Section 1
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What are Retrospective study designs best used for?
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Date created
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Cards (296)
Section 1
(50 cards)
What are Retrospective study designs best used for?
rare disease and initial etiologic studies
What would cause a low prevalence of disease?
high incidence but short duration (acute infections)
What are the two main measures of disease frequency?
-Prevalence (number of existing cases) -Incidence (number of new cases)
What is the strongest form of Ecological study?
systemic review and meta-analysis
What is the pharmacist's role in epidemiology?
-expand beyond dispensing and distributing medicines -prevention, immunizations, participatory and clinical research, counseling and health education
What is the goal of Primary Prevention?
reduce the number of new cases of disease (before exposure)
What does epidemiology assume about the cause of disease?
disease does not occur at random
What is Mortality Rate?
-total number of deaths from all causes per 100,000 population -usually 1 year period -cause, age and race-specific death rates
What outcome is measured in Tertiary Prevention?
incidence of death and lonf-term disability
What is the goal of Secondary Prevention?
reduce new cases (after exposure) and the severity of disease
What are Descriptive study designs typically used for?
prevalence rate: may suggest association between exposure and disease
What is the approach of Secondary Prevention?
screening, post-exposure prophylaxis, early treatment to reduce impact or reverse course of disease
What are Randomized trials/Experimental studies best for?
strongest evidence for etiology of disease
What is Pharmacoepidemiology?
drug utilization, treatment patterns, medication errors and overdoses, adverse events, effectiveness, medication adherence
What is the goal of Tertiary Prevention?
reduce the number of complications and deaths
What are Prospective study designs best used for?
-yield incidence rates and estimates of risk -better for casual association
What is Morbidity Rate?
the number of existing or new cases of a particular disease per 1,000 population (time period/population size of denominator varies)
What are the outcomes of Primary Prevention measures?
incidence of exposure and incidence of disease
What are the two categories of epidemiological study designs?
Descriptive (hypothesis generation) and Analytic (causal relationship)
What is Infant Mortality Rate?
total number of deaths of infants less than 1 year of age, calculated per 1,000 live births (1 year period)
What factors can increase incidence rate?
-increase in number of new cases -decrease in deaths due to disease -new treatments that prolong life but do not cure disease
What does epidemiology do to impact public health?
-monitor health of population -respond to emerging public health problems -promote research -evaluate effectiveness of a program/intervention -develop public health policy and law -set funding priorities
What are the two measures of disease incidence?
-Cumulative Incidence (CI) -Incidence Rate (IR)/Incidence Density (ID)
What measurement of disease frequency is considered the "true rate"
Incidence rate because it directly integrates time into the denominator
What factors can decrease incidence rate?
-reduced number of new cases -increase number of cures/advance medical treatment
What services do pharmacists offer today that is different than in the past?
-more patient oriented, administrative, and public health functions -scientific and advisory committees -understand importance of epi, expand knowledge base and apply in career path
What is the general aim of epidemiology?
Identify causes and risk factors of a disease in order to prevent it
What are the two types of Analytic study designs?
Intervention/Experimental and Observational (prospective cohort, retrospective cohort, case-control)
What is the approach of Tertiary Prevention?
treatment tailored to the patient, rehabilitation to promote recovery
What are the two main examples of Treatment Epidemiology?
Health Services Research (HSR) and Pharmacoepidemiology
What is the relationship between prevalence and incidence?
prevalence is a function of the incidence rate and duration of disease
What is the equation used in measure the prevalence of a disease?
(number of existing cases in a population)/(number in total population) measured at a single point in time or over a specified period of time
What is survival rate?
number of living cases per number of cases of disease
What is the equation of Cumulative Incidence?
(number of new cases)/(number of persons at risk in population) -over a specified period of time -uses a closed/fixed population
What is the approach of Primary Prevention?
remove or reduce source of the risk
What type of incidence is used in outbreak investigations?
attack rate
What are the key concepts of Incidence?
