T3: Midterm Objectives

Question 1

Explain the components of medication assessment (CO 4).

Answer 1

1. Appropriateness
2. Safety
3. Effectiveness
4. Adherence

Question 2

What is appropriateness?

Answer 2

1. Current/valid interactions
2. Duplicate therapy

Question 3

What is safety?

Answer 3

1. ADR
2. High dose
3. Allergic reaction

Question 4

What is effectiveness?

Answer 4

1. Does it work
2. Therupeutical desirabe?

Question 5

What is adherence?

Answer 5

1. Cost
2. Complexity
3. Other barriers

Question 6

Identify common causes of drug related problems (CO 7).

Answer 6

1. Unnecessary drug therapy
2. Needs additional therapy
3. Ineffective drug
4. Dose too high
5. Dose too low
6. ADR
7. Nonadherence

Question 7

Categories of DRP: appropriateness?

Answer 7

1. Unnecessary (duplicate) drug therapy
2. Needs additional drug therapy

Question 8

Categories of DRP: Safety?

Answer 8

3. Adverse drug reaction
4. Dosage too high

Question 9

Categories of DRP: Effectiveness?

Answer 9

5. Ineffective drug
6. Dosage too low

Question 10

Categories of DRP: Adherence?

Answer 10

Non adherence

Question 11

What is unnecessary drug therapy?

Answer 11

1. Duplicate therapy
   
   2. No indication
   3. Non-drug therapy is more appropriate

Question 12

What is needs additional therapy?

Answer 12

1. Untreated conditions
   
   2. Preventative treatment
   3. Synergistic therapy

Question 13

What is ineffective drug?

Answer 13

1. Contraindication
2. Not indicated for condition
3. More effective drugs available
4. Dosage form is not appropriate

Question 14

What is dosage too low?

Answer 14

1. Ineffective does
2. Inappropriate frequency, duration

Question 15

What is ADR?

Answer 15

1. Unsafe
2. Undesirable effect
3. Drug interactions
4. Allergic reactions
5. Inappropriate tapering

Question 16

What is dose too high?

Answer 16

1. Toxicity
2. Drug interaction
3. Needs additional monitoring
4. Inappropraite frequency, duration

Question 17

What is non adherence?

Answer 17

Cost, forgetfulness, admistration, complexity, availabity, lack of understanding

Question 18

Prioritize drug related problems (CO 7).

Answer 18

1. Urgency: which problem should be addressed first
2. Responsibility: Which prblem can be resolved by practioner and patient direcly
3. Synergy: Problems that require intervention by someone else

Question 19

Stating drug related problems

Answer 19

1. Description of patients medical conditions or clincal state
2. Drug therapy involved
3. Specific association between the drug therapy and patient’s codition

Question 20

Core elements of MTM

Answer 20

1. Medication therapy review
2. Personal med record
3. Medication related action plan
4. Intervention and referall
5. Documentation and follow up

Question 21

What is MTR?

Answer 21

1. Uses the PPCP
2. Comprehensive or targeted to an actual/potential DRP

Question 22

What is personal med record?

Answer 22

COmprehensize med list

Question 23

What is med related action plan?

Answer 23

1. Patient centered and collaborative
   
   2. Pharamcists scope of practice
   3. Include follow up

Question 24

What is intervention and referral?

Answer 24

1. Consulting
2. Addressing DRPs
3. Refer

Question 25

What is Documentation and follow up?

Answer 25

1. Evalves 2. Communication 3. Outcomes

Question 26

Describe the Plan, Implement, and Follow Up steps in the Pharmacist’s Patient Care Process (PPCP) (CO 4). - You should also be able to describe the Assess step.

Answer 26

1. Assess: prioritize and identify problems 2. Plan: patient-centered, individualized, collaborative Goals of therapy, DRPs, interventions neccesary, follow up to track outcome 3. Implement: put the plan into action, collaborate with patient and healthcare professionals 4. Follow up: How are thing, is it effective, what changes need to be made

Question 27

Develop an individualized patient-centered care plan using SMART goals (CO 4, 7).

Answer 27

Specifc: What is the goal Measurable: How will we know when the goal is reached Achievable: Is it in your power to accomplish it? Realistic: Can it be done? Timely: When do we want to accomplish it?

Question 28

Utilize appropriate PPCP documentation (CO 4).

Answer 28

1. Each med condition has a care plan 2. Each plan should be documented separately

Question 29

What should a DRP plan include?

Answer 29

1. Indiction 2. Summary of signs 3. Goals 4. Med instructions 5. Non pharm interventions 6. Follow up

Question 30

Implement a care plan using patient-centered communication (CO 4, 7).

Answer 30

1. Document all communication (coordination of care) 2. Schedule follow up 3. Address medications and HRP 4. Modify therapy 5. Educate and self-manage training

Question 31

Evaluate the effectiveness of a patient-centered care plan (CO 7).

Answer 31

1. Medication apprpriateness, effectiveness, and safety 2. Patient adherence: health data, biometric, patient feedback 3. Outcomes of care

Question 32

What is medication use process?

Answer 32

multistep process in which drug travels from the pharmacy to patient

Question 33

What are the steps of medication use process?

Answer 33

1. Prescribing 2. Transcribing/Documentation 3. Dispensing 4. Adminsitering 5. Monitoring

Question 34

What is prescribing?

Answer 34

1. Evaluate the patient 2. Establish need for meds 3. Select right med 4. Determine interactions and allergies 5. Precibe med

Question 35

What is Transcribing/Documentation?

Answer 35

1. Transcribe 2. Transmit to pharmacy

Question 36

What is dispensing?

