Medication Supply & Storage Lesson 11

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What are forms in which Medications cena be supplied?

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A)MULTIPLE DOSE CONTAINERS A ONE WEEK OR ONE MONTH SUPPLY OF MEDICATION IN A VIAL OR BOTTLE .

B)UNIT DOSE PACKAGING.
(EXAMPLE: BINGO CARDS, "BUBBLE PACK" OR INDIVIDUALLY SEALED DOSES OF A MEDICATION THAT ARE SENT BY THE PHARMACY IN A BOX.

C)DOCIDOSE PACKAGING; INCLUDE ALL OF A RESIDENT'S SCHEDULED MEDICATIONS IN A SEALED PACKET.

D)AEROSOLA - DISPENSED IN A MULTI-DOSE METERED DOSE INHALER (MDI).

E)BULK NON-LEGEND MEDICATIONS - MEDICATIONS SUPPLIED IN LARGE CONTAINERS. (EXAMPLE: METAMUCIL)

F)lIQUID MEDICATIONS - CAN BE DISPENSED IN UNIT DOSE PACKAGING OR IN 120CC BOTTLES.

G)OTIC, OPHTHALMIC, NASAL SPECIAL TYPE CONTAINERS.
(1)OTIC MEDICATIONS (EAR DROPS) ARE USUSALLY DISPENSED IN 1 OUNCE CONTAINERS.
(2)OPHTHALMIC MEDICATIONS ARE MEDICATIONS THAT ARE DISPENSED IN LIQUID OR OINTMENT FORMS. EYE MEDICATIONS ARE STERILE
MEDICATIONS.
(3)NASAL MEDICATIONS ARE INSTILLED INTO THE NARES AND CAN BE IN THE FORM OF SPRAYS OR DROPS.

H)ENTERIC COATED TABLETS ARE COATED WITH A CANDY-LIKE SHELL
(1)THESE MEDICATIONS ARE NOT RECOMMENDED FRO CRUSHING.
(2)THE COATING MAY BE EITHER FOR TASTE PURPOSES OR TO DELAY THE ABSORPTION OF MEDICATION IN THE GASTROINTESTINAL TRACT. (EXAMPLES OF THESE MEDICATIONS INCLUDE: ASPIRIN, MOTRIN, AND SOME POTASSIUM SUPPLEMENTS.

I)CAPSULES ARE CYLINDER SHAPED AND HAVE A GELATIN TYPE OF DISSOLVABLE COVERING
(1)CAPSULES SHOULD NOT BE OPENED OR CRUSHED UNLESS SPECICICALLY RECOMMENDED BY THE MANUFACTURER OR PRESCRIBING PHYSICIAN.
(2)CAPSULES OFTEN CONTAIN TIME-RELEASED MEDICATIONS.
(3)EXAMPLES OF MEDICATIONS HOUSED IN CAPSULES INCLUDE - DILANTIN, NITRO-BID AND IRON PREPARATIONS.

J)INJECTABLE MEDICATIONS
(1)TO BE ADMINISTERED ONLY BY A LICENSED NURSES OR PHYSICIANS.
(2)THESE MEDICATIONS ARE ADMINISTERED.
(a) SUBCUTANEOUS (SLIGHTLY UNDER THE SKIN)
(b)INTRAMUSCULAR (WITHIN THE MUSCLE)

K)INTRAVENOUS MEDICATIONS ARE ADMINISTERED THROUGH INTRAVENOUS SOLUTIONS. THESE MEDICATIONS ARE NOT TO BE PREPARED OR ADMINISTERED BY QMAS

L)TOPICAL MEDICATIONS SUCH AS CREAMS, OINTMENTS AND EMULSIONS ARE SUSPENDED IN A PETROLEUM BASE TO ALLOW FOR ABSORPTION IN THE SKIN.
(1)EXAMPLES OF THESE MEDICATIONS INCLUDE: NITRO PATCHES, DANDRUFF SHAMPOOS & LIDEX OINTMENT.
(2)THESE PRODUCTS USUALLY CONTAIN MULTIPLE DOSES OF MEDICATIONS. THE QMA SHOULD ALWAYS WEAR GLOVES WHEN APPLYING THESE TYPES OF PRODUCTS.
(3)IF PATCHES ARE PRESCRIBED, IT IS IMPERATIVE THE QMA REMOVE THE CURRENT PATCH FROM THE RESIDENT'S SKIN BEFORE APPLYING A NEW PATCH. MEDICATION ADMINISTERED IN PATCHES, SUCH AS NITROGLYCERIN OR ANALGESIS, CAN EASILY BE TRANSMITTED TO HEALTHCARE WORKERS WHEN THE PATCHES ARE REMOVED. THUS, THE QMA SHOULD ALWAYSWEAR GLOVES WHEN HANDLING TRANSDERMAL PATCHES.

