Policies and procedures that guide the pharmacy department in providing safe, effective, and cost-effective drug therapy
The Joint Commission
The personnel in a hospital pharmacy are classified into three categories. In order, from highest to lowest, they are:
professional, technical, and support
The medication order must contain the following information:
dosage schedule and strength, patient's name, height, weight, date of birth, medical record number, medical condition, and known allergies, route of administration and direction of use, and instructions for preparing the drugs
A disadvantage of the floor stock system is:
potential for medication errors
Many unit-dose systems use which system during the cart exchange process?
24-hour medication cart
The roles and duties of the technician in the hospital setting are:
maintenance of medication records and compounding medications, preparing unit doses and packaging, computer data input and maintaining privacy, and working safety and communication skills.
Pharmacy technician re-certification requires:
20 continuing education credits with 1 being in pharmacy law every 2 years
Who monitors the use of scheduled drugs and those who prescribe them:
DEA
For scheduled drugs, federal law requires that records be kept on file for how many years, depending on a state's law?
2-5 years
use of incorrect abbreviations
one way in which a physician can cause a medication error
lack of appropriate labeling
one way in which a manufacturer or pharmacist can cause a medication error
monitor for any undesirable effects
what nurses and other health care professinals must do after administering medications
medication administration record
what should health care professionals should double-check medications against
process of cleaning to remove undesirable debris
sanitization
A vertical laminar airflow hood is used for
chemotherapeutic agents
The work surface of the laminar airflow hood should be cleaned with
70% isopropyl alcohol
Medication errors should be reported to which agency by using the program MedWatch?
FDA
Which of the following factors may cause the patient harm during administration of medication using pumps?
when equipment and technique are not sterile
The HEPA filter should be serviced and certified
every 6 months
Which of the following is used to measure the intensity of a patient's pain level?
pain scale
Risk factors for medication errors regarding human factors include all of the following, EXCEPT
reviewing medical records
Which of the following is NOT essential to avoid medication errors?
verifying the patient's Social Security number
Medication errors in the health care setting may occur in which of the following processes?
ordering medications, dispensing medications, and transcribing medications
According to the USP, low-risk compounding products can be kept in a refrigerator for
14 days
The work area is bathed by positive, pressurized flowing air called
laminar
Which of the following medications is NOT on the list of "highest alert" concerning medication errors?
penicillin injection
The process of killing all microorganisms and their pathogenic products is known as
sterilization
Which of the following is an example of leading zeros?
0.6
The most common sterile irrigations include
gentamicin irrigation solution
How long must the blower run in a laminar airflow hood prior to use?
30 minutes
Which of the following is a good risk reduction strategy for preventing medication errors?
documenting essential patient information
A device that uses a combination of heat, steam, and pressure to sterilize equipment is known as a(n)
autoclave
Which of the following does not influence prescribing errors?
expiration of license
Most experts agree that medication errors are due to a
poor system
HEPA filters need to be certified every
6 months
Which statement is false about parenteral products?
They must be chemically and physically unstable
Which of the following factors has been documented as the second most prevalent cause of medication errors?
illegible handwriting
The most effective method of destruction of all types of microorganisms is
autoclave
Which of the following organizations works to analyze dangerous medication errors?
FDA and ISMP
Medication errors may occur
in pharmacies, in hospitals, and during manufacturing
To avoid medication errors, patients should be encouraged to
ask questions about their medications
Small spills of body fluids on the counter surfaces of a pharmacy must be cleaned with
household bleach
Which of the following is false about disadvantages of parenteral administration?
more readily controls the therapeutic response of a drug
Wrong doses can easily be avoided by using
unit-dose systems
The process for compounding ophthalmics properly takes
from 1 to 2 weeks
Which of the following is true about a HEPA filter?
It removes 99% of possible contaminants
Which of the following is the most common cause of death in the United States?
medical errors
The process of entering a physician's order into a computer is called
transcription
The time from when a sterile drug product is compounded until it is administered to a patient is referred to as
beyond-use date
There is only one second-generation cyclic antidepressant. What is the trade name?
Wellbutrin
The trade name for fluvoxamine is
Luvox
Name of drug that can be given for Bipolar Disorder?
Depakene
True or False: Elavil can be give IM
True
Patients with renal or hepatic insufficiency should be started with low doses of which anti-depressant?
Paxil or Paroxetine
Sucrets Cough's Generic Name is
Dextromethorphan
What are the two types of Anti-Tussives?
opioids and nonopioids
Can Codeine be given SC?
Yes
Only one of these Anti-Tussives can be given BID only. What is the trade name of this drug?