Answer 36

1. Review order 2. Confirm transcription 3. Contact prescribe for discrepancied 4. Prepar medicine 5. Distribute medicine

Question 37

What is administering?

Answer 37

1. Review order 2. Review warnings 3. Evaulate patient 4. Confirm transcription

Question 38

What is monitoring?

Answer 38

1. Assess patinet 2. Report and document results

Question 39

What is the purpose of medication use process?

Answer 39

1. Provide safe and effective medication management 2. You are responsible for patient safety 3. Safeguard for you and patient

Question 40

What is the role of Pharm tech?

Answer 40

1. Support pharmacist with order fulfillment 2. Manage all tasks not requiring a pharmacist’s direct participation or judgment 3. Free time for the pharmacist to preform professional responsibilities 4. Certification and CE may be required

Question 41

What is the role of pharm clerk?

Answer 41

1. Coduct sales transactions 2. Resonds to quesitons about general merchandise 3. Dircet customers to the correct department 4. May assist with accepting new prescriptions, triaging customer inquireies, and helping to answer general questions

Question 42

Explain the steps in the dispensing process (CO 1).

Answer 42

1. Drop off 2. Order entry 3. DUR 4. Filling 5. Final verification 6. Patient counceling

Question 43

What is drop off?

Answer 43

1. Recive prescription 2. Obtain any necessary info 3. Provide an estimated ready time

Question 44

What is order entry?

Answer 44

1. Scan hard copy Rx and file original 2. Type Rx info into system

Question 45

What is DUR?

Answer 45

Review Rx accuracy, appropriateness, and DRPs

Question 46

What is filling?

Answer 46

1. Counting out all the needed tablets and label bottle 2. Pick up the appropriate medicationa and scan the bottle and label

Question 47

What is final verification?

Answer 47

Verify all aspects of the Rx are accurate

Question 48

What is patient counceling?

Answer 48

Make sure you are giving the right prescription to right patient, IHS open ended questions

Question 49

3Cs of drop off?

Answer 49

1. Character: practice ethically and legally, ensure all required parts of a prescription are present 2. Chemistry: Build rapport by excellent customer service, let the patient know what to expect 3. Competence: verify and update patient info, ensure that the medication is in stock

Question 50

3 Cs of order entry?

Answer 50

1. Chracter: Be through 2. Chemistry: Proactive in contacting prescriber, let patient know of delays 3. Competence: Check for appropriateness, double check work

Question 51

3 Cs of DUR?

Answer 51

1. Character: Be ceratin before moving fast 2. Chemistry: Respectfully communicate DRPs 3. Competence: Cosult drug resources, Consider all aspects of appropriateness

Question 52

3 Cs of filling?

Answer 52

1. Character: follow procedures, don’t cut corners to save time 2. Chemistry: Build rapport with techs and prais work 3. Competence: Always scan, dowuble check work, avoid overrides

Question 53

3 Cs of final verification?

Answer 53

1. Character: send back errors to be corrects 2. Chemistry: communicate errors with kindness, use as training opportunities 3. Competence: always open every bottle, eliminate distract

Question 54

3 Cs of patient counseling

Answer 54

1. Character: correct errors, educate patient with humility 2. Chemistry: communicate genuine care and concern for the patient 3. Comeptence: verify patient and med info, ask open ended questions

Question 55

UNits in a mL of insulin?

Answer 55

100, 300, 500

Question 56

mL in pen?

Answer 56

3mL

Question 57

pens in boxes

Answer 57

5

Question 58

How much in Humalog and Humulin vial?

Answer 58

3mL or 10 mL, 100u/mL

Question 59

How much 10mL other insulins?

Answer 59

100u/mL

Question 60

How much in Humulin R?

Answer 60

500u/mL

Question 61

Identify the goal of medication reconciliation (CO 7, 8).

Answer 61

Avoid medication erros such as omissions, duplications, dosing errors, or drug interactions

Question 62

Explain the 5 steps of medication reconciliation (CO 7).

Answer 62

1.PReparation: review patient records and develop interview questions 2. Verification: conduct med history 3. Reconcilliation: Compare med lists and make clinical decisions 4. Documentation: Document changes and update med recs 5. Communication: Communicate changes/discrepancies and new med list to patient and appropriate caregivers

Question 63

What is preparation in med rec?

Answer 63

1. Review chart thoroughly 2. Are allergies listed (Always ask if they have allergies) 3. Decide what questions you want to ask

Question 64

What is verification in med rec?

Answer 64

1. Verify ID 2. HIPAA compliance 3. Open ended questions 4. OTCs? 5. Adherence? 6. Confirm patient’s current pharamacy

Question 65

What is reconciliation in med rec?

Answer 65

1. Compare med lists and check for: 1. Omissions 2. Commissions 3. Dosing errors 4. Discontinued meds 5. DDI 6. Drug disease interactions 7. Duplications 2. Use clinical judgement to assess: 1. Appropriateness 2. Safety 3. Effectiveness 4. Adherence

Question 66

What is documentation in med rec?

Answer 66

1. Update med list in chart 2. Document any recent or recommend changes in the chart

Question 67

What is communication in med rec?

Answer 67

1. Communicate discrepancies 2. Communicate any med changes 3. Provide the patient and team with updated list

Question 68

Describe when medication reconciliation is most beneficial (CO 7).

Answer 68

1. Admission: 24-48 hours of admission 2. Internal tranfer points: tranfers within facility, most difficult places to implement 3. Discharge: communicate med changes 1. Transitions of care: any change in setting, service, practitioner, or level of care

Question 69

Discuss the 3 C’s of a successful medication reconciliation (CO 7).

Answer 69

Character: thoroughness vs incompleteness Chemistry: good communication Competence: good med history, asking good questions