as the "Drug Efficacy Amendment" -required drug manufacturers to provide proof of the effectiveness and safety of their drugs before approval -required drug advertising to be more closely regulated and disclose accurate information about side effects
The Bureau of Narcotics and Dangerous Drugs (BNDD)
-predecessor agency of the DEA -BNDD merged into the DEA in 1973
Drug Abuse Prevention/ Control Act of 1970
-known as the CSA -completely replaced the Harrison Act -required the use of DEA numbers -required comprehensive record keeping and transaction tracking -enforced the DEA under the US Dept of Justice
Poison Prevention Packaging Act of 1970
-also known as the PPPA -designed to reduce the risk of children ingesting dangerous substances -required locking caps on most prescription
Combat Methamphetamine Epidemic Act (2005)
-enacted to regulate the OTC sales of pseudoephedrine -identity and address of each purchaser to be kept for two years -daily sales of regulated products not exceed 3.6 grams -30 day purchase limit not to exceed 9 grams -30 day purchase via mail order not to exceed 7.5 grams
National Drug Code (NDC)
-used to identify legend drugs -part of the drug listing act of 1972
NDC: ####-xxxx-xx
-identifies the drug's manufacturer -number is unique to the maker or re-packager of the product
NDC: xxxx-####-xx
-identifies the product -number unique to the formulation and strength of the product
NDC: xxxx-xxxx-##
-identifies the packaging -unique to the size and quantity of the product
q
every
qH
every hours
qAM
every morning
qPM
every evening
qHS
every bedtime
qD
every day
qOD
every other day
qWK
every week
qMO
every month
q__*
every __ hours
q__H
every __ hours
BID
twice a day
TID
three a day
QID
four a day
X__D
times __ days
TDS
3 times a day
C
with
AC
before a meal
PC
after a meal
HS
at bedtime
PRN
as needed
UD
as directed
AA
of each
QS
quantity sufficient
GTT
drop
OD
right eye
OS
left eye
OU
both eyes
AD
right ear
AS
left ear
AU
both ears
PO
by mouth/oral
SL
sub-lingual
NG
naso gastic
BUCCAL
cheek/gum
PR
rectally
PV
vaginally
SUPP
suppositiory
TAB
tablet
CAP
capsule
IM
intramuscular
SQ
sub-cutaneous
IV
intravenous
IC
intra cardiac
INJ
injection
STAT
immediately
Dosage Form: Enteral Medication
-given orally and pass through the GI tract to be absorbed into the bloodstream and metabolized by the liver -includes oral
Dosage Form: Parenteral medication
-injected or placed into the body tissues and do not pass through the liver before entering the bloodstream -can include injections
Dosage From: Injectable Drugs
-usually in the form of solution or powders -mixed with a sterile diluent to render an injectable solution
Topical
-applied to the skin surface or a mucous membrane
Tablets
-to form a tablet
Capsules
-to form a capsule
Caplet
-an oval shaped tablet
Oral Suspension
-drug is mixed with
Syrups
-contain a high concentration of sucrose or sugar to sweeten