Community Pharmacy OSCES Passive Quiz

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Questions and Answers

What is one of the primary clinical responsibilities of a community pharmacist?

  • Scheduling pharmacy personnel
  • Providing immunizations (correct)
  • Balancing profit and loss sheets
  • Compounding sterile drug products

Which of the following is NOT typically a responsibility of community pharmacists?

  • Monitoring patients' health
  • Performing major surgeries (correct)
  • Evaluating patients for self-care
  • Dispensing medication

During which step of the prescription process is patient information verified?

  • Prescription Entry
  • Patient Consultation
  • Final Dispensing
  • Drop-off Window (correct)

What business-related responsibility involves interacting with insurance companies?

<p>Prescription adjudication (B)</p> Signup and view all the answers

Which of the following is an essential aspect of medication therapy management services?

<p>Monitoring medication use to reduce adverse side effects (A)</p> Signup and view all the answers

What is the role of community pharmacists in health and wellness promotion?

<p>Providing education and immunizations (B)</p> Signup and view all the answers

Which task is typically performed by community pharmacists to ensure operational efficiency?

<p>Engaging in Continuous Quality Improvement Programs (A)</p> Signup and view all the answers

What is one of the ways community pharmacists serve as drug information resources?

<p>Educating the public on medication (D)</p> Signup and view all the answers

What is the primary role of the pharmacist during the verification process?

<p>Recalculating dosages and checking the NDC number (B)</p> Signup and view all the answers

Which of the following is NOT typically included when receiving a new prescription?

<p>Pharmacy sales report (D)</p> Signup and view all the answers

What does the SIG code in a prescription help pharmacists interpret?

<p>Directions for medication use (B)</p> Signup and view all the answers

Which of the following personnel is NOT typically found in a community pharmacy?

<p>Marketing Specialist (D)</p> Signup and view all the answers

What additional information is required for controlled substance prescriptions?

<p>Prescriber’s DEA number (D)</p> Signup and view all the answers

How do pharmacies typically verify a patient's identity at the pickup window?

<p>By checking their insurance card (A)</p> Signup and view all the answers

What role do health educators play in community pharmacies?

<p>Provide patients with medication and health information (B)</p> Signup and view all the answers

What step is crucial when inputting a prescription to ensure patient safety?

<p>Verifying the prescription for accuracy and completeness (C)</p> Signup and view all the answers

What type of information is considered subjective during a patient interview?

<p>Side effects experienced from a medication (C)</p> Signup and view all the answers

Which of the following is NOT a method of submission for prescriptions at community pharmacies?

<p>In-person appointments only (D)</p> Signup and view all the answers

What is the primary purpose of the consultation window in a pharmacy?

<p>To provide private counseling to patients (B)</p> Signup and view all the answers

What is one main benefit of utilizing technology such as barcoding in the filling process?

<p>To enhance accuracy in medication dispensing (C)</p> Signup and view all the answers

In what order should the three steps of a patient interview be conducted?

<p>Setting the stage, Collecting information, Closing the interview (D)</p> Signup and view all the answers

What should be collected as part of a patient's medication history?

<p>Indication for use, dose, and duration of use (A)</p> Signup and view all the answers

Which of the following is NOT included in the sections of an interview collection form?

<p>Psychological Assessment (D)</p> Signup and view all the answers

How should empathy be demonstrated during patient interactions?

<p>By utilizing reflective language (C)</p> Signup and view all the answers

What is a common consequence of low health literacy?

<p>Inappropriate use of emergency services (D)</p> Signup and view all the answers

What method should be employed to verify the accuracy of collected patient information?

<p>Utilizing a flipped teach-back approach (D)</p> Signup and view all the answers

Which level on the National Assessment of Adult Literacy (NAAL) indicates an ability to summarize text and perform calculations?

<p>Level 3 (D)</p> Signup and view all the answers

What should be the main focus when asking open-ended questions to patients?

<p>To gather detailed insights (C)</p> Signup and view all the answers

What does the cultural domain of health literacy acknowledge?

<p>The impact of individual beliefs and customs (C)</p> Signup and view all the answers

Which of the following is NOT a risk factor for inadequate health literacy?

<p>High socioeconomic status (C)</p> Signup and view all the answers

What is the primary purpose of collecting a patient's social history?

<p>To gain insight into lifestyle factors that affect health (A)</p> Signup and view all the answers

What type of questions should be used strategically to collect specific data from patients?

<p>Closed-ended questions (B)</p> Signup and view all the answers

What is the primary goal of the teach-back method?

<p>To assess and confirm patient understanding of information (D)</p> Signup and view all the answers

Which of the following options best represents the chief complaint?

<p>The primary reason a patient seeks care (C)</p> Signup and view all the answers

Which of the following is NOT a component of the Health Belief Model?

<p>Perceived importance (D)</p> Signup and view all the answers

Which medication history component is NOT typically assessed?

<p>Socioeconomic status (C)</p> Signup and view all the answers

Culturally appropriate health education materials should aim for which reading level?

<p>5th-grade reading level (D)</p> Signup and view all the answers

Which of the following best describes health disparities?

<p>Preventable differences in health outcomes among groups (B)</p> Signup and view all the answers

What role do pharmacists play in addressing health disparities?

<p>Educating patients on medication use and disease management (C)</p> Signup and view all the answers

Which strategy is effective for ensuring patient understanding?

<p>Employing teach-back and repetition (B)</p> Signup and view all the answers

Social determinants of health include which of the following factors?

<p>Economic stability and education access (B)</p> Signup and view all the answers

Health equity implies that individuals should have what kind of opportunity?

<p>Fair and just opportunities to achieve their full health potential (D)</p> Signup and view all the answers

Which population is likely to experience higher prevalence of uncontrolled hypertension?

<p>Non-Hispanic Black populations (A)</p> Signup and view all the answers

What is essential for fostering trust in patient-provider communication?

