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Chapter 8, Comp 15

Chapter 8, Comp 15 Orange Tech

Community Pharmacy pharmacies that provides prescription services to the public
Aphasia Communication disorder that results from brain damage, stroke
Interpersonal Skills skills involving relationships between people, Sender, the message, receiver, feedback, barriers.
Nonverbal Communication Body position, Facial expressions, Lack of eye contact, tone of voice.
Two principles of Communication To establish ongoing rapport, to provide an exchange of info for patient health and quality of life
5 RIGHTS The right patient, The right medicine, The right route, The right dose, The right time
Independent pharmacies Individually owned local pharmacies
Chain pharmacies Chains such as CVS, Walgreen’s and others
Mass Merchandiser Pharmacies National stores such as Walmart, Target and others that have pharmacy departments.
Food Store Pharmacies Chains such as Kroger, Giant Eagle and others that have pharmacy departments.
Attitude Can determine if a patient comes back, this involves; Appearance, Attitude, Efficiency, Helping out.
Ways to help a patient understand Pictograms, no medical jargon, avoid double meaning words, develop trustworthiness, be aware of cultural differences, use simple words and ideas to get patient info
Auxiliary Label Provides supplementary info on meds
Contraceptives AL Take as directed
NSAIDS AL May cause dizziness/drowsiness, Take with food
Narcotics AL Do Not Drink Alcohol, and/or drinking may increase the effects of the drug
Macrolide Antibiotics AL Take on an empty stomach, Take with plenty of water
All Antibiotics AL Take until gone/finished
Sulfa Antibiotics AL May cause sensitivity to light, take on an empty stomach, Take with plenty of water
Warfarin AL Do not take Aspirin unless prescribed
Applicator Bottles Topical meds
Dropper Bottles Ophthalmic, ear, nasal or liquid meds
Ointment jars, collapsible tubes Ointments, creams, and gels
RX Bottles Liquids
Round Vials Solid dosages (Pills, tablets, capsules, caplets)
Amber Color Protects meds from breaking down due to sunlight
Contamination Wash all tools after each use, and keep work area cleaned with 70% Isopropyl Alcohol
Pharmacist Immunization Programs Pharmacists may administer routine vaccinations (Flu, Pneumonia, Shingles, Hep A & B)
Good customer service Understanding customer request for services, empathize with the customer, speak gently and be kind
Federal Regulations Laws such as OBRA 90’, HIPAA
State Regulations Community pharmacies are most closely regulated by their BOP
Transaction Window Counter areas designated for taking prescriptions
(BIN) Bank Identification Number Six-digit # used for routing and identification to process an RX claim
Behind the counter medications (BTC) Sold behind the counter by pharmacist, not considered RX’s
Dispense as Written (DAW) A numeric set of codes created by (NCPDP) used when filling an RX, and for reimbursement from insurance
DAW 0 No product selection indicated
DAW 1 No Substitution
DAW 2 Substitution allowed if customer asks
DAW 3 Substitution allowed by pharmacist
DAW 4 Substitution allowed if generic not in stock
DAW 5 Substitution allowed Brand dispensed as generic
DAW 6 Override
DAW 7 No Substitution by law Brand mandated
DAW 8 Substitution allowed if generic not available in marketplace
DAW 9 Other
Drug utilization evaluation (DUE) Authorized, structured, ongoing review of health provider, dispensing, and patient use of meds
Dysarthria Speech disorder that interferes with the normal control of speech mechanism
e-Prescribing Computer-to-Computer transfer of RX , from prescriber to pharmacy
Federal Legend Federal law prohibits dispensing without a prescription
NDC Unique 10 or 11 digit # composed of three sets that is assigned to a med, 1st 4 #’s drug Maker, 2nd set specifics about the med, 3rd set drug packaging
National Provider Identifier (NPI) 10 digit # for covered health care providers issued by Medicare and Medicaid
Nonproprietary (Generic) name Short coined name for drug or chemical not subject to trademark, is official body
OTC medication Does not require RX, but may be behind the counter
Prescription Order for meds from a licensed practitioner
Proprietary (Name/trade Brand) Name Protected name or trade drug by trademark
Refills Permission by prescriber to replenish an ordered med
Repackage To reduce the amount of meds taken from a bulk bottle/package
Signatura (signa or sig) Directions on an RX for who to take the meds Latin for “write on label”
Prescription counter Counter area designated for preparing
Compounding area Counter area usually near a sink
Prescription bins or shelves Areas for completed prescriptions
Pharmacist's judgment Pharmacist's judgment; professional
Prescription in-take Drop-off area where patients bring prescriptions
Patient Profile Information about the patient, all meds, and OTC's taken by the patient as well as consult info from pharmacist
Online billing Fill a bill at the same time as filling RX
Sole Proprietorship Owned by one person and unincorporated business
Subscription Specific instructions to the pharmacist on how to compound the RX
Superscription Heading of an RX, Latin symbol RX meaning “Thou take” or “you take”
Therapeutic Alliance Trust relationship between the healthcare team and patient, mutually agreed upon goals for treatment, and patient perceptions, and the acceptability of interventions
Partial fills Dispensing a lesser quantity of a medication, or what is on hand, rest to be filled at a later time
Transfers Sending a prescription at another pharmacy, only a pharmacist can transfer to another pharmacy unless it is from one CVS to another CVS then a Tech can do it.
