1-30 (copy)
Tasks to identify as Rph or Tech
Recommending OTC products
RpH Only!
Ordering DME
Techicians can order Durable Medical Equipment
Consulting with patients
RpH only!
Preparing prescriptions
Technicians can do this, RpH must check
Counseling patients
RpH only!
Maintaining the pharmacy
Techs help RpH out with this
Stocking pharmacy & OTC departments
Techs do this
Obtaining patient information
Techs do this and fill it electronically
Explaining how to use a medication
RpH only!
Maintaining pharmacy records
Techs do this. They keep accurate records for the pharmacy department.
Labeling a prescription
Pharm techs print prescription labels.
Verifying medications before dispensed to patients
RpH only!
Administrating immunizations
Techs can do this if they have a certification for immunizations
Modify dosing for a patient
RpH only!
Process insurance claims (adjudicate third party)]
Techs responsibility. Techs enter insurance information into computer and submit it electronically.
Provide confidential PHI to prescribers
Tech’s can do this
Compounding nonsterile prescriptions
Tech’s can do this
Standard
Orange book
Approved Drug Products with Therapeutic Equivalence Evaluations
This list of all FDA-approved prescription and OTC medication products rates them for safety and effectiveness as well as bioequivalence.
Red Book
Provides formulary management and cost containment information
Contains average wholesale price information for brand-name and generic medications
Microdex
Web application that addresses medication disease and toxicology management and formulary management
Lexicomp
Comprehensive source of information that is used in the practice of pharmacy
Contains information about appropriate dosing and administration of a medicine
Warnings and precautions associated with each medication are provided
SBOP
State board of pharmacy
Regulatory agency that is responsible for the safety, health, and welfare of the public
Handbook on Injectables
Key reference used in hospital or home-infusion settings
Information is based on the results of primary research of parental medication stability and compatibility
Discusses storage requirements and general stability information
Physicians’ Desk Reference (PDR)
A listing of more than 4000 current brand-name and generic medications with descriptions and information on their usage, warnings, medication interactions, category, and more than 2,000 life-size color photos
Considered the standard prescription medication information source
Comply with Federal Laws and regulations applicable to pharmacy practice
Health Insurance Portability and Accountability Act (HIPAA)
PHI: Protected Health Information
Legal standard to protect patient privacy
Protects patients’ medical information
Combat Methamphetamine Epidemic Act of 2005 (CMEA)
Why?: To limit the use of pseudoephedrine (BTC)
Sudafed Requirements: Be 18 and older, show ID
Qty allowed for purchasing daily and monthly: 3.6g/day , 9g/month
Created a new category of products called schedule listed chemical products (SLCP)
This act also placed limits on daily and monthly sales of these products and requires identification by buyers.
Drug Listing Act of 1972
Components of NDC: National Drug Code 5 (manufacturer)-4(product)-2(Package size) 5-4-2
Assigned all medications a specific 10-digit identification number
Food and Drug Act of 1906
Prohibited the interstate transportation or sale of adulterated or misbranded medications and food.
Omnibus Budget Reconciliation Act of 1990 (OBRA 90)
Federal law increases pharmacists’ professional responsibilities in two ways
Requires pharmacists to keep records of all medications used by Medicaid patients
Requires pharmacists to offer to counsel all Medicaid patients about the proper use of their prescription
Includes all patients, not just those covered by Medicaid.
Helped expand the use of pharmacy techs as a way to allow PrH more time to counsel patients
Durham-Humphrey Amendment
Requires all products to have adequate directions for use UNLESS they contain the federal legend “Caution: Federal Law prohibits dispensing without a prescription.”
Food, Drug, and Cosmetic Act
Was enacted to ensure that all medications are pure and safe.
FDA was created as a result of this legislation
FDA supervises the development, testing, purity, and effectiveness of Rx and OTC medications
Drug Supply Chain Security Act (DSCSA) a.k.a Track and Trace
-Who do they report to? The FDA
Outlines the critical steps to build a system to identify and trace prescription medications as they are disturbed throughout the U.S.
Poison Prevention Packaging Act (PPPA)
-Medication exemptions: If doctors or patient request non-childproof caps
This act requires most prescriptions for oral use to be dispensed in chid-resistant containers unless patients or prescribers request otherwise.
Nitroglycerin Sublingual tablets are exempted from being dispensed in child-resistant containers.
Kefauver-Harris Amendment
(FDA) was enacted to ensure that all medications are pure, safe, and effective.
Gave the FDA the authority to require proof of efficacy instead of only safety prior to approving new medication therapy.
Orphan Drug Act
Provided an incentive for drug manufacturers to develop medications for the treatment, diagnosis, or prevention of rare diseases
Used to treat diseases that are fewer than 200,000 cases in the U.S.
Medicare Modernization Act 2003
Provides voluntary prescription medication benefits to Medicare beneficiaries
Added preventive medical benefits for older adults
Centers for Medicare and Medicaid Services (CMS)
Regulates and administers Medicare, Medicaid, The State Children’s Health Insurance Program, HIPPA, and more
Inspects, facilities to ensure compliance with its guidelines
Anabolic Steroid Act 1990
Classified anabolic steroids as C-III controlled substances, all regulations related to rregistration, security, labeling, packaging, inventory, record maintenance, prescriptions, and disposal of these steroids must be followed
The Joint Commission
Organization that sets forth standards for organizations such as hospitals, ambulatory health care, behavioral health, and more
Makes hospitals improve as well as patient care
Makes hospitals eligible for reimbursement
FDA: food and drug act
DEA: Drug Efficacy Amendment
SBOP: State board of pharmacy
Drug classification
Auxiliary Labels:
Take with food or milk
Do not drink alcholic beverages when taking this medication
Avoid Sunlight
Drink milk before consumption
Finish all medication unless otherwise directed by prescriber
Reye’s Syndrome
Caused by giving children aspirin when they have a fever.
Rare but can be fatal
“Aspirin Reye’s”
Tylenol
APAP, Acetaminophen
4,000 mg a day/or 4g max dosage
Not a NSAID
Analgesic, pyrocramatic
Safe for pregnant women
Fentanyl
Duragesic, C-II, Flush pad down toilet
NSAIDS
Ibuprofen
Naproxyn
Diclofenac Sodium
Nabumetone
Can cause: GIL, Kidney Damage
Pharmacy Operations and Process flow
Counseling Area
Designated area used for a patient being counseled by the pharmacist
Out of the way of customer traffic to allow counseling to occur while protecting patient’s privacy
Dispensing Area
Where a tech counts, pours, and packages medications
Mixups here can be serious and only equipment needed to dispense should be here
In-Window
Where a tech greets patients and obtains patient information about prescriptions and refills
Gives first impression of Pharmacy
Known as the “drop-off window”
Out Window
Where pharmacists counsel patients and a tech or staff completes sales
Also called the pick-up window
Where patients sign forms and write checks
The to-be-entered section
Usually a rack or filing system, organized by pick-up times
Prepared by working a tech’s way through this file according to pick up times
The to-be-filled section
The counter space next to or near the dispensing area
The label, original prescription order, and stock bottles of medications to dispense are placed here
Compounding area
Designated for the compounding of nonsterile products such as creams, ointments, lotions, and gels
Often located next to the sink
Data entry area
Where tech enters information into patient profiles
Administration Area
Used to complete paperwork and to check in orders from suppliers
Pick-up area
Group of bins or baskets where finished prescriptions await pick up