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PHP 308- Exam 1

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Section 1

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Negative Formulary

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Date created

Mar 1, 2020

Cards (38)

Section 1

(38 cards)

Negative Formulary

Front

list of trade name drugs that pharmacists may not dispense as generic drugs

Back

DUR (Drug Utilization Review)

Front

identify and decrease fraud, abuse, overuse, inappropriate/medically unnecessary care

Back

Reckless Behavior

Front

recognizes the risks associated with the chosen behavior/conscious disregard of risk of harm; punish the employee and manage through remedial action and disciplinary measures

Back

indication, effectiveness, risk, and cost

Front

What are the minimum requirements included in the summary of a drug monograph?

Back

MUE (Medication Use Evaluation)

Front

focused effort to evaluate medication use processes or treatment response; optimize patient outcomes

Back

Retrospective DUR

Front

review of drug therapy after the patient has received the medication

Back

present information without bias

Front

Why use drug monographs?

Back

Closed Formulary

Front

a limited list of approved medications

Back

Sub-Committees

Front

divisions of existing committees formed to address specific issues (example= infectious disease or antimicrobial)

Back

Receive, Research, Respond, Record

Front

What are the steps to the 'Simplified Process'?

Back

Prior Authorization

Front

need approval from payer prior to dispensing/administering; ensure that the medication is necessary

Back

indication, prescribed by appropriate physicians, initial/continuing criteria, duration of approval, quantity limits

Front

What goes into prior authorization criteria?

Back

Concurrent DUR

Front

ongoing monitoring of a drug therapy during the course of treatment

Back

evaluate efficacy/improve safety, standardize therapy, minimize cost

Front

Why do we use MUE?

Back

Purposes of DI Consults:

Front

-provide solution -relate findings -voice concern -use thorough analysis to convince audience of your recommendation

Back

Prospective DUR

Front

evaluation of patient's drug therapy before medication is dispensed

Back

Human Error

Front

unintentional conduct; console the employee and manage through process change, training, and system design

Back

oversee all aspects of drug therapy

Front

What do P/T Committees do?

Back

Formulary

Front

a list of medications readily available for use within an institution or 3rd party that reflects current clinical judgement of medical staff and payer

Back

Positive Formulary

Front

list of drugs that MAY be generically substituted based on bioavailability data

Back

consult with pharmacist about drugs

Front

What is a DI Consult?

Back

Medication Error

Front

any preventable event that may cause or lead to inappropriate medication use or patient harm while the medication is in the control of the healthcare professional, patient, or consumer

Back

-package inserts are for patients to reference and identify indication of use -drug monographs are used by professionals; database

Front

Why is a drug monograph not the same as a package insert?

Back

At-Risk Behavior

Front

intentional behavior that unknowingly increased risk of error; coach the employee and manage through removing incentives and increasing situational awareness

Back

P/T Committee, Medication/Patient Safety

Front

Where are ADR's reported?

Back

-MedWatch (drugs) -VAERS (injections)

Front

How do you report an ADR?

Back

Ad Hoc Committee

Front

formed and adjourned as needed (example: opioid epidemic)

Back

Step Therapy

Front

based on national guidelines; step through agents that are deemed more effective before resorting to using other agents

Back

Open Formulary

Front

allows providers unlimited access to any medication of their choice

Back

ADR (Adverse Drug Reaction)

Front

any noxious or unintended response to a drug that occurs at doses usually used for prophylaxis, diagnosis, or therapy of disease or for the modification of physiological function

Back

list of medications that are safe, effective, and cost-effective to the institution

Front

Why are formularies used?

Back

Benefit Management

Front

ensures that the right patient receives medication and benefits from it

Back

Medical Executive Committee

Front

Where does P/T report?

Back

Just Culture

Front

system of justice that reflects what we know of socio-technical system design, human free will, and our inescapable human fallibility; approaches decisions about remedial actions for employee's involvement in an error by looking at the 'type of behavior'

Back

within three years of drug on market and not indicated on package insert; if teratogenic/deadly

Front

When do you report an ADR?

Back

DRR (Drug Regimen Review)

Front

monthly review of drug regimens (nursing facilities)

Back

ensure safe/effective drug use

Front

What is the role of a P/T Committee?

Back

Utilization Management

Front

strategies/tools used by health plans and PBMs to administer the pharmaceutical benefit

Back