Pharmacy Practice & Drug Regulations

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Questions and Answers

Which of the following may be performed only by a pharmacist?

  • Alerting the pharmacist of a possible therapeutic duplication
  • Accepting a return call from a prescriber's office clarifying a prescription (correct)
  • Selecting an OTC product for a patient
  • Manually checking order reports

All of the following duties may be performed by a pharmacy technician EXCEPT:

  • Providing counseling to patients (correct)
  • Compounding prescriptions
  • Selecting an OTC product for a patient (correct)
  • Dispensing medication

What should the technician do when a patient brings in prescriptions for ibuprofen and Anaprox DS?

Alert the pharmacist of a possible therapeutic duplication.

What is a list of goods or items a business will use in its normal operation called?

<p>Inventory</p> Signup and view all the answers

Checking order reports to ensure the order contains no errors is done how?

<p>Manually</p> Signup and view all the answers

In receiving an order, it is important to be alert for drugs that have been incorrectly picked, receiving damaged, are outdated or missing. How are orders reconciled?

<p>Item by item</p> Signup and view all the answers

What is a small volume intravenous bag specifically used to deliver medication called?

<p>IVPB</p> Signup and view all the answers

According to federal law, the prescriber must provide his/her DEA number for which of the following prescriptions?

<p>Xanax</p> Signup and view all the answers

Isotretinoin is associated with?

<p>iPledge</p> Signup and view all the answers

SDS sheets provide what?

<p>Information about hazardous substances.</p> Signup and view all the answers

An antibiotic prescribed is for 15mg/kg twice a day by IV. What is the daily dose in mg for a child weighing 66 pounds?

<p>900 mg</p> Signup and view all the answers

What can outdated drugs be?

<p>Sent to reverse distributors.</p> Signup and view all the answers

An example of a major drug-drug interaction is?

<p>Warfarin-aspirin</p> Signup and view all the answers

The Patient ___________ is necessary for billing a prescription.

<p>date of birth</p> Signup and view all the answers

Why is a drug that is missing a label not dispensable?

<p>It is misbranded.</p> Signup and view all the answers

Companies that administer drug benefit programs are called?

<p>PBMs</p> Signup and view all the answers

What does Copy 2 of DEA form 222 involve?

<p>Forward to the DEA</p> Signup and view all the answers

What is proper disposal or destruction of non-returnable medications?

<p>Using a company that meets EPA regulations.</p> Signup and view all the answers

Each tablet of Claritin D 12 hour contains 120 mg of pseudoephedrine sulfate. What is the maximum amount per transaction if the limit is 3.6 g?

<p>30</p> Signup and view all the answers

Exempt narcotics are in which DEA schedule?

<p>V or 5</p> Signup and view all the answers

Exempt narcotics are regulated for how many dosage units can be sold without a prescription in a ________ hour period.

<p>48 hours</p> Signup and view all the answers

Federal law requires pharmacies to keep _______ of the DEA form 22.

<p>Copy 3</p> Signup and view all the answers

For aseptic technique, all work should be performed at least ________ inches inside the laminar flow hood.

<p>6 inches</p> Signup and view all the answers

All of the following are used to store medications except:

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

Counseling as required by OBRA is provided by?

<p>Pharmacists.</p> Signup and view all the answers

All of the following pharmacy personnel must be formally trained on HIPAA except:

<p>None of the above (D)</p> Signup and view all the answers

For the prescription of Amoxicillin 250 mg/5 mL, how much drug is taken each day if the sig is 2 teaspoons tid?

<p>30 mL</p> Signup and view all the answers

HIPAA is a federal law that protects a patient's PHI when it is:

<p>All of the above (D)</p> Signup and view all the answers

The directions on a prescription read ii gtt q8h ou. How should the directions on the label read?

<p>Instill two drops in each eye every 8 hours.</p> Signup and view all the answers

How many cases of 8 dram vials should be ordered to last two weeks if there are 500 vials per case?

<p>4</p> Signup and view all the answers

The common abbreviation ss means?

<p>One half</p> Signup and view all the answers

Which abbreviation is on the Joint Commission's 'Do Not Use List'?

<p>qd</p> Signup and view all the answers

How many grams of sucrose are needed to prepare 4 ounces of a 20% solution?

<p>24 g</p> Signup and view all the answers

How many milliliters of magnesium sulfate 4 mEq/mL are needed to add 10 mEq of magnesium sulfate to an IV bag?

<p>2.5 mL</p> Signup and view all the answers

Aseptic techniques are methods used to maintain?

<p>Sterility</p> Signup and view all the answers

How much hydrocortisone powder is needed to compound 60 g of hydrocortisone cream 2%?

<p>1200 mg</p> Signup and view all the answers

Good interpersonal skills include?

<p>All of the above (D)</p> Signup and view all the answers

How much should be withdrawn from a vial if the strength of the medication is 1 mg/mL and a dose of 5000 micrograms is needed?

<p>0.5 mL</p> Signup and view all the answers

How should a prescription for BenzaCline be stored after it has been mixed?