-new disease events -population at risk (PAR) can't have disease already and must have relevant organs of interest -time must pass for a person to move from health to disease
What would cause a high prevalence of disease?
low incidence but long duration of disease (heart disease)
What is the general definition of epidemiology?
the study of the distribution and determinants of disease and/or health-related states/events in a population (The science of public health)
What is the weakest form of Ecological study?
In vitro (test tube) research
What are the two levels of Descriptive study designs?
Individual level (cross-sectional, case series, case report) and Population level (ecologic)
How is Incidence Rate used in epidemiology?
-undertand the risk factors of a disease -help with the planning and resource allocation for health services and interventions -understand trends of disease over time/over geographic areas
What is Health Services Research (HSR)?
study of the organization, delivery, and financing of healthcare
What is Attack Rate?
number of new cases of disease that develop (usually during a defined and short period) per the number in a health population at risk at the start of the period
What is the equation for Incidence Rate?
(number of new cases)/(person-time of population at risk) over a specified period of time
What are the greek roots of the word "epidemiology"?
epi=upon demos=the people ology=to study
How is the measure of Prevalence used in epidemiology?
-assessing health status of population -planning and allocating healthcare resources -tracking trends of disease over time -determining geographic areas that need attention -identifying most problematic chronic diseases
What are the two factors in Disease Epidemiology?
health promotion and disease prevention
What is case-fatality rate?
number of deaths per number of cases of disease (aggressiveness of a disease)
What outcome is measured in Secondary Prevention?
incedence of disease
Section 2
(50 cards)
What are the limitations of Ecological studies?
-ecological fallacy -lack information on important variables
What are the limitations of an Experimental Study?
-often too costly -ethical barriers -outcomes may be too rare -tend to restrict the scope and narrow the study
What are the main components of drug order reviews?
-correct dose, route, frequency -screen for drug interactions -check labs -concomitant disease states -nurse/doctor notes -diagnostic procedures -Medication Administrant Record (MAR)
Who is responsible for med administration?
nurses
What are the strengths of Cross-Sectional Studies?
-hypothesis formation -relatively inexpensive compared to some other study designs -loss to follow-up not typically problematic -good generalizability -public health planning
What are the roles of Hospital Pharmacists?
-review and process physician orders -dispense medications -sterile IV compounding -development of safe medication use system -provide drug information -inventory management -informatics -clinical services
What does CPOE stand for?
computerized physician order entry
What are the limitations of Case-Crossover Studies?
-does not assess chronic exposures -difficulty in interpreations
What clean room garb is outlined in USP 797?
-Booties -masks -hair covers -gowns -sterile gloves -socks -no makeup/artificial nails
What are the limitations of Cross-Sectional Studies?
-temporal sequence can be clouded -measures the prevalence and not the incidence of cases of disease
What can be ordered through the CPOE?
-medications -labs -dietary
What are the strengths of an Experimental Study?
-can produce the strongest evidence for cause and effect -can by the only possible design for some research questions -can potentially produce faster and less expensive answer than prospective observational studies
What are the advantages of using CPOE?
-improved safety -elimination of handwriting/interpretation -complete orders -eliminates abbreviations -eliminates faxing -quick -reduces cost
What are Cross-Sectional Studies?
-"Snapshot": Looks at prevalence of disease and/or exposure at one time point -examines the characteristics associated with disease (age, gender, etc.)
What are the two types of Cohort studies?
-Prospective: subjects enrolled before they develop the outcome -Retrospective: subjects enrolled after they develop the outcome
What are the limitations of Cohort Studies?
-inefficient for rare outcomes -loss to follow-up (affects validity)
How is external variation reduced in Experimental Studies?
-randomization -placebo -blinding
What is a Case-Crossover Study?
-relatively new epidemiological approach -each case serves as its own control -to study the transient drug effects on the occurrence of an event
What are the strengths of Ecological studies?
-low cost -wide range of exposure levels
What are the strengths of Prospective Cohort Studies?