Tussionex
A drug distribution system that provides medication in its final unit of use form
unit-dose system
A group of medications provided to a hospice patient by the hospice pharmacy to provide a "start" in treatment for most urgent problems that can develop during the last days or weeks of life
starter kit
An intravenous feeding that supplies all the nutrients necessary for life
total parenteral nutrition
A safe and economical way of distributing a drug
drug distribution system
A high-volume pharmacy that fills prescriptions for a number of individual pharmacies
central fill pharmacy
A drug distribution system that combines a unit-of-use medication package with a non-unit-dose drug distribution system
blended dose system
A drug dispensing system that is computer or robot based
automatic dispensing system
An established commercial website that enables a patient to obtain medications by way of the Internet
Internet pharmacy
Originally a facility, usually within a hospital, intended to care for the terminally ill, in particular, by providing physical comfort to the patient and emotional support and counseling to the patient and the family; currently hospice care is also provided in home settings
hospice
A licensed pharmacy that uses the mail or other carriers to deliver prescriptions to patients
mail-order pharmacy
An organization involving a licensed professional pharmacy or practice that provides medications and clinical services to long-term care facilities and other residents
long-term care pharmacy org
A range of health and health-related support services provided over an extended period of time
long-term care
The practice of pharmacy that provides medications, home health care products and services, and pharmaceutical care to patients at home
home health care pharmacy
Feedings given through a tube passed directly into the stomach or intestines
enteral nutrition
A mail-order pharmacy that concentrates on specific areas of the prescription drug market
specialty mail-order pharmacy
Vials containing particular compounds, usually in freeze-dried form used in nuclear pharmacy
reagent kit
A drug that is or has been made to be radioactive
radiopharmaceutical
A combination of amino acids, dextrose, fats, vitamins, minerals, electrolytes, and water administered intravenously
parenteral nutrition
A pharmacy that is specially licensed to work with radioactive materials
nuclear pharmacy
A medication package in which all medications for a specific medication time are packaged together
multiple medication package
A drug distribution system that combines unit-dose medications blister packaged onto a multiple dose card
modified unit dose system
These cassettes contain either one-week or two-week medication strips that also contain reserve closes in a narrow plastic slidetray design.
modular cassette
One of the fastest-growing parts of the health care market is
home health care pharmacy
The major sources of payment for home health services are:
Medicare and Medicaid
TPNs consist of:
amino acid and dextrose, fats and electrolytes, and vitamins and trace elements
Hospice pharmacy services can be divided into two areas:
clinical services and dispensing services
Ambulatory care services provide:
mobile imaging, rehabilitation, and dialysis centers
Mucous membranes of the eyes
conjunctiva
A method of cleaning equipment used for instruments that cannot be exposed to the high temperatures of steam sterilization
chemical sterilization
Date after which a product is no longer effective and should not be used
beyond use date
A sterilizing machine. It uses a combination of heat, steam, and pressure to sterilize equipment
autoclave
Preparing and handling sterile products in a manner that prevents microbial contamination
aseptic technique
A method of sterilization that uses heated dry air at a temperature of 320 degrees to 365 degrees for 90 minutes to 3 hours
dry heat sterilization
The use of a gas such as ethylene oxide to sterilize medical equipment
gas sterilization
A system of circulating filtered air in parallel-flowing planes in hospitals or other health care facilities. The system reduces the risk of airborne contamination and exposure to chemical pollutants in surgical theaters, food preparation areas, hospital pharmacies, and laboratories.
laminar airflow hood
Nutrition system involving the intravenous infusion directly into a vein of lipids, proteins, electrolytes, sugars, salts, vitamins, and essential elements.
total parenteral nutrition
The complete destruction of organisms before they enter the body
surgical asepsis
Complete destruction of all forms of microbial life.
sterilization
A process of cleaning to remove undesirable debris
sanitization
Complete destruction of organisms after they leave the body
medical asepsis
Bypassing the skin and gastrointestinal tract; injected
parenteral
Parenteral products must have the following unique qualities:
must be sterile, be free from contamination by endotoxins, and free from visible particles
A disadvantage of parenteral administration is that:
asepsis is required at administration
Important properties of parenteral preparations that must be considered include:
compatability and osmolality
Methods of sterilization include:
application of steam under pressure, dry heat and gas, and chemicals and radiation.
Used to remove particulates and microorganisms from solutions:
filters
Laminar airflow hoods are used to prepare sterile compounds by circulating air through HEPA filters to remove how much possible contaminants?
99%
Sneezing produces how many aerosol droplets?
200,000
Inventory control systems that allow monthly drug use reviews
perpetual inventory system
A list of drugs and devices that routinely need to be reordered
want book
The stock of medications a pharmacy keeps immediately on hand
inventory
A document showing received items; it should match the purchase order exactly
receiving report
An inventory control system that allows inventory to be tracked as it is used
point-of-sale master
A mathematical calculation of the number of times the average inventory is replaced over a period of time (usually annually)
inventory turnover rate
Controlling the amount of product on hand to maximize the return on investment
inventory control
Several important factors and issues with regard to inventory are:
How much inventory should be maintained, when should inventory levels be adjusted, and where should inventory be stored
A common inventory management error is
miscounting the final inventory and creating labels that are not easily read
One of the simplest and most widely used methods of inventory control is
the want book
Board regulation requires that a pharmacist should keep what type of inventory for each controlled substance in Schedule II, which has been received, dispensed or disposed of?
perpetual inventory
An advantage of computerized inventory control systems is
time saving for the pharmacy and the business office.