Filing Hard copies of prescription are filed, or scanned into a computer for later retrieval
Scanning a hard copy prescription Accuracy and improved record keeping
Safety Caps Vials and bottles must have a safety cap or child resistant cap, Per Poison Control Act
Counting tray A tray designed for counting pills
Automated filling and dispensing machines Machines that automatically fill and label pill bottles
Fill master Device that dispenses the exact amount of distilled water
Final check by the pharmacist Final check of the product and all paperwork by the pharmacist
Separation and removal of trash Separate trash that contains protected health information (PHI)
OTC products Products that do not require a prescription
Unit price Price of a single unit of a product such as for 1 ounce of a liquid cold remedy.
Drive-through An external site at a pharmacy that can be accessed by driving up in the car
Legend Drugs A medication that may be dispensed only with a prescription directly from the pharmacy
Pharmacy compounding The preparation, mixing, assembling, packaging, or labeling of a drug or device
Professionalism The following of a profession as an occupation
Refrigerator Temperature 2-8 C (36-46 F)
Group number A number that identifies a patient's employer
Shelf stickers Stickers with bar codes that can be scanned for inventory identification
MTM Provide one-on-one pharmacist-patient consultation to help manage chronic diseases and conditions
States have limits on number of pharmacy technicians assisting the pharmacist at a given time Yes (3:1) Three techs per one pharmacist
What information should a tech get when patient requests a refill Patient's name and prescription number, DOB, telephone number, Medication name and strength, Doctors name, and waiting or returning to pick up
The primary card holder is usually designated by_________ 01
Mark up The amount of the retailer's sale price minus their purchase price
Transaction windows Counter areas designated for taking prescriptions and for dispensing them to patients
Community pharmacies that are individually owned local pharmacies are_________ Independent pharmacies
Community pharmacies such as CVS , Walgreen's that are part of regional or national pharmacy chains are____________ Chain pharmacies
Community pharmacies that are part of regional or national food store chains are__________ Food Store Pharmacies
Requires pharmacists to offer counseling for each new patient medications OBRA 90’
Eleven-digit number that is unique to each drug product NDC Number
Unit price information is found on shelf stickers for_______ OTC Products
Refills When processing a refill prescription, it is necessary to check that there are refills available.
Reconstitution Some medications are shipped as powders, but must be mixed with distilled water so they are dispensed as liquids.
Almost _______ of all prescription drugs in the US are dispensed by community pharmacies 2/3
INTERPERSONAL SKILLS Skills involving relationships between people
MEDICARE PRESCRIPTION DRUG IMPROVEMENT AND MODERNIZATION ACT Benefit program to senior citizens, known as Medicare Part D, MTM is also part of it, provides a discount drug card to low income people
COMMBAT METHAMPHETAMINE EPIDEMIC ACT Limits the sales of all over the counter products in any form contains the methamphetamine chemicals pseudoephedrine, ephedrine or phenylpropanolamine
Outcomes MTM, Rx THERAPY MANAGEMENT, MIRIXA Three of the online platforms for MTM
3.6 grams Retail sales may not exceed _________PSE per day purchaser, regardless of the number of transactions
9 grams Individuals are prohibited from purchasing more then ________PSE per 30-day period
BLISTER PACKS, 2 DOSAGES OR UNIT DOSE PACKETS OR POUCHES All non-liquid forms including gel caps of PSE products must be sold in ________ with no more than _______ or ______________
7.5 grams, 30 Mail order companies may not sell more than _______ to any single customer within _____ day period
60 mg Retailers must maintain a written or electronic logbook of all transactions involving products with more than _____ of PSE
RED FLAG RULE The Federal Trade Commission (FTC) enacted provisions known as _________ help prevent identity theft
Customer Service Provision of service to customers, before, during, and after a purchase. Customers expect more from their brick and mortar pharmacy, not just wait time, but interaction with pharmacy staff.