-clear temporal relationship between exposure and outcome -efficient for disease with short induction and latent periods -exposure information is usually more reliable and valid
What does Cohort mean?
persons banded together (from Latin origin of group of persons with a common statistical characteristic)
What is the name of the computer system implemented in many hospital record systems?
EPIC
What is a Cohort Study?
-participants are selected based on exposure status -includes sufficient time between exposure and outcome for "causation" to be possible"
What are the limitations of Retrospective Cohort Studies?
-poor information on exposure and potential confounders -no control over which variables collected or quality of data
What are the limitations of Prospective Cohort Studies?
-expensive and time consuming -inefficient for diseases with long induction and latent periods
What are the strengths of Case-Control Studies?
-more efficient for diseases with long latency periods -can look at multiple exposures -less time-consuming, less expensive
What are the strengths of Case Reports/Case Series?
-information on new disease or new therapy -generate a hypothesis for further investigation -convey "clinical experience" -relatively inexpensive
What are the steps in the Closed Medication Safety Loop?
-Prescribing -Order Review -Dispensing -Transcription -Administration
How often should work surfaces be cleaned according to USP 797?
prior to compounding and each shift (3 times daily)
What happened if hospitals failed to achieve HITECH standards?
If not achieved by 2015, received financial penalties
What are Experimental Studies?
-investigator assigns intervention -reduce external variation
What is USP 797?
formal and enforceable requirements for how pharmacists/technical personnel compound sterile products
What are the strengths of Cohort Studies?
-can evaluate multiple outcomes -good for rare exposures -can directly measure disease incidence or risk
When was USP 797 published?
January 1, 2004
What are the strengths of Case-Crossover Studies?
-can frequently be done in administrative claims databases -only need half (or less) the sample size of a comparable case-control study
What are Smart Pumps?
-intravenous medication pumps -predefined drug concentrations and library -dosing limits
What is an Ecologic (Aggregate) Study?
-examines rates of disease at the population level -either an exposure or a disease is measured at the population level -compare disease rates over time in different geographically defined populations
What is a Case-Control Study?
compare the odds of exposure among the diseased (cases) with the odds of exposure among the non-diseased (controls)
What is the benefit of Retrospective Cohort Studies?
efficient for diseases with long induction and latent periods
What is Ecological Fallacy?
The association observed at the population level may not represent the association that exists at the individual level (cannot infer findings from an ecologic study to the individual level)
What does HITECH stand for?
Healthcare Information Technology for Economic and Clinical Health Act
What are the limitations of Case-Control Studies?
-inefficient for rare exposures -generally do not allow calculations of incidence -susceptibility to bias -usually difficult to estimate rates
What are the two periods studied in Case-Crossover Studies?
-Control period: measures exposure when the event did not occur -Hazard period: measures exposure when the event occurred
How often should drug containers and bins be cleaned according to USP 797?
monthly
What are the limitations of Case Reports/Case Series?
-only one or several patients (conclusions are not generalized) -no comparison (control group) -outcome may be a chance finding, not characteristic of disease
What is the update to USP 797 and when is it going to be published?
USP 800- postponed to 2019
How often should walls and ceilings be cleaned according to USP 797?
once a week
What methods are used in quality assurance according to USP 797?
-finger tip sampling -hood calibration/testing every 6 months -air quality, humidity -annual medial fill tests
What technology is used to confirm medication is going to the correct patient?
Bar code technology
What is a Case Report/Case Series?
describe the experience of a single patient or a group of patients with a similar diagnosis
Section 3
(50 cards)
What are the steps in Drug Review and life cycle
1. IND 2. NDA/BLA 3. ANDA 4. OTC
What are examples of clinical services provided by hospital pharmacists?
-clinical rounding -antibiotic stewardship programs -Pharmacokinetic Servies -Clinical Pharmacy Specialists
What are common medical errors that occur?
-adverse drug events -improper transfusions -surgical injuries and wrong-site surgery -mistaken patient identities
What are examples of errors of commission?
wrong drug, interacting drug
What two drugs are most common in ADR reports?
insulins and warfarin
What is the annual cost of medication errors?
$3.5 billion
What does JCAHO stand for?
