1
Q
Drug-Drug Interactions
A
- Addition - combined effect of two drugs equals the sum of the effects of each drug taken alone
- Antagonism - one drug works against the action of another
- Potentiation - one drug increases or prolongs the effect of the other, the total effect is greater than the sum of the effects of each (e.g. Vistaril and Demerol)
- Synergism - joint action of drugs in which their combined effect is more intense or longer than the sum of effects
2
Q
Drug-Disease Interactions
A
- Various disease may inhibit the absorption, metabolism and elimination of different drugs (e.g decongestants may increase blood pressure for patients with hypertension or diabetes)
3
Q
Drug-Nutrient Interactions
A
- Poor nutrition may affect the metabolism of various drugs (e.g. Warfarin and vitamin K)
4
Q
Drug-Food Interactions
A
- Improved absorption with a fatty meal
- Ketoconazole
- Nitrofurantoin
- Griseofulvin
- Decreased absorption with food
- Tetracycline
- Ciprofloxacin
- Etidronate
- Phenytoin
- Norfloxacin
- Zidorudine
- Levothyroxine
- Didanosine
- Grapefruit affects drugs metabolized by cytochrome P450
- Calcium channel blockers
- Estrogens
- Cyclosporine
- Midazolam
- Triazolam
- Warfarin interacts with vitamin K which is in romaine lettuce and spinach
5
Q
Drug-Related Problems
A
- An event/situation that actually/potentially inteferes with optimum outcome, including untreated indication, improper drug selection, subtherapeutic dosage, failure to receive a drug, overdosage, drug use without indication
6
Q
Drug Information Sources
A
- Primary - original reports of scientific, clinical, tehnical, and administrative research projects
- Secondary - general reference books based on primary sources, including abstracting and bibliographic services and specialized microfiche systems
- Tertiary - condensed works based on primary sources, including monographs and textbooks
7
Q
American Hospital Formulary Service Drug Information
A
- Provides information on uses, interactions, pharmacokinetics, dosage, and administration of commercial and experimental drugs
8
Q
Drug Topics Red Book
A
- Source of information concerning prices
- Sections for emergency information, clinical reference guide, practice management, professional development, pharmacy and healthcare organizations, drug reimbursement, manufacturer/wholesale information, product identification, prescription product listing, OTC and non-drug products, and complementary and herbal products
- Necessary for third party reimbursement
9
Q
Goodman and Gilman’s The Pharmacological Basis of Therapeutics
A
- Examines the principles of pharmacokinetics as they relate to medications
10
Q
FDA: Approved Drug Products with Therapeutic Equivalence Evaluations (Orange Book)
A
- Approved drugs for use in the US
11
Q
Drug Facts and Comparisons
A
- Provides information with regard to brand and generic names, orphan and investigationa drugs, drug monographs, drug identifcation, dosage calculations
- Updated monthly
12
Q
Handbook on Injectable Drugs
A
- References the compatibility of various parenteral drugs
13
Q
Handbook of Nonprescription Drugs
A
- OTC reference book
14
Q
Martindale: The complete Drug Reference
A
- International reference book on medications
15
Q
Merck Index
A
- Source of chemical substance data
16
Q
Pharmaceutical Dosage Forms and Drug Delivery Systems
A
- Discusses dosage forms and delivery systems
17
Q
Physicians’ Desk Reference
A
- Compilation of product inserts from pharmaceutical manufacturers
- Indices of manufacturers and product category
- Generic and trade names
- Product identification guide
- Product information
18
Q
Remington’s Pharmaceutical Sciences
A
- Detailed book on the practice of pharmacy
19
Q
U.S. Pharmacopeia an National Formulary
A
- Official compendium of drug mongraphs setting official standards for pharmaceuticals
20
Q
USP Dictionary of USAN and International Drug Names
A
- Reference for nonproprietary drug names and chemical structures
21
Q
USP Drug Information Vol. I
Drug Information for the Health Care Professional
A
- Describes medically accepted uses of medications which include labeled and unlabeled uses
22
Q
USP Drug Information Vol. II
Advice for the Patient
A
- Assists the pharmacist in advising and counseling patients about their medications
23
Q
USP Drug Information Vol. III