M) SUPPOSITORIES ARE MEDICATIONS WITHIN A SEMI-SOLID MATERIAL THAT MELTS AT BODY TEMPERATURE.
(1)SUPPOSITORIES CAN BE USED TO ADMINISTER MEDICATION VAGINALLY OR RECTALLY FOR ABSPRPTION INTO THE BODY.
(2)EXAMPLES OF MEDICATIONS THAT CAN BE ADMINISTERED IN THE SUPPOSITORY FORM INCLUDE - DULCOLAZ, ASPIRIN, AND TYLENOL.

Front 2

What Labeling should be on the Medication Containers?

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1)RESIDENT'S FULL NAME
2)PRESCRIBING PHYSICIAN'S NAME.
3)PHARMACY PRESCRIPTION NUMBER.
4)NAME, STRENGTH, & AMOUNT OF THE MEDICATION DISPENSED.
5)EXPIRATION DATE OF ALL TIME-DATED MEDICATIONS
6)DATE OF ISSUANCE (DATE THE PRESCRIPTION WAS FILLED OR REFILLED)
7)WARNING LABELS IF NEEDED.
8)PHYSICIAN'S DIRECTION FOR USE.
9)LABELS ON CONTAINERS OF CONTROLLED SUBSTANCES MUST HAVE THE FOLLOWING WARNING, "CAUTION; FEDERAL LAW PROHIBITS THE TRANSFER OF THIS MEDICATION TO ANY PERSON OTHER THAN THE PERSON FOR WHOM IT WAS PRESCRIBED"
10)NAME, ADDRESS AND TELEPHONE NUMBER OF THE ISSUING PHARMACY.

NOTE* IF THE MEDICATION IS AN OVER THE COUNTER MEDICATION WHICH WAS NOT DELIVERED BY THE PHARMACY, A HANDWRITTEN LEGIBLE LABEL WITH THE RESIDENT'S NAME AND STRENGTH SHOULD BE PRINTED ON THE CONTAINER AND NOT OBSCURED BY THE HANDWRITTEN LABEL.

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Who is authorized to have access to the Medication Storage?

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A)MEDICATION ROOM - ONLY AUTHORIZED PERSONNEL MAY HAVE ACCESS. THE MEDICATION ROOMS MUST REMAIN LOCKED. KEYS MUST REMAIN WITH THE STAFF MEMBER (LICENSED NURSE OR QMA) RESPONSIBLE FOR MEDICATION ADMINISTRATION ON EACH SHIFT. DO NOT LAY KEYS DOWN ON MEDICATION CART, OR AT NURSE'S STATION, ETC.

B)INDIVIDUAL STORAGE BIN - MUST BE LOCKED WHEN NOT ATTENDED OR WITHIN VISUAL RANGE.

C)SCHEDULE 2 CONTROLLED SUBSTANCES - MUST BE STORED IN THE LOCKED MEDICATION ROON OR THE LOCKED MEDICATION CART AND ROUTINELY COUNTED EVERY SHIFT.

D)SOME MEDICATIONS REQUIRE REFRIGERATION OR PROTECTION FROM LIGHT.

E)EMERGENCY DRUG KIT (EDK)
(1)PROVIDE BY THE FACILITY'S PHARMACY.
(2)USUSALLY 3 ARE KEPT IN FACILITY.
(a) LARGE, NON-REFRIGERATED, CONTAINING A VARIETY OF MEDICATIONS THAT SO NOT REQUIRE REFRIGERATION.
(b) SMALL, REFRIGERATED, CONTAINING MEDICATIONS THAT MUST REMAIN REFRIGERATED
(C) I.V. SUPPLIES
(3)UTILIZED TO START A NEWLY ORDERED MEDICATION NEEDED TO BE ADMINISTERED IMMEDIATELY OR IN THE EVENT A CURRENTLY ORDERED MEDICATION IS OUT OF SUPPLY.

F)OVERFLOW OR BACK-UP MEDS - MEDICATION STORED IN A DESIGNATED AREA OF THE MEDICATION ROOM, TO BE UTILIZED WHEN THE SUPPLY ON THE MEDICATION CART IS EXHAUSTED.