<p>Respecting patient belief systems (A)</p> Signup and view all the answers

What factors can influence healthcare access and quality?

<p>Healthcare service availability and affordability (C)</p> Signup and view all the answers

Which of the following is a strategy for effective cross-cultural communication?

<p>Employing licensed interpreters when necessary (D)</p> Signup and view all the answers

How should written educational materials be designed for a diverse audience?

<p>Incorporating culturally appropriate images (B)</p> Signup and view all the answers

What is the primary function of auto-adjudication in claims processing?

<p>To electronically review claims for errors and eligibility (C)</p> Signup and view all the answers

Which element on the prescription insurance card helps route a claim to the correct insurance?

<p>Rx BIN (B)</p> Signup and view all the answers

Which of the following is NOT a possible outcome of claims adjudication?

<p>Under Review (C)</p> Signup and view all the answers

What type of items does Medicare Part B cover?

<p>Items not covered under other parts of Medicare (B)</p> Signup and view all the answers

Which of the following NCPDP reject codes indicates that a medication is not covered due to a plan exclusion?

<p>70 (D)</p> Signup and view all the answers

What does a 'Prior Authorization Required' rejection indicate?

<p>Approval from the health plan is needed before coverage (D)</p> Signup and view all the answers

What does reject code 79 signify?

<p>Patient is trying to refill too soon (C)</p> Signup and view all the answers

How can pharmacist override a DUR rejection?

<p>Based on a thorough review of the patient's profile (A)</p> Signup and view all the answers

Which of the following is a reason for issuing a clinical alert in pharmacy management systems?

<p>Medication has a potential drug-drug interaction (A)</p> Signup and view all the answers

What does a 'Plan Limitations Exceeded' rejection code indicate?

<p>Daily medication supply exceeds prescribed limit (B)</p> Signup and view all the answers

What should patients ensure to present when filling a prescription?

<p>Prescription insurance card (C)</p> Signup and view all the answers

Which of the following could signal a possible duplicate therapy alert?

<p>Two different medications from the same therapeutic class (B)</p> Signup and view all the answers

Which of the following steps comes first in the prescription pathway process?

<p>Drop off (D)</p> Signup and view all the answers

What is indicated by reject code 88?

<p>Potential drug interactions need review (B)</p> Signup and view all the answers

What is the normal pulse rate range for adults?

<p>60-100 beats per minute (A)</p> Signup and view all the answers

Which term describes abnormally slow breathing?

<p>Bradypnea (B)</p> Signup and view all the answers

What is the primary method for calculating Body Mass Index (BMI)?

<p>Weight (kg) / Height (m)^2 (C)</p> Signup and view all the answers

Which of the following sites is considered the least reliable for measuring temperature?

<p>Axillary (B)</p> Signup and view all the answers

What classification of hypertension includes systolic blood pressure of 130-139 or diastolic of 80-89?

<p>Stage 1 Hypertension (D)</p> Signup and view all the answers

Which complication is NOT associated with uncontrolled hypertension?

<p>Diabetes (C)</p> Signup and view all the answers

Which medication classes are considered first-line treatments for hypertension according to AHA/ACC 2017 guidelines?

<p>ACE inhibitors, ARBs, Thiazide diuretics, CCBs (D)</p> Signup and view all the answers

What is the maximum recommended blood pressure target for most patients with diabetes according to ADA guidelines?

<p>&lt; 130/80 (B)</p> Signup and view all the answers

How should pulse and respiratory rates be ideally obtained?

<p>Simultaneously while observing the patient (D)</p> Signup and view all the answers

What is a common strategy pharmacists can use to improve medication adherence?

<p>Provide clear instructions and reminders (D)</p> Signup and view all the answers

Which of the following is an effect of uncontrolled hypertension?

<p>Heart attack (A)</p> Signup and view all the answers

What is tachycardia defined as?

<p>A pulse rate above 100 beats per minute (B)</p> Signup and view all the answers

Which statement about temperature measurement is accurate?

<p>Oral measurements are unreliable after consuming hot or cold substances. (A)</p> Signup and view all the answers

What is dyslipidemia characterized by?

<p>Abnormal lipid levels in the blood (A)</p> Signup and view all the answers

How is total cholesterol classified as high?

<p>Above 200 (A)</p> Signup and view all the answers

What is the desirable level for LDL cholesterol according to lipid level classification?

<p>&lt; 100 (B)</p> Signup and view all the answers

Which population would benefit the most from statin therapy?

<p>Individuals with diabetes and LDL between 70 and 189 (C)</p> Signup and view all the answers

What is the maximum triglyceride level for the Friedewald equation to be accurate?

<p>&lt; 400 (C)</p> Signup and view all the answers

What is the primary aim of secondary prevention in cardiovascular health?

<p>To prevent future events in individuals with a history of CVD (B)</p> Signup and view all the answers

How is ASCVD risk categorized when assessing a patient's 10-year risk?

<p>Intermediate risk: 7.5% - 19.9% (C)</p> Signup and view all the answers

What is the desired HDL cholesterol level for men?

<blockquote> <p>40 (D)</p> </blockquote> Signup and view all the answers

What does a BNP level greater than 400 indicate?

<p>Likely heart failure (B)</p> Signup and view all the answers

Which biomarker is released by cardiac cells in response to increased heart volume or pressure?

<p>BNP (C)</p> Signup and view all the answers

What role does pitting edema play in heart failure diagnosis?

<p>Reflects fluid buildup due to heart failure (D)</p> Signup and view all the answers

Which class of the NYHA classification denotes no symptoms even with physical exertion?

<p>Class I (B)</p> Signup and view all the answers

What is the main focus of the ACC/AHA classification system for heart failure?

<p>Stage of heart failure progression (C)</p> Signup and view all the answers

What is the purpose of measuring Forced Expiratory Volume in One Second (FEV1) during spirometry?