<p>Room Temperature</p> Signup and view all the answers

Which dispensing code should be used for a prescription written for Cymbalta 20 mg if DAW was not written?

<p>0</p> Signup and view all the answers

If medication is to be taken PC, when should it be taken?

<p>After meals</p> Signup and view all the answers

Which dispensing code should be used for a prescription written for Norvasc 5 mg if the patient requested the brand name?

<p>3</p> Signup and view all the answers

If the dose of liquid amoxicillin for a child is one and one-half teaspoonful three times a day for 10 days, what is the volume needed to fill the prescription?

<p>225 mL</p> Signup and view all the answers

Information about generic equivalents can be found in the?

<p>Orange Book</p> Signup and view all the answers

Tall man letters are used for?

<p>To distinguish look-alike and sound-alike drug names.</p> Signup and view all the answers

MedWatch form 3500 is for reporting adverse reactions to?

<p>Drugs</p> Signup and view all the answers

Normal saline solution is?

<p>Isotonic</p> Signup and view all the answers

OSHA requires notice for hazardous substances that provide hazard, handling, clean-up, and first aid information. What are these called?

<p>SDS</p> Signup and view all the answers

When a technician receives a rejected claim 'NDC not covered', this probably means?

<p>The insurance plan has a closed formulary.</p> Signup and view all the answers

The age required to purchase a CV exempt narcotic without a prescription is?

<p>18 years old</p> Signup and view all the answers

Premarin cream has been prescribed 0.5 g pv twice a week. The medication should be administered?

<p>Vaginally</p> Signup and view all the answers

Lidoderm is an example of an?

<p>Anesthetic</p> Signup and view all the answers

What is the % concentration if 134 g of sugar is in 200 mL of aqueous solution?

<p>67%</p> Signup and view all the answers

Sublingual nitroglycerin is used for?

<p>Angina</p> Signup and view all the answers

The term for a drug that reduces fever is?

<p>Antipyretic</p> Signup and view all the answers

When a technician receives a rejected claim 'Invalid Person Code', this probably means?

<p>The person code entered doesn't match the birth date and/or sex in the insurer's computer.</p> Signup and view all the answers

When a technician receives a rejected claim 'Unable to connect', this probably means?

<p>The connection with the insurer's computer is temporarily unavailable due to computer problems.</p> Signup and view all the answers

The class of drugs to dissolve blood clots is?

<p>Thrombolytics</p> Signup and view all the answers

The CMEA set _______ and _______ limits on the OTC sales of pseudoephedrine.

<p>daily - monthly</p> Signup and view all the answers

The commission that surveys and accredits health-care organizations is the?

<p>TJC</p> Signup and view all the answers

Nitroglycerin sublingual tablets should be dispensed?

<p>In a glass container</p> Signup and view all the answers

The Controlled Substance Act is enforced by the?

<p>DEA</p> Signup and view all the answers

The directions state 2 gtt au q12h. How is the drug administered?

<p>Both ears</p> Signup and view all the answers

The CPT codes for billing medication therapy management service provided by pharmacists are?

<p>99605, 99606, 99607</p> Signup and view all the answers

Which of the following types of information is generally not required for the online claim process?

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

The following drugs are antidepressants except:

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

The following drugs are considered Antihyperlipidemics except:

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

The following medications should be refrigerated except:

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

The generic name for Neurotin is?

<p>Gabapentin</p> Signup and view all the answers

The government agency that regulates investigational medications is the?

<p>FDA</p> Signup and view all the answers

An example of a robotic dispensing machine is?

<p>Parata Max</p> Signup and view all the answers

The middle set of digits of the NDC represents?

<p>Product identification</p> Signup and view all the answers

Patient package inserts are required to be dispensed with all new prescriptions and at least every 30 days with refill prescriptions for?

<p>Oral contraceptives.</p> Signup and view all the answers

The pharmacist should be alerted if a patient is allergic to sulfa and prescribed?

<p>Bactrim</p> Signup and view all the answers

The Red Book provides information about?

<p>Pricing</p> Signup and view all the answers

Prescriptions for controlled substances from schedules 2, 3, and 4 must contain the following warning:

<p>Caution: Federal Law prohibits the transfer of this drug to any person other than the patient for whom it was prescribed.</p> Signup and view all the answers

The temperature of a refrigerator in a pharmacy should be?

<p>40-42°F</p> Signup and view all the answers

The type of formulary that allows the pharmacy to obtain only drugs listed on the formulary with no exceptions is?

<p>Closed formulary</p> Signup and view all the answers

The type of medication order for medication to be administered only on an as-needed basis is called a?

<p>PRN order</p> Signup and view all the answers

The unique identifying number of a drug is called a?

<p>NDC</p> Signup and view all the answers

Theft or loss of controlled substance must be recorded on DEA form?

<p>106</p> Signup and view all the answers

When compounds are prepared from solids dissolved in water, the beyond-use date should not be later than ______ when stored in the refrigerator.

<p>14 days</p> Signup and view all the answers

The type of recall for drug products most likely to cause serious adverse effects or death is?