Joint Commission on Accreditation of Healthcare Organizations
What is the general definition of Pharmacoepidemiology?
The study of the use of and the effects of drugs in large numbers of people
What is BLA?
Biologic License Application
What is OTC?
over the counter
What are the duties of a Decentralized Pharmacist?
-Round on all patients of unit -medication reconciliation -in servicing of staff members -precepting pharmacy students -teaching medical residents
How many hospitalized patients are injured by medication errors every year?
400,000
What is the definition of Medication-Related Problems
An event or circumstance involving a patient's drug treatment that actually, or potentially interferes with the achievement of an optimal outcome
When was To Err is Human written?
1999
What are Type B ADRs?
-unpredictable -unrelated to drug's known action -allergic, immunologic, carcinogenic, teratogenic
What are the categories of Sub-Optimal Medication Use?
-Overuse -Misuse -Under-use
What events are considered Adverse Drug Events?
-intentional and accidental poisoning and drug abuse -errors in administration or adherence to therapy -adverse drug reactions and overdoses
What is IND?
Investigational New Drug
What is ANDA?
Abbreviated New Drug Application
What are examples of health care system redesign imperatives?
-reengineered care processes -effective use of information technologies -knowledge and skills management -development of effective teams -coordination of care across patient conditions, services, sites of care over time
When was the IOM Roundtable?
1996
What are the underlying reasons for inadequate quality of care?
-growing complexity of science and technology -increase in chronic conditions -poorly organized delivery system -constraints on exploiting the revolution in information technology
How many people die in hospitals each year as a result of medical errors that could have been prevented
44,000-98,000
What is NDA?
New Drug Application
What are examples of Medication Safety Initiatives?
-medication reconciliation -anticoagulation safety
What are examples of Clinical Pharmacy Specialties?
-Critical Care -ID -Pediatrics -Oncology -Psych -Emergency
What are the outcomes achieved in the medication use process?
clinical, humanistic, and economic
What are exclusions to Adverse Drug Reactions?
-therapeutic failures -intentional and accidental poisoning and drug abuse -errors in administration or adherence to therapy
What happens if a hospital is not accredited by the JCAHO?
cannot bill Medicare
When was the Crossing the Quality Chasm written?
2001--how the healthcare system can be designed to innovate and improve care
What is an Adverse Drug Reaction according to WHO?
any noxious and unintended effect of a drug which occurs at doses used in humans
What are examples of error of omission?
-untreated disease -lack of monitoring -lack of appropriate response to error
What is the purpose of the Committee on the Quality of Health Care in America?
to identify strategies for achieving a substantial improvement in quality of care delivered in US
What does a pharmacist check/do when rounding on patients?
-indication of drugs -renal function -kinetics -therapeutic drug monitoring -choice and duration of antibiotic treatment -optimal pharmacotherapy -rapid response team/code team -immunizations
When was the Committee on the Quality of Health Care in America appointed?
1998
What is the general definition of a medical error?
the failure of a planned action to be completed as intended or the use of a wrong plan to achieve an aim
What are examples of patient education in hospitals?
-discharge counseling -glucometer teaching -psychiatric medication ed sessions -anticoagulant teaching/warfarin
How many people are injured by medication errors every year?
1.5 million nationally
What are JCAHO requirements pertaining to Meds?
-storage of medications -prospective review by a pharmacist -orientation and competency -"PRN" reasons -unacceptable abbreviations -formulary management -reporting of Adverse Drug Events -Medication Safety Initiatives
What is the usual cause of medical errors?
system failures
What are the six aims for improvement outlines in the Crossing of the Quality Chasm?
1. safe 2. timely 3. effective 4. efficient 5. equitable 6. patient-centered
What is the JCAHO?
an independent non-profit organization that establishes standards and monitors compliance in health care organizations
What are the two IOM reports?
To Err is Human and Crossing the Quality Chasm
What is checked when determining optimal pharmacotherapy?
CORE MEASURES (over and under utilization)
What are Type A ADRs?