<p>To evaluate how quickly lungs empty. (A)</p> Signup and view all the answers

Which of the following findings during auscultation is associated with fluid in the lungs?

<p>Fine Crackles (A)</p> Signup and view all the answers

What does a dull sound during percussion of the chest likely indicate?

<p>Fluid or solid tissue (C)</p> Signup and view all the answers

Which respiratory condition is most commonly associated with wheezing during expiration?

<p>Asthma (A)</p> Signup and view all the answers

What does the Tiffeneau-Pinelli Index (FEV1/FVC) help determine?

<p>Specific types of lung diseases (B)</p> Signup and view all the answers

What condition is characterized by the use of accessory muscles for breathing?

<p>Acute respiratory distress (C)</p> Signup and view all the answers

What is a common purpose of a peak flow meter?

<p>To monitor changes in lung function (C)</p> Signup and view all the answers

What might the presence of jugular venous distension (JVD) suggest?

<p>Congestive heart failure (A)</p> Signup and view all the answers

Which of the following represents an indication of normal oxygen saturation levels?

<p>95-100% (A)</p> Signup and view all the answers

What technique is important for ensuring proper inhaler use among patients?

<p>Providing inhaler technique education (B)</p> Signup and view all the answers

Which type of breath sound is often described as snoring or gurgling?

<p>Rhonchi (C)</p> Signup and view all the answers

What is the primary benefit of peak flow monitoring in asthma management?

<p>Detects airway narrowing before symptoms become noticeable (C)</p> Signup and view all the answers

What is the significance of a normal auscultation finding recorded as CTAB?

<p>Lungs clear to auscultation bilaterally (A)</p> Signup and view all the answers

What does Beers criteria specifically focus on?

<p>Potentially inappropriate medications for older adults (A)</p> Signup and view all the answers

Which vital sign is associated with systolic and diastolic pressure?

<p>Blood pressure (C)</p> Signup and view all the answers

What information should be assessed before measuring a patient's blood pressure?

<p>Recent exercise and medication use (A)</p> Signup and view all the answers

When taking blood pressure, which position should the patient's arm be in?

<p>At heart level with support (D)</p> Signup and view all the answers

What does a prescription alert coded 'Clinical Alert Allergy (Codeine)' indicate?

<p>The patient has a documented allergy to codeine (C)</p> Signup and view all the answers

What steps should be taken if abnormal vital signs are noted?

<p>Recheck and investigate further (C)</p> Signup and view all the answers

What is a significant aspect of patient communication regarding clinical alerts?

<p>Use clear and understandable language (B)</p> Signup and view all the answers

What is the recommended bladder length for a blood pressure cuff?

<p>Encircles approximately 80% of the arm circumference (C)</p> Signup and view all the answers

What type of blood pressure cuff rises as pressure increases?

<p>Mercury cuff (C)</p> Signup and view all the answers

Which of the following is an important factor before measuring blood pressure?

<p>Duration of recent exercise (B)</p> Signup and view all the answers

What equipment should be checked for accuracy before measuring blood pressure?

<p>Manual blood pressure cuff (B)</p> Signup and view all the answers

What is the correct response when systolic pressure is first heard during blood pressure measurement?

<p>Systolic pressure reading is recorded (B)</p> Signup and view all the answers

What is the main purpose of manual blood pressure assessment?

<p>To provide a precise measurement (C)</p> Signup and view all the answers

In blood pressure measurement, what is 'white coat syndrome'?

<p>High readings due to anxiety in medical settings (D)</p> Signup and view all the answers

What is a notable advantage of using a Diskus inhaler?

<p>No coordination needed between actuation and inhalation (A)</p> Signup and view all the answers

What is a common characteristic of Soft Mist Inhalers (SMIs)?

<p>They provide a high fine particle fraction for better lung deposition (D)</p> Signup and view all the answers

Which inhaler requires coordination between actuation and inhalation?

<p>Respimat (B)</p> Signup and view all the answers

Which of the following steps is included in using the HandiHaler?

<p>Press the green button to pierce the capsule (B)</p> Signup and view all the answers

What is a potential disadvantage of the RespiClick inhaler?

<p>It requires a forceful inhalation to activate medication delivery (B)</p> Signup and view all the answers

What is a unique feature of the Ellipta inhaler?

<p>Has a built-in dose counter (B)</p> Signup and view all the answers

Which inhaler does not require washing or rinsing after use?

<p>Diskus (B)</p> Signup and view all the answers

What is a primary advantage of nebulizers?

<p>They are effective for delivering medication to lower airways (A)</p> Signup and view all the answers

What is one important step in the use of the Twisthaler inhaler?

<p>Twist the cap off to load a dose (C)</p> Signup and view all the answers

What occurs immediately after inserting the cartridge into a Respimat inhaler?

<p>The base is twisted and capped to prepare for inhalation (B)</p> Signup and view all the answers

What must a patient do after using their Diskus inhaler?

<p>Rinse their mouth with water (C)</p> Signup and view all the answers

Which inhaler utilizes capsules containing medication?

<p>HandiHaler (B)</p> Signup and view all the answers

What can happen if humidity affects the use of powdered inhalers?

<p>They may experience clumping which affects delivery (C)</p> Signup and view all the answers

What happens after inhalation of medication from the Respimat inhaler?

<p>A breath-holding is required for medication absorption (A)</p> Signup and view all the answers

What is a common risk factor associated with atrial fibrillation (AFib)?

<p>Previous heart attack (D)</p> Signup and view all the answers

Which diagnostic test is specifically used to monitor intermittent AFib over an extended period?

<p>Holter monitor (A)</p> Signup and view all the answers

What does a higher CHADS2-VASc score indicate for patients with AFib?

<p>Increased need for anticoagulation (C)</p> Signup and view all the answers

What is the typical INR goal for patients with AFib receiving warfarin therapy?

<p>2 - 3 (A)</p> Signup and view all the answers

Which factor does NOT commonly influence INR levels in patients taking warfarin?

