BIG pharm review

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DEA form 106

report of theft or loss of controlled substances

DEA form 41

request permission to destroy exp C-2

DEA form 224

Apply for a DEA registration number (to disp control)

DEA form 222

Order form for CI and CII substances. Must be kept for 2 years.

Medicare part A

hospital insurance

Medicare part B

-physicians services
-diabetic services
-specialty meds
-medical equipment

Medicare part C

provides supplemental coverage allow patients to participate in HMO/PPO for extra cost

Medicate part D

Prescription drug coverage (insulin, vaccines..)

DAW 0

no product selection indicated, generic ok, pt ok

DAW 1

substitution not allowed by prescriber, fill exactly as written

DAW 2

substitution ok, but pt request that brand be disp'd

DAW 3

substitution ok, but pharmacy fills bran even though generic is available

DAW 4

Substitution allowed - generic drug not in stock

DAW 5

substitution allowed but pharmacy uses the brand

DAW 6

override

DAW 7

substitution not ok, brand mandated by state

DAW 8

substitution ok, brand disp'd because generic is not manufactured

DAW 9

other

Drug Utilization Review (DUR)

(pharmacist's job) reviewing the patient's profile with medication to ensure safety

How many hours of CE are technicians required to complete? How often?

20 hours every 2 years

Adjudication

submitting 3rd party insurance claim for payment

How are legend and controlled prescriptions filed?

legend are filed together, c-ii are filed separately, and c-iii to c-iv are filed together

ad

right ear

as

left ear

au

both ears

bu

buccal

im

intramuscular

it

intrathecal (into the spine)

od

right eye

os

left eye

ou

both eyes

po

by mouth

pr

rectal

pv

vaginally

sub q

subcutaneous

sl

sublingual (under the tongue)

ac

before meals

bid

twice daily

hs

at bedtime

pc

after meals

prn

as needed

qh

every hours

qid

four times daily

tid

three times daily

aaa

apply to affected area

gtts

drops

ha

headache

qs

quantity sufficient

ung

ointment

Patience Adherence

pt taking meds exactly as directed and going to all doctor appointments and labs

Why do hospital pharmacies only give a 24 hour supply?

reduces stealing, any qty after 24 hours would clutter the upper floor, its best to wait for pt's tests and results to come in

the basic layout of the pharmacy

intake area, processing area, processed rxs area, out window

first in first out

method for stocking medications, earlier exp date goes in the front

common refrigerator vaccines

hepatitis B vaccine (all age groups)
influenza vaccine (6 months/older)
DTAP vaccine, tetinus, pertussis (11-18 y/o)

common freezer vaccines

measles, mumps, rubella, varicella (MMRV)
zoster

USP 800

handling hazardous drugs

Who releases medication recalls?

the FDA

Class 1 medication recall

serious adverse effects or death

Class 2 medication recall

temporary adverse effect or a small chance of an adverse effect

Class 3 medication recall

problem not likely to cause adverse effects

Department of transportation (DOT)

regulates how medication waste should be shipped

P-listed

acutely hazardous waste (epinephrine, nicotine, warfarin)

D-listed

toxic, ignitable, corrosive (benzoyl alcohol, albuterol inhaler)

U-listed

toxic (chemotherapy)

What is on a patient profile

(basic demographic info) name, address, DOB, phone\#, email

types of drug interactions

drug-drug
drug-age
drug-health condition

NKDA

no known drug allergies to all drugs

NKA

no known allergies to anything

Trissel's Handbook on Injectable Drugs

Provides information on the stability and compatibility of injectable drugs

post

after, behind

peri

around, surrounding

how to dispose of antibiotics

mixed with coffee grounds or soaked in water

how to dispose of warfarin

hazardous, so meant to be placed in a specific bin for professional disposal

how to dispose of chemotherapy

yellow sharps container

how to dispose of fentanyl patches

flush down toilet

USP

United States Pharmacopeia: info about product, med quality standards, and info about legend + OTC

Pink book

provides info about vaccines and diseases

The Merck Index

lists chemical attributes of chemicals, meds, and biologicals

barbiturates

central nervous center depressant, used to treat seizures and anxiety

medicaid

health care coverage for low income children, adults, elderly, and people with disabilities

National Formulary (NF)

list of officially recognized names of drugs that have an established usefulness

how often is the national formulary updated

every 5 years

PDR (Physician's Desk Reference)

The most widely used refernces for drugs in current use.

Who act created the FDA

Pure Food and Drug Act of 1906

Pure Food and Drug Act of 1906

prevented the adulteration and mislabeling of foods and pharmaceuticals

The Joint Commission

Independent non-profit organization, sets healthcare quality standards and protects patients and visitors, conducts inspections of healthcare facilities.

tort

act that causes harm/injury to a person intentionally or negligently

Harrison Narcotic Act of 1914

curb the recreational use of opium, established that opiums cannot be purchased without an rxs

Federal Food, Drug, and Cosmetic Act of 1938

created because the pure food and drug act was not worded strictly enough, emphasized adulteration and misbranding

Durham-Humphrey Amendment of 1951

required all rx drugs to be labeled "caution: federal law prohibits dispensing without an prescription", created the distinction between legend and OTC

Kefauver-Harris Amendment of 1962

ensured that drugs be proven safe and effective, gave FDA authority to approve manufacturers marketing

Controlled Substances Act of 1970

enforced by the DEA, created the drug classes I-V

Poison Prevention Packaging Act of 1970

Requires use of child-resistant containers for prescription and nonprescription drugs

what is required for non childproof lids

patient's written consent

Drug Listing Act of 1972

implemented under the FDA, required that all drugs have an NDC code

NDC number

number that identifies manufacturer, product, and package size

Orphan Drug Act of 1983

Provided incentives for the development of orphan drugs for treatment of rare diseases

Prescription Drug Marketing Act of 1987

solidified legal supply channel of rx drugs from manufacturer to authorized distributors, prevent the selling of counterfeit drugs

Omnibus Budget Reconciliation Act (OBRA)

law passed by the federal government that includes minimum standards for nursing assistant training, staffing requirements, resident assessment instructions, and information on rights for residents

OBRA '87

set requirements for facilities participating in medicare and medicaid