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7295 Week 1 Pre-Class Objectives

Terms in this set (9)

List the components of a written prescription drug order.
- Date Written
- Name and Address of Patient
- Name and Quantity of Drug Prescribed
- Directions for Use
- Prescriber Name, Address, and Telephone Number
- Species (if prescribed for an animal)
- CONTROLLED SUBSTANCES:
o Patient DOB or Age
o Quantify (numerically AND in word)
o Prescriber MANUAL Signature on Hard Copy
- CII Prescriptions:
o Earliest Fill Date
o Unique Control Number for Drug


**DOB is NOT required for non-controlled substances but is used for good practice to help avoid errors. It IS required for controlled substances!
**MUST check PMP BEFORE dispensing/prescribing opioids, benzodiazepines, barbiturates, or carisoprodol.
**MUST NOT return hard copy back to patient after dispensing ANY of it! Can only be returned if NONE of the prescription has been filled.
List the components of a community pharmacy prescription drug label.
- Name, Address, and Phone Number of the Dispensing Pharmacy
- Prescription Number
- Date Dispensed
- Identification of Dispensing Pharmacist (can be initials or ID code)
- Name of Pharmacist Signing the Prescription Drug Order (if applicable)
- Name of Prescriber
- Name of Patient (and species if not human)
- Name/Strength of Drug Dispensed
- Quantity Dispensed
- Instructions for Use
- Beyond Use Date
- "Substituted for Brand Prescribed" if Generic
- SCHEDULE II-IV DRUGS (not V):
o MUST include the standard federal statement "Caution: Federal law prohibits the transfer of this drug to any person other than the patient for whom it was prescribed."

**GOOD PRACTICE NOTE: refills should be on the label (but are not required)
**GOOD PRACTICE NOTE: circline or otherwise noting a double count for controlled substances is not required but should be done as good practice
**NOTE: though not required, the statement "Do not flush unused medications or pour down sink or drain" can be included
List the components of a transferred prescription.
NON-CONTROLLED Drugs Between Pharmacies NOT Sharing an Electronic Database:
- must be communicated orally or via telephone or fax directly by a pharmacist/intern to another pharmacist/intern EXCEPT interns cannot transfer to other interns (due to COVID-19, Texas currently allows techs to receive oral prescriptions and transfers temporarily)

TRANSFERRING OUT:
- write the word "void" on the face of the prescription hard copy OR void/transfer in the data processing system
- record on the back of the voided prescription OR in the data processing system:
o Name/Address of the Pharmacy Receiving Transferred Prescription
o Name of the Individual Receiving the Prescription
o Name of the Individual Transferring the Prescription
o Date of Transfer

TRANSFERRING IN:
- write the word "transfer" on the face of the newly transferred prescription hard copy OR indicate in the data processing system that the prescription is a transfer
- both individuals MUST confirm the prescription information by either the transferring individual faxing the original hard copy prescription OR the receiving individual orally repeating the information received
- record on the back of the hard copy OR in the data processing system:
o Original Written Date
o Date First Filled/Dispensed
o Original Rx Number
o Original Number of Refills
o Date of Last Refill (if applicable)
o Number of Valid Refills Remaining
o Name and Address of Transferring Pharmacy
o Name of the Individual Transferring the Prescription
List the components of a prospective drug utilization review and maintenance of patient records as defined by OBRA '90.
PROSPECTIVE DRUG UTILIZATION REVIEW:
- Over/Under Utilization
- Therapeutic Duplications
- Drug-Disease Interactions
- Drug-Drug Interactions
- Incorrect Dosage or Duration of Treatment
- Drug-Allergy Interactions
- Clinical Abuse and/or Misuse

MAINTENANCE OF PATIENT RECORDS:
- Patient's Full Name
- Address and Telephone Number
- Date of Birth or Age
- Gender
- Drug Profile
- Pharmacist Comments
- Chronic Conditions, Allergies, and Drug Reactions
List the components of a drug regimen review as defined by the TSBP.
- Known Allergies
- Rational Therapy Contraindications
- Reasonable Dose and Route of Administration
- Reasonable Directions for Use
- Duplication of Therapy
- Drug-Drug Interactions
- Drug-Food Interactions
- Drug-Disease Interactions
- Adverse Drug reactions
- Proper Utilization (including over/under utilization)
Identify DEA red flags for diversion.
Diversion is the unlawful transfer of a controlled substance from the legal market to an illegal market.

PRESENTATION OF PRESCRIPTION:
- Patients travel in groups and/or have unexplainable factors in their relationships with each other (e.g., groups of patient's present prescriptions for the same controlled substance(s) from the same prescriber)
- A patient presents prescriptions for controlled substances written in the names of other people (not applicable to caregivers presenting prescriptions for their patient).
- A patient presents a prescription for a controlled substance that the pharmacist knows or reasonably believes that another pharmacy refused to fill.
- A handwritten prescription is presented at the pharmacy, looking altered or flawlessly thorough ("Flawless" contains patient address, quantity spelled out, patient's date of birth, multiple provider identifiers, lacks common abbreviations, etc.)
- The pharmacist becomes aware that the prescriber's DEA registration has been previously suspended or revoked or is pending suspension/revocation.

PATIENT BEHAVIOR:
- threatening behavior
- patient appears intoxicated or shows signs of substance abuse
- non-disclosure of similar prescriptions
- prescription is for controlled substances highly abused in your region
- patient prioritizes controlled substance prescriptions
- previous patient problems

MEDICATION TAKING/SUPPLY:
- prescription(s) for large quantities or multiple controlled substances

ILLEGAL ACTS:
- patient indicates that drugs will be shared with others or sold
- prescriber's DEA registration or state license has expired or been suspended/revoked
- patient presents a prescription from a prescriber who is prescribing outside of the scope of his/her practice
- patient alters, forges, sells, or re-writes prescriptions
- patient is diverting/selling medication or getting drugs from others
Review the format and components of a typical prescription and typical institutional medication order.
- Prescriber information and signature
- Patient information
- Date prescription was written
- Rx symbol
- Inscription (medication prescribed)
- Subscription (dispensing instructions to the pharmacist)
- Signa (directions to the patient)
- Special instructions (e.g., Brand Necessary)

INSTITUTIONAL:
- specialized units may use certain forms
- drug-specific forms may be used for drugs like heparin, electrolyte infusions, and morphine
- military time may be used
Calculate compliance rate.
Proportion of Days Covered (PDC) = (Number of Days in Period "Covered")/(Number of Days in Period)
CMS plan ratings define adherence as...
PDC >0.8 or 80% of days covered
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