<p>Dietary fiber (D)</p> Signup and view all the answers

What characterizes asthma compared to other respiratory conditions?

<p>Airway constriction caused by triggers (B)</p> Signup and view all the answers

What percentage of patients with asthma usually report nocturnal symptoms?

<p>20-30% (B)</p> Signup and view all the answers

Which age group is most commonly affected by asthma?

<p>Children (D)</p> Signup and view all the answers

What is a major contributing factor to the development of COPD?

<p>Smoking (B)</p> Signup and view all the answers

How is the severity of an asthma attack typically characterized?

<p>Requirement of immediate treatment (D)</p> Signup and view all the answers

Which of the following does NOT represent a symptom of COPD?

<p>Elevated energy levels (B)</p> Signup and view all the answers

What role do pharmacists play in managing patients on anticoagulation therapy?

<p>Educate patients about warfarin (C)</p> Signup and view all the answers

What is the primary purpose of a respiratory examination?

<p>To evaluate respiratory health (C)</p> Signup and view all the answers

What is a significant complication of atrial fibrillation?

<p>Increased stroke risk (B)</p> Signup and view all the answers

What is a common consequence of improper inhaler technique in patients?

<p>Increased risk of missed work or school (B)</p> Signup and view all the answers

What is an example of a medication-related factor that contributes to poor medication adherence?

<p>Forgetfulness in taking medication (A)</p> Signup and view all the answers

Which drug is NOT typically used as a pharmacotherapy option for smoking cessation?

<p>Albuterol (B)</p> Signup and view all the answers

What organization recommends annual influenza vaccinations for adults with COPD or asthma?

<p>Centers for Disease Control and Prevention (A)</p> Signup and view all the answers

Which of the following inhalers requires coordination of actuation and inhalation?

<p>Metered dose inhalers (MDIs) (A)</p> Signup and view all the answers

What is the primary purpose of using spacers with metered dose inhalers?

<p>To facilitate easier inhalation (C)</p> Signup and view all the answers

How is the days' supply calculated for an inhaler with 200 puffs if the prescription is for two puffs twice daily as needed?

<p>50-day supply (A)</p> Signup and view all the answers

Which of the following is a recommended step in cleaning a metered dose inhaler (MDI)?

<p>Rinse with warm water for 30 seconds (B)</p> Signup and view all the answers

Which term best describes medications that can exacerbate respiratory distress, like opioids?

<p>Disease-drug interactions (A)</p> Signup and view all the answers

During which step of using a metered dose inhaler should the patient hold their breath?

<p>After inhalation (B)</p> Signup and view all the answers

What is a key advantage of metered dose inhalers (MDIs)?

<p>They can be used with or without a spacer. (D)</p> Signup and view all the answers

Which of the following is a recommended vaccination for adults aged 65 years and older?

<p>Influenza (D)</p> Signup and view all the answers

What is the role of pharmacists in the management of smoking cessation?

<p>To employ techniques to encourage quitting (C)</p> Signup and view all the answers

Flashcards

Community Pharmacist Role

A community pharmacist acts as a vital healthcare professional, processing prescriptions, providing patients with medication knowledge, and promoting health.

Clinical Responsibilities (pharmacist)

The clinical duties of a pharmacist include medication therapy management, drug compounding, symptom relief advice, and patient health monitoring.

Business Responsibilities (pharmacist)

Pharmacists manage pharmacy operations, finances, inventory, insurance claims, and administrative tasks.

Prescription Drop-off

The initial step where patients present their prescriptions for filling, and the pharmacist verifies information and availability.

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Prescription Entry

The process of recording prescription details into the pharmacy system, updating patient profiles.

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Medication Therapy Management

A pharmacist actively manages a patient's medication regimen to ensure safety and effectiveness.

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Drug Compounding

The process of preparing medications in non-sterile forms and doses.

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Prescription Adjudication

The process of reviewing and approving insurance claims for prescription costs.

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Filling Station

The pharmacy area where prescriptions are filled, including counting medication and preparing for release.

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NDC number

National Drug Code; a unique identification number for medications.

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Verification

The pharmacist's process of reviewing the prescription against the original for accuracy and checking medications.

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Pickup Window

Pharmacy area where patients pick up their prescriptions and cashier processes the transaction.

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Consultation Window

Private area for pharmacist-patient counseling about new prescriptions and over-the-counter products.

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Subjective Information

Information provided by the patient, based on their experience or perception.

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Objective Information

Information that is verifiable and not based on the patient's feelings or subjective opinions.

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Patient Interview

A process of gathering information about a patient's medical history, current condition, and medications.

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Prescription Information

Details about the medication, dosage, quantity, refills, and directions.

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Controlled Substances

Drugs that have potential for abuse or addiction.

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E-prescriptions

Electronic prescriptions sent directly to the pharmacy.

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Review Prescription

Checking the prescription's accuracy and verifying all details are correct.

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SIG Codes

Codes that indicate directions on how to take a medicine, like the frequency and dose.

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Prescription Review

The process of carefully examining a new prescription.

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Chief Complaint (CC)

The main reason the patient is seeking care, usually expressed in their own words.

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History of Present Illness (HPI)

A detailed story about the patient's current complaint, providing context and background.

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Past Medical History (PMH)

A list of previously diagnosed medical conditions the patient has experienced.

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Social History

Information about the patient's lifestyle, including habits, work, and social factors.

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Family History (FH)

Information about medical conditions in the patient's immediate family members.

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Medication History

A complete list of all medications the patient is taking or has taken, including prescriptions, over-the-counter drugs, and supplements.

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Medication Indication

The reason why a specific medication is prescribed, or what it treats.

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Medication Dose & Timing

The amount of medication taken at each administration and when it is taken.

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Teach-Back

A technique where the patient summarizes information back to the pharmacist to ensure understanding.

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Open-Ended Question Example

A question that cannot be answered with a simple 'yes' or 'no,' encouraging a detailed response.