Approved Drug Products and Legal Requirements
A
- Discusses state and federal requirements of a medication which may include storage and dispensing information
24
Q
Bureau of Alcohol, Tobacco, and Firearms
(ATF)
A
- Sets regulations regarding the purchase of tax-free alcohol
- Tax-free alcohol may be used in hospitals and clinics
25
Centers for Medicare and Medicaid Services
(CMS)
* Oversees Medicare and Medicaid
* Establishes conditions for a facility to be reimbursed for services rendered
26
Drug Enforcement Agency
| (DEA)
* Enforces compliance with the Controlled Substances Act by placing meds inappropriate schedules, monitoring records and reports, registering pharmacies, issuing DEA forms 222 and 41, and monitoring the destruction of controlled substances
* Overseen by the Department of Justice
27
Environmental Protection Agency
| (EPA)
* Sets guidelines for the disposal of hazardous waste, including controlled substances
28
Food and Drug Administration
| (FDA)
* Ensures all pharmaceuticals are pure, safe, and effective
* Reviews information supplied on MedWatch forms
* Can issue drug recall for adulterated/misbranded products
* Performs post-call audits to ensure manufacturers, wholsalers, pharmacists, and customers have been notified and appropriate action has occurred
* Regulates the distribution of patient package inserts and repackaging of meds
* Reviews new drug applications and investigational new drug applications
29
Institutional Review Board
* A board, committee, or other group designed by an institution to approve biomedical research in accordance with the FDA
30
The Joint Commission
| (TJC)
* Formerly The Joint Commisson of Accreditation of Healthcare Organizations
* Addresses quality of patient care and safety
* Establishes standards and accredits hospitals, home healthcare agencies, home infusion providers, long-term care pharmacies, ambulatory infusion pharmacies, home medical equipment/oxygen providers, ambulatory surgical centers, community health clinics, college/prison healthcare centers, nursing homes, subacute facilities, assisted living facilities, clinical laboratories, behavioral health organizations, alcohol and chemical dependency centers, health care networks, and preferred provider organizations
* Accreditation is voluntary
* TJC has a "deemed status" for participation in Medicare which means the institution has met the Medicare conditions of participation and can receive Medicare funding, the institution does not need to meet requirements for annual Medicare surveys by state inspectors
31
National Association of the Boards of Pharmacy
(NABP)
* Composed of all state boards of pharmacy
* Has no regulatory authority, but meets to discuss current trends and issues in pharmacy that affect its practice
32
State Boards of Pharmacy
* Regulatory state agency that ovesees the practice of pharmacy in a given state
* Defines regulations affecting pharmcy and the roles, duties, and expectations of pharmacts and pharmacy techs in that state
* Has the ability to discipline pharmacies, pharmacists, and possibly techs for improper behavior
33
United States Pharmacopeia
| (USP)
* Official public standards setting authority for all prescription and OTC meds and other healthcare products manufactured or sold in the US
* Sets widely recognized standards for food ingedients and dietary supplements
* Sets standards for the quality, purity, strength, and consistency of these products
* The standards are recognized in the US and 130+ other countries
34
State Specific Prescription Transfer Regulations
* Federal law states that controlled substances can only be transferred one time between pharmacies
* Techs may assist in the transfer of prescription between pharmacies
* Techs may fax a copy of a prescription to another pharmacy under the supervision of a pharmacist
35
Therapeutic Equivalence
* According to the Orange Book, two drugs are therapeutially equivalent if they contain the same active ingredients and have the same strength/concentration, dosage form, and route of administration
* Must have the same clinical effect and safety profile
36
Therapeutic Interchange
* Substitution of one med for another that is not generically equivalent but would provide the same therapeutic effect
PTCE
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