01 person code for insurance; indicates the patient is the primary cardholder
02 person code for insurance; indicates the spouse
03 person code for insurance; child
PRESCRIPTION NUMBER OR LOOKING IN PATIENT'S PROFILE Most refills are looked up either by the ________ or _________
AUTOMATED FILLING AND DISPENSING MACHINE Automated machines that fill and label pill bottles with correct quantities of ordered drugs
KIRBY LESTER (KL1) Pill counters
SIGNATURE LOG Community pharmacies have customers sign a log to record that the prescription was picked up, may also record that patient medication counseling was offered
MARK UP To make a profit, the retailer sells the products at __________ form the purchase price they paid wholesalers and manufacturers
SHELF STICKERS OTC products have _________ that can be scanned for inventory identification; it also indicates the unit price information for consumers
DURABLE MEDICAL EQUIPMENT (DME) Canes, walkers and wheelchairs
PROTECTED HEALTH INFORMATION (PHI) Includes any patient specifics such as names, address, phone numbers, medication, medical history etc., must be shredded or separate in receptacle to be picked up by outside vendor contracted to shred trash
What is the Orange Book used for? Used by pharmacists to find the FDA's determination that a particular manufacturer's drug is therapeutically equivalent to the brand name.
FMEA Failure Mode and Effects Analysis
What is FMEA used for? To predict the opportunity for and severity of errors at various steps in the process.
CPOE Computerized Physician (or prescriber) order entry
RCA Root Cause Analysis
What is RCA? A process that examines the contributing factors regarding why and how an error occurred.
MERP Medication errors reporting process
What does a package insert provide? Indications for use, Dosage and administration technique, Adverse reactions, Warnings, Precautions, Contraindications for the drug, how to prepare the drug, proper storage, available package sizes with NDC numbers.
What factors in the workplace contribute to medication errors? Inadequate lighting, poorly designed work spaces, inefficient work flow, cluttered work spaces, loss of concentration, Improper equipment maintenance, staff schedule, untrained staff, relying on memory instead of checking with a chart.Noise
Why mark open containers with an "X"? To readily identify the container that should be used first
When should you read the medication label? When you remove it from the shelf, as it is being prepared, As the finished product is set aside for the pharmacist to check.
How many times should you read the label? And the prescription when filling. Three times
What should the recipient of a telephone or verbal order immediately do? Give it to the pharmacists for techs cannot take verbal or phone orders
What is a good general rule to follow for calculations? Question a dosage that requires less than 1/2 or more than 2 of the dosage unit.
Day’s Supply Total quantity divided Total quantity taken per day
Day’s Supply GTTs 15gtts/mL x Number of mL divided Number of gtts instilled per day
Day’s Supply Inhalers Number of inhalations per container divided by number of inhalations used each day
How can you prevent calculation errors? Tech-check-tech/ pharmacist checks work, ask "Does the answer seem reasonable?"
How are calculation errors commonly made? Wrong concentration of stock solutions, misplacing a decimal, Wrong conversions, neglecting to double check, Relying on memory.
Why is the pediatric population particularly at risk for calculation errors? Because many drugs do not come in pediatric formulations so adult formulations have to be diluted or manipulated many times for the correct dose.
If a patient losses faith in the medical community what might they do? Switch Pharmacies or Physicians, hesitate to seek help for fear of not receiving quality care, Seek non-conventional treatments from out of the medical community.
Clark’s Rule for Pediatric dosing Child’s weight in pounds x adult dose(AD) 150
What Should be on a Prescription? Prescriber's name, Office address, Telephone number, DEA # if controls are ordered, and maybe the NPI #
Missing or invalid pharmacy number 5
Missing or invalid group number 6
Missing or invalid cardholder ID number 7
Missing or invalid person code 8
Missing or invalid birthdate 9
Missing relationship code 11
Missing days supply 19
Missing or invalid DAW code/product selection code 22
Missing or invalid prescriber ID 25
Missing or invalid unit of measure 26
Non-matched National Drug Code (NDC) number 54
Drug not covered for patient 60
Prior authorization required 75
Refill to soon 79
DUE, examines patients' medication records before dispensing is conducted. Clinical abuse/misuse, drug allergies, drug overutilization, underutilization, contraindications, drug interactions, incorrect dosages, incorrect duration of drug treatment, therapeutic duplication.
Date Date the drug is repackaged, which includes date, month and year
Drug Drug name, usually generic and the brand name, if indicated on the repackaging log sheet
Dosage Form examples include tablet, capsule, spansule , troche, suspension, elixir, solution
Drug Manufacturer Drug manufacturer usually abbreviated
Drug Manufacturer lot number Control number located on the side of the label or on the bottom of the bottle
Drugs expiration date located with the lot number; remember that if the date indicates only the month and year, the medicine is good through the end of the month
Assigned pharmacy lot number each repackaged item in pharmacy is given a number consecutive to the previous batch prepared
Pharmacy beyond-use date (BUD) New date assigned to repackage medications according to United States Pharmacopeia <795> guidelines
Pharm Tech Must initial log book entry
Pharmacist Must check off each item repackaged
Created by: roseoforlando



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