-predictable -often dose-dependent
What are the steps in the medication use process?
-drug ordering -transcribing -dispensing -administering -monitoring
How common are deaths related to medical errors in the United States?
third leading cause (251,454 fatalities)
What is the IOM?
Institute of Medicine
What are measurable drug effects?
1. anticipated beneficial effects 2. unanticipated beneficial effects 3. unanticipated harmful effects 4. anticipated harmful effects
What are the three strategies to reduce the number of deaths from medical errors?
-making errors more visible when they occur -having remedies at hand to rescue patients -making errors less frequently by following principles that take human limitations into account
Section 4
(50 cards)
What are common pitfalls to culturally competent care?
-Assumptions -Inflexibility -Inadequate resources -expecting the patient to volunteer information -not exploring resistance
What is the health belief of hot and cold maintenance?
"hot" illnesses need to be treated with "cold" medicines and vice versa (Asian and hispanic cultures)
What are the goals of cultural competence?
-promote an attitude of acceptance and sincerity -knowing specific cultural facts about patient groups -developing skills that promote effective patient interactions
What is the FDA MedWatch Program?
healthcare professionals and consumers report serious problems that they suspect are associated with the drugs and medical devices they prescribe, dispense or use
What are financial barriers to care?
-not eligible -not medically necessary -equipment cost -no coverage for replacement -faulty or contaminated equipment due to high cost
What are the five key components to cultural competence?
desire, awareness, knowledge, skill, encounters
What part of the US government does U.S. Public Health Service belong to?
Federal government --> executive branch--> Department of Health and Human Services
What are personal/cultural barriers to care?
-"difficult patient" -provider knowledge -patient distrust
Where is the US Public Health Service located?
-all 50 states -US territories -international
What are the strengths of MedWatch?
-identify events as they occur -pre-marketing trials limited -signal/early warning
How does the Public Health Service protect, promote and advance the health and safety of the US?
-rapid and effective response to public health needs -leadership and excellence in public health practices -advancement of public health science
What are Phase IV Studies?
-postmarketing safety -other indications -extension to other populations
What is Accelerated Approval in expedited drug approval?
earlier approval to treat serious diseases
What is Fast Track for expedited drug approval?
-showing superior effectiveness -avoiding serious side effects -improving diagnosis of serious disease -decreasing a clinically significant toxicity of an accepted treatment
What is the U.S. Public Health Service?
-highly trained and mobile health professionals -foremost health service -only uniformed service in the world dedicated to a public health mission -principle component of the Department of Health and Human Services
What are methods of expedited drug approval?
-fast track -breakthrough -priority review -accelerated approval
What words should you watch out for when communicating to a patient?
-medicinal words (benign, inhibitor) -concept words (avoid, intake) -category words (adverse, cognitive) -value judgement words (adequate, excessive)
What is Form FDA 3500
voluntary reporting for providers/patients
What are the objectives of MedWatch
-make it easier to report ADEs -make it clear what FDA wants -disseminate more widely what FDA action resulting from reports -increase understanding and awareness of drug-induced disease
What are structural barriers to care?
-transportation -physical access, facility layout -communication -time constraints
What are some health disparities in the LGBTIQQ community?
-less likely to have health insurance (transgender people have lowest insurance rate) -68% more likely to smoke -2.5X more likely to experience depression and anxiety -20-30% abuse substances
What is the Indian Health Services Model?
pharmacists are supposed to ask: "what did the provider tell you this medication was for?" "how did the provider tell you to take this" "what did the provider tell you to expect" "can you show me how you take this medication?"
What are tools/strategies of the Risk minimization action plan (RiskMAP)?
-restricted distribution -medication guides -provider registration/training -patient-prescriber agreements
What are examples of health care disparities?
-vaccinations -health insurance -provider status -hospital quality -pain management
Who is vulnerable to low health literacy?
-older population -minorities -immigrants -low income population -individuals with chronic physical or psychiatric conditions
What are common beliefs in the culture of western medicine?