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Closed-Ended Question Example

A question that can be answered with a simple 'yes' or 'no,' used to gather specific information.

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Health Literacy

The ability to understand and use health information to make informed decisions about your health.

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Consequences of Low Health Literacy

Negative effects of not understanding health information, including misuse of healthcare, longer hospital stays, and poor health outcomes.

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NAAL Levels

Measures of adult literacy in the U.S., ranging from 'Below Basic' to 'Proficient,' reflecting different levels of reading, writing, and math skills.

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Four Domains of Health Literacy

Basic, Scientific, Cultural, and Civic - encompassing different aspects of understanding health information and services.

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Teach-back Method

A communication technique where the patient explains information back in their own words, ensuring understanding and addressing misunderstandings.

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Health Belief Model

A framework that explains how individual beliefs influence their health behaviors, including perceived susceptibility, severity, benefits of action, and barriers.

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Health Disparities

Preventable differences in health outcomes experienced by socially disadvantaged groups, often resulting from inequities in social determinants of health.

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Social Determinants of Health

Factors that influence health outcomes, often stemming from social, economic, and environmental conditions.

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Economic Stability

A social determinant encompassing poverty, employment, food security, and housing stability.

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Education Access and Quality

A social determinant focusing on early childhood education, high school graduation rates, and higher education opportunities.

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Healthcare Access and Quality

A social determinant encompassing the availability of affordable and culturally sensitive healthcare services.

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Neighborhood and Built Environment

A social determinant that includes access to safe housing, transportation, healthy food options, and clean air and water.

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Social and Community Context

A social determinant that encompasses social support networks, civic participation, discrimination, and community safety.

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Cultural Competency

The ability to provide care that respects cultural differences and values.

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Knowledge (Cultural Competency)

Understanding the perspectives, values, traditions, and practices of diverse cultures.

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Education and Training (Cultural Competency)

Acquiring skills to deliver culturally sensitive healthcare.

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Critical Reflection (Cultural Competency)

Examining one's own biases and how they might affect patient care.

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Cross-Cultural Communication

Developing effective communication strategies that respect cultural differences.

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Patient Advocacy and Empowerment

Supporting patients' needs and empowering them to make informed decisions.

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Auto-adjudication

An automated process where software reviews prescription claims for accuracy and eligibility, then determines the payment amount.

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Claim Outcomes

Possible results for a prescription claim after adjudication, including acceptance, denial (or declination), or partial approval.

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Member ID

A unique number identifying an insured individual on their insurance card.

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Rx BIN

The Bank Identification Number on an insurance card, directing a claim to the correct insurance provider.

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Rx PCN

The Processor Control Number on an insurance card, narrowing a claim to the specific insurance plan.

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Rx Group

The employer plan associated with an insurance card, identifying the group that pays for the insurance.

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Medicare Part B

A Medicare plan covering prescription items not usually covered by other Medicare parts, often called the "Red, White, and Blue Card."

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Insurance Formulary

A list of medications covered by a specific health insurance plan, often organized into tiers based on cost and coverage.

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Prior Authorization (PA)

Approval required from the health plan before certain medications or services are covered, often needed for medications above tier 2 on the formulary.

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Plan Limit

The maximum quantity of a specific medication that an insurance plan will cover within a certain period.

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NCPDP Reject Codes

Standardized codes used to communicate reasons for prescription claim rejections.

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Non-Matched Pharmacy Number (Code 50)

Occurs when the pharmacy is not contracted with the insurance company or when trying to fill a specialty drug at a non-specialty pharmacy.

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Plan Exclusion (Code 70)

A provision in an insurance policy that eliminates coverage for certain medications or classes of medications, often because the drug is not on the formulary.

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Prior Authorization Required (Code 75)

Indicates that a prior authorization from the insurance company is needed before the medication can be filled.

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Plan Limitations Exceeded (Code 76)

Occurs when the prescription's days' supply or quantity exceeds the maximum allowed by the insurance plan.

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High-Risk Medications

Medications with a higher potential for adverse effects, like chemotherapy drugs. These require careful monitoring and management.

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Pediatric Dosing

Adjusting medication doses based on a child's age, weight, and other factors to ensure safe and effective treatment.

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Beers Criteria

Guidelines identifying medications that may be inappropriate for older adults due to potential risks or interactions.

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Clinical Alert

Warning triggered by the pharmacy system indicating a potential problem with a prescription, such as an allergy or drug interaction.

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Prior Authorization

A process where a prescriber needs approval from an insurance company before a medication can be dispensed.

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Drug Utilization Review (DUR)

A process that checks for potential drug interactions, allergies, and other issues before dispensing medications.

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Vital Signs

Measurements of the body's basic functions, including temperature, pulse rate, respiratory rate, blood pressure, and height/weight.

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Population Normal

Typical ranges for vital signs based on general population data.

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Personal Normal

Individual's typical vital sign ranges based on their health history and goals.

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White Coat Syndrome

Elevated blood pressure readings caused by anxiety and stress in a medical setting.

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Open-Ended Questions

Questions that encourage patients to provide detailed information and explanations.

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Blood Pressure Cuff

Device used to measure blood pressure, consisting of a bladder, pressure gauge, and tubes.

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Stethoscope

Medical instrument used to listen to sounds inside the body, including heart and lung sounds.

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Systolic Pressure

The top number in a blood pressure reading, representing the pressure in the arteries when the heart beats.

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Diastolic Pressure

The bottom number in a blood pressure reading, representing the pressure in the arteries when the heart rests between beats.

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Pulse Rate

The number of times your heart beats per minute, typically measured at your wrist.

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Normal Pulse Rate

A healthy range of heartbeats per minute, between 60 and 100 beats.

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Tachycardia

A fast heart rate, above 100 beats per minute.

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Bradycardia

A slow heart rate, under 60 beats per minute.