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

Under HIPAA, who cannot have access to information about a patient's prescription?

<p>The pharmaceutical companies or their representatives.</p> Signup and view all the answers

Under the Combat Methamphetamine Epidemic Act, what is the maximum amount of pseudoephedrine that can be sold per month to an individual?

<p>9 grams</p> Signup and view all the answers

Warfarin is a common?

<p>Anticoagulant</p> Signup and view all the answers

What is the cost for 6 tablets of a drug if the cost for 100 tablets is $75.00?

<p>$45.00</p> Signup and view all the answers

Which type of mortar and pestle is recommended for mixing liquids and semisolids?

<p>Glass</p> Signup and view all the answers

When compounding parenteral, multi-dose vials?

<p>Contain preservatives.</p> Signup and view all the answers

What size of insulin syringe is needed to deliver a dose of 60 units?

<p>1 mL</p> Signup and view all the answers

Irrigation solutions are administered how?

<p>By pouring from a bottle</p> Signup and view all the answers

Which class of drugs is used to treat elevated blood lipids?

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

Which dispensing code should be entered if a physician has ordered Coumadin DAW?

<p>1</p> Signup and view all the answers

Which drug does not require child-resistant packaging according to the Poison Prevention Packaging Act?

<p>Nitroglycerin sublingual tablets</p> Signup and view all the answers

If a laminar airflow workstation is turned off between aseptic processing sessions, how long should it run before it is used again?

<p>It should never be turned off.</p> Signup and view all the answers

Which drug is an NSAID?

<p>Nabumetone</p> Signup and view all the answers

Which information is not required by federal law on a prescription label?

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

Which medication is ordered using DEA form 222?

<p>Morphine sulfate</p> Signup and view all the answers

Which of the following drugs is a controlled substance?

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

Which of the following drugs is considered a diuretic?

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

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Study Notes

Pharmacy Practice and Regulations

  • Only a pharmacist can accept a return call clarifying a prescription from a prescriber’s office.
  • Pharmacy technicians cannot select OTC products for patients.
  • Therapeutic duplication, such as ibuprofen and Anaprox DS prescribed simultaneously, should be reported to the pharmacist.

Inventory Management

  • Inventory refers to the list of goods a business uses in operations.
  • Orders must be manually checked for errors upon receipt to ensure accuracy.
  • Item-by-item reconciliation is crucial for identifying incorrectly picked or damaged drugs.

Drug Administration and Prescribing

  • IVPB (Intravenous Piggyback) is a small volume IV bag used for medication administration.
  • Federal law requires a prescriber’s DEA number for prescriptions like Xanax.
  • Isotretinoin is associated with the iPledge program for safety.

Drug Information and Storage

  • Safety Data Sheets (SDS) provide crucial hazard and handling information about substances.
  • Controlled substances prescriptions require warnings against transferring medication.
  • Medications must be stored appropriately, with misbranded drugs needing return or destruction.

Calculations and Conversion

  • For dosing calculations: 15 mg/kg/day for a 66 lb child equates to 900 mg.
  • The maximum pseudoephrine allowed per transaction is 30 tablets based on formulation.
  • A hydrocortisone cream requires 1200 mg of the powder for 60 g at 2% concentration.

Drug Interaction and Patient Safety

  • Warfarin has a significant interaction with aspirin.
  • Allergies, such as to sulfa drugs, must be monitored especially with prescriptions like Bactrim.
  • Proper disposal of non-returnable medications must meet EPA regulations.

Compliance and Regulations

  • HIPAA protects patient health information (PHI) and all pharmacy staff must be trained about it.
  • Exempt narcotics are in DEA schedule V and regulated under strict sales limits.
  • The CMEA sets daily and monthly limits on the OTC sales of products like pseudoephedrine.

Prescription Processing

  • Ensure correct abbreviations used; "ss" means one-half.
  • Be aware of Joint Commission's "Do Not Use" list, which includes abbreviations like "qd".
  • Claims rejections can indicate formulary issues or incorrect patient information.

Compounding and Pharmacotherapy

  • Aseptic techniques maintain sterility; compounding can influence beyond-use dates.
  • The proper technique is required for mixing liquids, ideally using glass mortar and pestle.
  • Pharmacists provide counseling as mandated by OBRA (Omnibus Budget Reconciliation Act).

Key Medications and Their Characteristics

  • Recognize that antidepressants do not include diazepam.
  • Sucrose concentrations are critical; a 20% solution requires 24g for 4 ounces.
  • Common medications: Warfarin is an anticoagulant, while Furosemide is a diuretic.

Controlled Substance Regulations

  • Theft or loss of controlled substances should be documented on DEA form 106.
  • Use of a glass container for dispensing nitroglycerin sublingual tablets is standard.
  • The DEA enforces the Controlled Substance Act, ensuring proper medication management.

Miscellaneous

  • The temperature for drug storage, especially refrigerants, should be maintained between 40-42°F.
  • The FDA regulates investigational medications for safety and efficacy.
  • Improper claims handling must consider patient ID, including age for purchasing controlled substances.

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