-individual is responsible for their own health -illness belongs to medically derived categories -evidence-based medicine approach -patients expected to conform to the system
What is ask me 3?
What is my main problem? What do I need to do? Why is it important for me to do this?
What is Form FDA 3500A?
Mandatory reporting for manufacturers
Who is Jerome M. Adams?
20th Surgeon General of the United States
What defines culture?
beliefs, customs, values (passed down from generation to generation)
What are health care disparities?
-access -use -quality -outcomes
What is Form FDA 3500B?
Voluntary Reporting for consumers
What are some examples of health disparities?
-diabetes -asthma -CVD -cancer -obesity -HIV/AIDs
What is the BOP?
Bureau of Prisons
What is Breakthrough for expedited drug approval?
-effect on established surrogate endpoint -effect on surrogate endpoint or intermediate clinical endpoint -effect on pharmacodynamic biomarker -significantly improved safety profile
What percentage of drugs in 2015 were designated in one or more categories of expedited drug approval?
60%
What are health disparities?
differences in health outcomes among groups
What are examples of non-verbal communication?
-eye contact -personal space -facial expression -gestures -posture
What is the relationship between health beliefs and evidence-based medicine?
-evidence based medicine should take precedence over health beliefs -patient's health beliefs take precedence because they will not adhere to therapies they do not believe in
What are the key determinants of population health?
-social/societal characteristics -medical care -health behaviors -genes and biology
What is the AHRQ?
Agency for Healthcare Research and Quality
What are health disparities for diseases and conditions?
-incidence -prevalence -mortality -burden
How has FDA increases risk management in the 20th century?
-package inserts (1976) -med guides (1999)
What are important things to remember when communicating with people in the LGBTIQQ community?
-language matters -health forms are not designed to capture spectrum of information about gender vs sex -high risk sexual practices, especially among adolescents
What are weaknesses of MedWatch?
-cannot provide incidence rates -under-reporting -detection bias -severity of event
What is the FDAAA?
(2007) Risk Evaluation Management Strategies for drugs deemed high risk
What are considered serious problems that should be reported to MedWatch?
-death -life-threatening -hospitalization -disability -congenital anomaly -requires intervention to prevent permanent impairment or damage
What is the CMS?
Centers for Medicare and Medicaid Services
What are strategies to provide culturally competent pharmaceutical care?
-open ended questions -assess health literacy and avoid problem words -use universal symbols/drawings -remember cultural differences are not externally visible -empathy is not sympathy -avoid assumptions -use exclusive language
What are examples of social determinants of health?
-how much a person develops in early life -education -ability to get/keep a job -type of work someone does -food security -access to health services -housing status
Section 5
(50 cards)
What do RedDOG pharmacists do?
-vaccination teams -prepare shelters -assist in clinics -operate onsite pharmacists -support disaster-stricken hospitals -logistical support
What are mass merchants/supermarket pharmacies?
retail outlets whose primary goal is generating conventional retail sales, not pharmacy business (goal is to attract new types of customers)
What is the NIH?
National Institute of Health
What are QREs?
quality related events
What is the role of a pharmacy technician?
to support the pharmacist with order fulfillment, manage all tasks not requiring a pharmacist's direct participation or judgment and free time for the pharmacist to perform professional responsibilities
What is the USCG?
United States Coast Guard
What is the SAMHSA?
Substance Abuse and Mental Health Services Administration
How many USPHS officers have been deployed in the last 5 years?
over 4,1000 in 117 missions
What is RedDOG?
-readiness & deployment operations group -coordinates deployment of USPHS officers
How are prescriptions sent to internet pharmacies?
mailed, transmitted via fax from prescriber, or transferred via phone from community pharmacy
What is the ICE?
Immigration and Customs Enforcement
How much are community pharmacies reimbursed for prescriptions?
-percentage of Average Wholesale Price (AWP) -dispensing fee for pharmacy services
What is SRCOSTEP program?
-agreement to join Commissioned Corps after graduation -help pay for final academic year -assigned for twice the time sponsored -apply fall of P3 year
Who are the three parties involved in the payment of a prescription?
patient, pharmacist, third party payer
What is Tier One deployment?
