Pharmacy Technician Study Notes

Chapter 1: Pharmacy Tech

1. Pharmacy Technician and Pharmacist

  • A pharmacy technician assists a pharmacist.
  • Distinction between roles:
    • Pharmacists are the primary healthcare professionals who manage and dispense medications, while pharmacy technicians support them in various tasks.
  • Objective: By the end of the eight-week course, students will be certified as Pharmacy Technicians (CPhT).

2. Responsibilities of a Pharmacy Technician

  • Tasks that a pharmacy technician can do include:
    • Ordering and putting away medications.
    • Maintaining the pharmacy department.
    • Billing patients and third-party payers.
    • Helping patients find medications.
    • Filling prescription orders.
    • Compounding medications.
    • Assisting pharmacists.
    • Filling a unit dose cart.
    • Obtaining a patient’s health history.
    • Additional responsibilities will be discussed throughout the course.

3. Limitations of a Pharmacy Technician

  • Responsibilities that a pharmacy technician cannot perform include:
    • Recommending medications.
    • Counseling patients.
    • Discussing adverse effects of medications with patients.
    • Verifying medications.
    • Performing final checks on medications.
    • Suggesting changes in medication therapy.
  • Legal implications: Engaging in the obligations listed above is against the law for pharmacy technicians.
  • Important procedural example:
    • If a technician receives a call inquiring about medication side effects: The correct action is to place the caller on hold and notify the pharmacist.

4. Vocabulary: A-B

  • Beyond use date (BUD): The date assigned by the pharmacy for when a compound should no longer be used; involves calculations based on the medication's stability.
  • Bioavailability: A measure required by the FDA to demonstrate that a generic drug is equivalent to a brand name, covering how a drug is absorbed, metabolized, distributed, and eliminated from the body.
  • Biometric marker: A fingerprint reader used for identification.
  • Black box warning: A regulatory warning on medication labels indicating the potential for life-threatening adverse effects, commonly found on package inserts or patient profiles.
  • Buccal: A route of administration where a drug is placed between the gum and cheek; a troche (halls) that is designed to dissolve slowly in the mouth.
  • Auxiliary label: A supplementary label providing additional instructions to the patient, distinct from the primary prescription label.

5. Vocabulary: C-G

  • Cardiac: Pertaining to the heart.
  • CHF: Congestive Heart Failure.
  • Controlled substance: A drug that has potential for abuse or dependence, either physical or psychological.
  • Contraindication: Specific condition or factor that prohibits treatment due to potential harm to the patient; mandated by the FDA to be published in a drug's monograph.
  • Dispense as written (DAW): A prescriber's directive to fulfill a prescription with the brand-name drug rather than a generic.
  • Expiration date: Indicates when medication potency cannot be guaranteed; if only the month and year are printed, it refers to the month's final day.
  • FDA: Food and Drug Administration.

6. Vocabulary: H-L

  • High Alert Medications: These medications are associated with significant risk of causing severe harm if a mistake occurs.
  • HIPAA: Health Insurance Portability and Accountability Act, which protects personal health information and grants rights related to this information to patients.
    • Key HIPAA compliance points for pharmacy technicians:
    • Disclose only necessary information when communicating outside pharmacy operations.
    • Must inform patients of privacy policies during their first visit.
    • Ensure patient confidentiality; do NOT announce medications over intercoms.
  • Examples of specific high alert medications: Epinephrine, Warfarin, Insulin, IV Potassium chloride, Oxytocin (Pitocin).

7. Vocabulary: M-O

  • MAR (Medication Administration Record): A form used by nurses to track medication administration.
  • Metabolism: The process through which a drug is broken down in the body, typically by the liver.
  • Medication Guide: A required FDA handout that accompanies certain prescription medications, containing vital usage information and side effects.
  • Multiple Source Medications: Medications available from various manufacturers.
  • Ophthalmic: Referring to medications intended for eye use.
  • Otic: Referring to medications intended for ear use.
  • Over-the-counter: Medications safe for use without a prescription.

8. Vocabulary: P

  • Parenteral: Refers to the administration of medications via routes outside the gastrointestinal tract, predominantly through injections.
    • Common form: Intravenous (IV).
  • Patient Profile: A detailed record of a patient's health and medication history, important for minimizing medication error risks.
  • PHI (Protected Health Information): Information that can identify a patient, including names, birth dates, and insurance information.
  • Polydipsia, Polyphagia, Polyuria: Terms indicating excessive thirst, eating, and urination, respectively; common in diabetes mellitus.
  • PRN Order: A prescription for medication to be taken as needed, refilled up to one year after the prescription date.