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Respiratory Rate

The number of breaths you take per minute.

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Normal Respiratory Rate

A healthy breathing rate, between 12 and 16 breaths per minute.

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Tachypnea

Rapid, shallow breathing, more than 16 breaths per minute.

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Bradypnea

Abnormally slow breathing, less than 12 breaths per minute.

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Body Mass Index (BMI)

A measure of body fat based on your height and weight.

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Hypertension (HTN)

High blood pressure, consistently elevated pressure in the arteries.

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Complications of Uncontrolled HTN

Serious health problems that can occur if high blood pressure isn't managed, such as heart attack and stroke.

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Normal Blood Pressure

Healthy blood pressure, below 120/80 mmHg.

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Stage 1 Hypertension

Elevated blood pressure, between 130-139 systolic or 80-89 diastolic.

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Stage 2 Hypertension

High blood pressure, 140 or higher systolic or 90 or higher diastolic.

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First-Line Treatment for HTN

The initial medications recommended to lower blood pressure, often ACE inhibitors, ARBs, thiazide diuretics, or calcium channel blockers.

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Dyslipidemia

An umbrella term for abnormal lipid levels in the blood, encompassing both high and low levels of cholesterol and other fats.

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Hyperlipidemia

Specifically refers to elevated cholesterol levels in the blood, often associated with a higher risk of heart disease.

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Atherosclerosis

A buildup of plaque within the arteries, narrowing them and potentially leading to heart attacks or strokes.

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Lipid Panel

A blood test that measures different types of lipids, including total cholesterol, LDL, HDL, and triglycerides.

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LDL

Low-density lipoprotein, often referred to as 'bad cholesterol,' contributes to plaque buildup and heart disease.

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HDL

High-density lipoprotein known as 'good cholesterol,' helps remove LDL from the bloodstream, reducing heart disease risk.

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Triglycerides

A type of fat found in the blood, elevated levels can increase the risk of heart disease.

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Non-HDL Cholesterol

A calculated value representing LDL plus triglycerides, provides a more accurate estimate of heart disease risk.

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Friedewald Equation

A mathematical formula used to estimate LDL cholesterol when only total cholesterol, HDL, and triglycerides are known.

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What are the desirable levels for total cholesterol?

Less than 200 mg/dL.

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What are the desirable levels for LDL?

Less than 100 mg/dL, ideally less than 70 mg/dL.

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What are the desirable levels for fasting triglycerides?

Less than 150 mg/dL.

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What are the desirable levels for HDL?

Men: Greater than 40 mg/dL, Women: Greater than 50 mg/dL.

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Primary Prevention

Measures taken to prevent the onset of a disease or condition in individuals with risk factors but no history of the disease.

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Secondary Prevention

Measures taken to prevent future events in individuals who have already experienced a disease or condition.

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AFib

Atrial fibrillation, a heart rhythm disorder where the upper chambers of the heart beat irregularly and rapidly.

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Stroke Risk

A significant complication of AFib, where blood clots form in the heart and can travel to the brain, causing a stroke.

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CHADS2-VASc Score

A tool used to assess stroke risk in patients with AFib, considering factors like heart failure, hypertension, age, diabetes, etc.

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Anticoagulation

Treatment to prevent blood clots from forming, often used for patients with AFib to reduce stroke risk.

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INR Goal for AFib

The desired INR range for patients with AFib is typically 2-3, balancing stroke risk and bleeding risk.

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Pharmacist's Role in INR Monitoring

Pharmacists play a key role in managing anticoagulation therapy, monitoring INR levels and educating patients.

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Asthma Prevalence

Asthma affects a significant portion of the population, with a higher prevalence among certain groups like Black Americans and Puerto Rican Americans.

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Asthma Triggers

Factors that worsen symptoms, including allergens, irritants, medications, infections, exercise, stress, etc.

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Asthma Symptoms

Characterized by coughing, wheezing, chest tightness, and shortness of breath, often worse at night.

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Asthma Attacks

Sudden worsening of symptoms, requiring immediate treatment; severe attacks can be life-threatening.

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COPD

Chronic Obstructive Pulmonary Disease, a group of lung diseases that cause airflow obstruction and breathing problems.

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COPD Prevalence

COPD affects millions worldwide, with smoking being the primary cause for 90% of cases.

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COPD Symptoms

Progressive shortness of breath, frequent coughing, chest tightness, wheezing, fatigue, and weight loss.

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Respiratory Examination

A comprehensive assessment of respiratory health to identify potential abnormalities, typically conducted by healthcare professionals.

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Pursed Lips

A sign of respiratory distress, commonly seen in COPD or difficulty exhaling.

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Accessory Muscle Use

Using abdominal muscles and sternocleidomastoid for breathing, indicating acute respiratory distress.

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Nasal Flaring

A sign of airway obstruction, often seen in asthma, croup, and pneumonia.

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Jugular Venous Distension

Suggests respiratory issues related to heart failure.

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Palpation in Respiratory Assessment

Feeling the chest to assess lung expansion symmetry.

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Percussion in Respiratory Assessment

Tapping on the chest to evaluate lung tissue resonance.

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Auscultation in Respiratory Assessment

Listening to breath sounds using a stethoscope.

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Crackles (Rales)

Discontinuous popping sounds heard during inspiration, indicating fluid in the lungs.

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Wheezes

Continuous whistling sounds due to narrowed airways.

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Rhonchi

Low-pitched wheezing, often due to mucus buildup in the airways.

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Pleural Rubs

Creaking or grating sounds due to inflamed pleural surfaces.

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Spirometry

A pulmonary function test measuring lung capacity and airflow.

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Forced Expiratory Volume in One Second (FEV1)

The amount of air forcefully exhaled in one second, indicating how quickly the lungs empty.

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Peak Flow Meter

Measures the maximum airflow rate during forceful exhalation, assessing lung function severity.

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Oximetry

Measures oxygen saturation in the blood using light.