-rapid deployment force -secretary's emergency response -national/regional incident temas -report within 12 hours of notification
What is the prescription intake workstation?
"drop off window" where patients present prescriptions for filling
What is the medication storage system?
consists of shelving units called "bays" that hold stock bottles in a specific organized way (alphabetically/manufacturer)
What is the definition of order fulfillment process?
bottling and preparation of the medication to be dispensed and the oversight and quality control of order fulfillment systems are professional functions of pharmacists that cannot be delegated
What is the IHS?
Indian Health Services
What is the seal of approval for internet pharmacies called?
Verified Internet Pharmacy Practice Sites (VIPPS)
What is Tier Two deployment?
-applied public health -mental health -serice access -capital area provider status -report within 36 hours of notification
What is the JRCOSTEP program?
-student opportunity to serve USPHS for 31-120 days -receive all benefits of officer -apply during P2 year for P2 summer
What is dispensing?
medication has been packaged and is ready to be reviewed by the pharmacist
What is the key concern with third-party prescriptions?
the amount of payment received by the pharmacy (total reimbursement is insufficient to make a profit)
What is the pickup workstation?
Where prescriptions that have been filled and are ready for patient pickup are stored
What is telepharmacy?
the use of electronic information and communication technologies to provide and support health care when distance separates the participants
What is one common law in every state regarding a pharmacist's role?
must verify the final prescription product before it is given to the patient
What does the US Public Health Service do?
-patient care through clinical practice -public health programs -new drug approval and monitoring -medical research -healthcare policy -epidemiology
What is an NDC?
National Drug Code
What are the main types of community pharmacies?
-chain (CVS, Walgreens) -mass merchant (Walmart, Target) -Supermarket (Shaws, Hannaford) -Independent -Mail order -Internet
What are independent pharmacies?
long-established type of pharmacy with a single store or two and one or two owners, whose primary product line is the prescription department
What is the FDA?
Food and Drug Administration
How many days leave does a USPHS officer have a year?
30 (60 days carried over)
What is the CDC?
Centers for Disease Control and Prevention
What recent missions has RedDOG taken part in?
-2017 Hurricanes -Liberia Ebola Epidemic -Great Plains Indian Reservation -Zika -Presidential Inauguration
What factors contribute to pharmacy income?
sales of prescription medications, sales of nonprescription products, and other income that varies based on organization
What is the prescription entry workstation?
Where information is entered into the computer system and profiles are maintained and updated
What do USPHS officers get deployed for?
-national emergencies -public health emergencies -urgent public needs -national special security evens
About how many pharmacists serve in the Bureau of Prisons
182
What are mail-order pharmacies?
many larger chain pharmacies and pharmacy benefits managers have developed mail order to maximize efficiency, address the insurance companies and third party payers' demands for less costly prescription processing, and meet customer needs
What is the HRSA?
Health Resources and Services Administration
What is the OS?
Office of the Secretary
What is Tier Three Deployment?
-every other active duty officer in the Commissioned Corps -report within 72 hours of notification -Augment Tier 1 and 2 teams
What are the components of an NDC?
manufacturer (first five) drug name, strength, dosage form (next four digits) package size (last two)
What is a central fill pharmacist?
work at a central location (not store where prescription was dropped off) and perform prescription entry and/or assembly functions (telepharmacy)
What is the assembly workstation?
where all the parts of the prescription come together to be assembled
What are all of the key components of a prescription that should be assembled in the assembly workstation?
written prescription, patient medication container with label, stock bottle of medication, patient medication leaflet, med guide and adherence aids
What is CQI?
continuous quality improvement--system of standards or procedures to identify and evaluate QREs to improve patient care
What is a chain pharmacy?
an operation with multiple locations, similar physical designs, one primary management/leadership team, and a varied mix of merchandise to offer
What is the auxiliary label?
provide additional patient information and instructions for medication use (applied to vial)
Section 6
(46 cards)