*CARE AND CLEANING OF MEDICATION ROOM, CART AND REFRIGERATOR IS NORMALLY DICTATED BY FACILITY CLEANING POLICIES.

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What is EDK mean?

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EMERGENCY DRUG KIT

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Who must maintain records of controlled substances?

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A)THE PHARMACIST MUST MAINTAIN RECORDS OF THE AMOUNT OF CONTROLLED MEDICATIONS FILLED FOR EACH RESIDENT FOR WHOM HE/SHE PROVIDES THE MEDICATION, EACH PHARMACIST AND PHYSICIAN HAS A SPECIAL NUMBER WHICH ALLOWS CLOSE MONITORING OF ALL CONTROLLED MEDICATIONS BY THE DEA )DRUG ENFORCEMENT AGENCY)
B)EACH FACILITY HAS POLICIES AND PROCEDURES THAT ACCOUNT FOR SONTROLLED MEDICATIONS AND A QUALITY ASSURANCE SYSTEM TO ASSURE A VALID COUNTING SYSTEM.

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MEDICATIONS CLASSIFIED UNDER THE LAW AS CONTROLLED SUBSTANCES ARE CATEGORIZED IN THE FOLLOWING CLASSIFICATIONS???

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1) SCHEDULE 1 MEDICATIONS
A) HAVE THE HIGHEST POTENTIAL FOR ABOUSE.
B) THESE MEDICATION COULD ALSO BE CALLED HIGH MARKET STREET MEDICATIONS.
C)EXAMPLES OF THESE MEDICATIONS INCLUDE HEROIN AND COCAINE.

2) SCHEDULE 2 MEDICATIONS
A) HAVE A HIGH POTENTIAL FOR ABUSE.
B) EXAMPLES OF THESE MEDICATIONS INCLUDE - PERCODAN, DILAUDID.

3)SCHEDULE 3 MEDICATIONS
A) HAVE A MODERATE POTENTIAL FOR ABUSE.
B)EXAMPLES OF THESE MEDICATIONS INCLUDE - PERCOCET, VICODIN, AND CODEINE

4)SCHEDULE 4 MEDICATIONS
A)HAVE MINIMAL POTENTIAL FOR ABUSE.
B)EXAMPLES OF THESE MEDICATIONS INCLUDE TALWIN, DARVON, AND AMBIEN

5)SCHEDULE 5 MEDICATIONS
A)ARE ROUTIMELY ADMINISTERED MEDICATIONS.
B)EXAMPLES OF THESE MEDICATIONS INCLUDE LASIX, DIGOXIN, AND DILANTIN,

Front 7

What does DEA mean?

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DRUG ENFOURCEMENT AGENCY

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How many categorized classifications are there?

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THERE ARE 5 SCHEDULED MEDICATIONS.

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When should Schedule 1,2,3, and 4 medications be counted?

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SCHEDULE MEDICATIONS 1, 2, 3, AND 4 SHOULD BE COUNTED AT THE BEGINNING AND END OF EACH SHIFT.

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The count is normally conducted of which individuals?

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THE COUNT IS NORMALLY CONDUCTED WITH ONE "OFF GOING" STAFF MEMBER AND ONE "ON-COMING" STAFF NUMBER. THIS CAN BE TWO LICENSED NURSES OR ONE LICENSED NURSE AND ONE QMA.

1) THESE MEDICATIONS MUST BE SIGNED OUT FOR EACH ADMINISTRATION WITH THE AMOUNT REMAINING ACCURATELY DOCUMENTED.

2)A QMA MAY ADMINISTER CONTROLLED SUBSTANCES IF THE TASK HAS BEEN ADDRESSED IN THE FACILITTY'S POLICY AND PROCEDURE.

3)SHOULD A QMA DISCOVER THE MEDICATION COUNT IS WRONG OR THAT PILLS ARE MISSING THE QMA MUST IMMEDIATELY NOTIFY THE NURSE FOR FURTHER INVESTIGATION.

Front 11

WHAT is a crime under indiana law and what is the offense referred to as?

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ADMINISTERING CONTROLLED SUBSTANCES TO AN INDIVIDUAL OTHER THAN THE PERSON FOR WHOM THEY WERE PRESCRIBED IS A CRIME UNDER INDIANA LAW. THIS OFFENSE IS REFERRED TO AS DRUG DIVERSION HEALTHCARE WORKERS ASSOCIATED WITH DRUG DIVERSION UNDERGO INVESTIGATION AND RISH THE REVOCATION OF LICENSURE/CERTIFICATION AS WELL AS BEING INCARCERATED IF FOUND GUILTY.