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Medication Counseling

Explaining potential side effects of medications to patients, such as the increased heart rate that can occur with albuterol.

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Drug Interaction Screening

Checking patients' medication profiles for potential harmful interactions between different drugs.

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Disease-Drug Interaction Awareness

Educating patients on medications that can worsen respiratory conditions, like opioids' impact on breathing.

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Vaccination Advocacy

Promoting and administering recommended vaccines to reduce the risk of respiratory infections in patients.

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Smoking Cessation Support

Encouraging and assisting patients in quitting smoking through counseling and medication.

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Difficulty using inhalers

A medication-related factor that can contribute to poor medication adherence in respiratory patients.

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Multiple inhaler types

A medication-related factor that may make it harder for patients to take their respiratory medications consistently.

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Unintentional non-adherence

A patient-related factor where patients forget to take their medications, leading to poor adherence.

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Importance of Vaccinations

Adults with COPD or asthma have a higher risk of complications from infections, making vaccinations crucial.

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Influenza Vaccination

An annual vaccination recommended for adults with COPD or asthma to prevent complications from influenza.

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Pneumococcal Vaccination

Vaccination recommended for children and adults 65 years and older to help prevent pneumococcal infections.

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Pharmacist's Role in Smoking Cessation

Pharmacists employ motivational counseling techniques to encourage and support patients in quitting smoking.

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Bupropion

A medication used to help people quit smoking by reducing nicotine cravings.

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Importance of Proper Inhaler Technique

Up to 80% of patients use inhalers incorrectly, reducing effectiveness and leading to health risks.

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MDIs: Advantages

Metered Dose Inhalers are portable, multi-dose, and can be used with or without a spacer, making them versatile.

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Dry Powder Inhaler (DPI)

A device that delivers medication as a fine powder, inhaled directly into the lungs.

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Diskus Inhaler

A type of DPI with a sliding cover that releases medication with each push of the lever.

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HandiHaler

A DPI that uses capsules for medication delivery, requiring a piercing mechanism to release the powder.

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Twisthaler

A DPI with a twisting cap that loads a dose, releasing medication upon inhalation.

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RespiClick

A single-dose, disposable inhaler that delivers medication using a forceful inhalation to activate release.

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Ellipta

A DPI with a sliding cover to access the mouthpiece and a dose counter to track remaining doses.

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Soft Mist Inhaler (SMI)

A newer inhaler type that delivers medication as a fine mist, replacing older CFC-based MDIs.

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Respimat

A specific SMI with a spring mechanism for medication aerosolization, requiring priming before first use.

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Nebulizer

A device that converts liquid medication into a fine mist for inhalation, ideal for patients who cannot use inhalers.

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Spacers

Devices attached to MDIs or DPIs, allowing patients to inhale medication slowly and deeply.

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Fine Particle Fraction (FPF)

A measure of the percentage of medication particles that are small enough to reach the deep airways in the lungs.

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Oral Side Effects

Side effects of medications that affect the mouth or digestive system, often occurring with inhalers.

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Coordination of Inhalation

The ability to synchronize the actuation of an inhaler with the inhalation of medication for maximum effectiveness.

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Medication Clumping

The formation of clumps in powdered medication due to exposure to moisture, hindering proper delivery.

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Dose Counter

A feature on inhalers that displays the number of doses remaining, helping track medication usage.

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Study Notes

Community Pharmacy

  • Historical Role: Community pharmacists initially served as healthcare's first point of contact, acting as chemists, doctors, and counselors.
  • Modern Role: Today, community pharmacists safely, legally, and ethically process prescriptions, educating patients on medications to improve their health.

Pharmacist Responsibilities

  • Clinical:
    • Evaluate prescription drug orders and provide medication therapy management.
    • Compound non-sterile drugs on a small scale.
    • Assess patients for self-care needs and recommend appropriate solutions or referrals.
    • Provide drug information to health professionals and the public.
    • Promote health through education, immunizations, and screenings.
    • Dispense medications.
    • Monitor patient health through medication use.
    • Educate patients on medications, both prescription and over-the-counter.
    • Monitor medication usage for adverse reactions.
    • Advise physicians, nurses, and other healthcare professionals.
    • Offer drug information and immunizations.
  • Business:
    • Manage pharmacy personnel and workflow.
    • Manage finances, including profit and loss.
    • Handle order procurement and inventory.
    • Collaborate with insurance companies for prescription processes and billing.
    • Ensure the availability of necessary supplies (paper, labels, bottles).
    • Participate in continuing education for licensure.
    • Engage in quality reporting and continuous improvement programs.

Prescription Path

  • Drop-off: Patients present prescriptions; pharmacy staff review for accuracy, availability, and wait times.
  • Entry: Prescription details are entered into the system (may be at the drop-off window or separate).
  • Filling: Staff fill prescriptions, verifying NDC numbers, double-counting controlled substances, documenting counts.
  • Verification: Pharmacist verifies prescription against original, recalculates dosages, visually inspects medications, and checks NDC.
  • Pickup: Cashier verifies patient identity; counseling provided for new prescriptions.
  • Consultation: Private area for counseling on new prescriptions and over-the-counter medication.
  • Telephone: Staff professionally handle inquiries, transfers of prescription requests, and patient/provider questions.

Pharmacy Personnel

  • Variety: Pharmacists, technicians, interns, staff pharmacists, and pharmacy managers work together.

Receiving a New Prescription

  • Verification: Patient information, allergies, insurance, and medication stock are verified.
  • Questions: Patients are asked if they have questions.
  • Time Estimate: Patients receive an estimated time for prescription completion.

Prescription Types

  • Types: Written, faxed, e-prescriptions, phoned-in, and transfers from other pharmacies.

Inputting a Prescription

  • Technician/Intern: Technicians or interns typically input prescriptions, ensuring accuracy.
  • Critical Step: Crucial for patient safety.