9. Vocabulary Q-S

  • Reconstitutable: Medications needing distilled water or diluents added before administration.
  • Sentinel event: An unexpected medical occurrence that leads to death or serious harm, necessitating intervention.
  • Reverse distributors: Firms that specialize in returning expired or discontinued drugs to manufacturers.
  • Sublingual (SL): Refers to medications placed beneath the tongue for absorption.
  • Safety Data Sheet: A document providing critical safety information about hazardous materials in the pharmacy.
  • Speed Shelf (Fast Mover Section): Area housing frequently prescribed medications for quick access.

10. Vocabulary: Sig Codes

  • Sig Codes: Codes used in prescribing to indicate administration instructions:

    • A = Audio for EAR
    • O = Ophthalmic for EYE
    • D = Dominant side
    • S = LEFT side
    • C = Chow (eat)
    • AC = Before meals
    • PC = After meals
    • BID = Twice a day
    • TID = Three times a day
    • QID = Four times a day

  • Examples of Sig Codes and meanings:

    • AU, AD, AS, OU, OD, OS: Both ears, right ear, left ear, both eyes, right eye, left eye respectively.
    • NA: Not available; q4h: Every 4 hours, etc.

11. Regulation and Drug Legislation

  • Comprehensive Drug Abuse Prevention and Control Act of 1970: Defines five levels of controlled substances and requires DEA numbers for prescribers.
  • Drug Enforcement Agency (DEA): Enforces laws concerning the trade of drugs, particularly controlled substances.
  • Durham-Humphrey Amendment: Classifies medications as prescription or over-the-counter, marking those needing a doctor's supervision.
  • Environmental Protection Agency (EPA): Regulates hazardous waste disposal from healthcare facilities.
  • Food and Drug Administration (FDA): Oversees medication production, safety, and efficacy guidelines.

12. Medication Management Processes

  • Medication Therapy Management (MTM): A coordinated effort to improve chronic care outcomes and reduce adverse events. Involves reviewing patient medications, adherence rates, and ensuring safety during medication use.
  • Medication Reconciliation: Reviewing and documenting a patient's medication orders against their existing medications to prevent errors.

13. Medication Error Reporting Programs

  • Medication Error Reporting Program (MERP): Used to report medication errors (not specifically vaccines).
  • Vaccine Error Reporting Program (VERP): Focused solely on vaccine administration errors.
  • Vaccine Adverse Event Reporting System (VAERS): A national database for reporting vaccine-related adverse effects managed by the CDC and FDA.

14. Conversions & Calculations

  • Weight conversion: 2.2extlbs=1extkg2.2 ext{ lbs} = 1 ext{ kg} ; To convert lbs to kg: ext{Weight (kg)} = rac{ ext{Weight (lbs)}}{2.2}
  • Key conversions to remember: 1extoz=30extmL1 ext{ oz} = 30 ext{ mL}; 1exttsp=5extmL1 ext{ tsp} = 5 ext{ mL}; 1exttbsp=15extmL1 ext{ tbsp} = 15 ext{ mL}
  • Temperature conversions: Using the formula to convert °C to °F: °F=(°Cimes1.8)+32°F = (°C imes 1.8) + 32

15. Common Drug Categories and Their Uses

  • Anticoagulants: Blood thinners (e.g., Warfarin)
  • Thrombolytics: Dissolve blood clots.
  • Antineoplastics: Cancer medications, contraindicated for pregnant women.
  • High Blood Pressure (HBP) and corresponding medications:
    • Beta blockers: Medications ending in “olol”.
    • ACE inhibitors: Medications ending in “pril” and may cause cough.
  • What to remember about each category of medications regarding their use and potential adverse effects.

16. Drug Clues to Remember

  • Types of medications with specific endings that indicate their use:
    • ‘-statin’ for cholesterol, ‘-olol’ for blood pressure, ‘-pril’ for hypertension, and ‘-pam’/‘-olam’* for anxiety.

17. Medication Risks in Pregnancy

  • Identify medications that are contraindicated during pregnancy and those that are safer options, based on the risks of adverse outcomes.

18. Pharmacy Reference Materials

  • Understanding key pharmacy references like the Orange Book for therapeutic equivalence and the PDR for comprehensive drug information.

19. Automated Dispensing Machines (ADM)

  • The role of pharmacy technicians in restocking and verifying medications in ADMs, and the limitations of which medications can be stored within them.

20. Infection Control & Disposal Methodology

  • Guidelines on handling and disposing of hazardous medications along with the requirement for safe labeling practices in pharmacy settings.