Prescription Information

  • Requirements: Patient and insurance details, medication details (name, strength, directions, quantity, refills), prescriber information (name, address, NPI, DEA number for controlled substances).

Controlled Substances

  • Extra Information: Requires prescriber DEA number, quantity written alphabetically and numerically, detailed directions, tamper-resistant prescription pads.

Reviewing Prescriptions

  • Critical Aspects: Checking patient details, date, medication details, directions, quantity, refills, prescriber signature, name, address, phone number, DAW.

SIG Codes

  • Use: Pharmacists utilize SIG codes for interpreting prescription directions.

Health Educators

  • Role: Pharmacists instruct patients on medications and health conditions, providing accessible, knowledgeable, and trusted care.

Communication

  • Importance: Essential for effective patient care and counseling.

Patient Interviewing

  • Goal: Gather subjective and objective data on patient's medical and medication history to develop care plans.
  • Subjective: Patient-reported information (e.g., side effects, medication adherence barriers).
  • Objective: Verifiable data (e.g., medical records, lab results, vital signs).
  • Three Steps:
    1. Setting the Stage: Introduce yourself, define purpose, verify patient identity.
    2. Collecting Background: Chief Complaint, HPI, PMH, social history, family history, physical assessment, comprehensive medication history (including current, past, and supplements).
    3. Closing Out: Summarize, verify accuracy, answer questions, set up follow-up.
  • Documentation: Use interview forms to organize information for other providers.
  • Communication Strategies: Use transitional phrases, open-ended questions (Who, What, Where, How), closed-ended questions, empathy (reflecting feelings, acknowledging achievements, disarming anger).

Health Literacy

  • Definition: Individuals' ability to obtain, process, and understand health information to make appropriate decisions.
  • Pharmacist's Role: Enhancing patient health literacy.
  • Consequences of Low Health Literacy: Inappropriate use of emergency services, extended hospital stays, misinterpretation of treatment, and poor health outcomes.
  • National Assessment of Adult Literacy (NAAL): Measures literacy levels (Below Basic, Basic, Intermediate, Proficient).
  • Four Domains: Fundamental, scientific, cultural, and civic.
  • Risk Factors: Older age, low education, low income, non-English speakers.
  • Topic-Specific Literacy: Patients may struggle with complex conditions, and tailoring communication accordingly is crucial.
  • Assessing Understanding: Open-ended questions, teach-back method.
  • Health Beliefs: Respect patient's religious, moral, and cultural beliefs.
  • Health Belief Model: Perceived susceptibility, severity, benefits of action, barriers to action.
  • Written Materials: Use visual aids, simple language, and clear sentence structure. Cultural sensitivity in images.
  • Health Disparities: Differences in health outcomes between socially disadvantaged groups due to inequities in social determinants of health.
  • Pharmacy-Specific Disparities: Examine disparities in medication adherence, disease management, and access to healthcare services.
  • Cultural Competency: Knowledge, training, reflection, communication, advocacy.

Insurance Claims

  • Adjudication: Insurance evaluating prescription claims.
  • Electronic Submission: Primarily handled through computer systems.
  • Potential Outcomes: Accepted, denied/declined.
  • Insurance Card Information: Member ID, Rx BIN, Rx PCN, Rx group.
  • Prescription Pathway: Drop-off, input, verification, claims submission, filling, final verification.
  • NCPDP Reject Codes: Standardized codes for claim rejections (e.g., non-matched pharmacy number, plan exclusion, prior authorization required, cost exceeds maximum).
  • Clinical Alerts: Automated system warnings for potential safety issues (e.g., allergies, interactions).
  • Case Examples: illustrate application of claims concepts.
  • Pharmacist Tasks: Respond to alerts systematically, communicate clearly with patients and prescribers.

Vital Signs

  • Definition: Measurements of basic body functions (temperature, pulse rate, respiratory rate, blood pressure, height, weight).
  • Blood Pressure: Measured effectively with patient preparation (rest, posture).
  • Blood Pressure Measurement: Using manual equipment (cuff and stethoscope), following proper techniques.
  • Korotkoff Sounds: First and last sounds heard that determine systolic and diastolic pressures.
  • Pulse Rate: Measured at radial artery, counting beats per minute.
  • Respiratory Rate: Observed for breaths per minute.
  • Temperature Measurement: Oral, tympanic, axillary, rectal, or infrared.
  • Height, Weight, and BMI: Measured and used to evaluate weight status.
  • Cardiovascular Diseases: Overview of key diseases. Prevalence and statistics (hypertension, dyslipidemia, heart failure).

Cardiovascular Diseases

  • Hypertension (HTN): Elevated blood pressure; prevalence, complications, classifications, and treatment.
  • Dyslipidemia/Hyperlipidemia: Abnormal lipid levels, prevalence, and risk assessment. Treatment options include statin therapy.
  • Heart Failure: Classification systems, diagnosis using biomarkers (BNP, NT-proBNP), and factors affecting treatment.

Respiratory Conditions

  • Asthma: Common respiratory disease, symptoms, variability, triggers, exacerbations. Impact & disparities on various demographics.
  • COPD: Chronic Obstructive Pulmonary Disease, symptoms, causes, and relationship with asthma.
  • Respiratory Examination: Inspection, palpation, percussion, and auscultation methods, and identifying abnormal breath sounds.
  • Spirometry: Measurement of lung function, utilizing FEV1, FVC, and FEV1/FVC ratios.
  • Peak Flow Meter: Measures peak expiratory flow.
  • Oximetry: Measures blood oxygen saturation.
  • Role of the Pharmacist: Medication adherence, inhaler technique education, disease management counseling, smoking cessation support, and vaccination advocacy.
  • Respiratory Devices: MDIs, DPIs, SMIs, nebulizers.
  • Steps for Device Use: Detailed instructions for using various inhaler devices.
  • Risk Factors: Smoking, environmental factors; differences in risk factors for different demographics.

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