Pharm Care/management Test 1 Set 1

Front 1

US Health System is a complex network of: (3)

Back 1

1)providers
2)patients
3)payers (insurance)

Front 2

Only constant in US Healthcare system is...

Back 2

CHANGE

Front 3

Cost of US Healthcare system
a)by %GNP is (1991 and 2000)
b)by $

Back 3

a)12%, 17%
b)$1.6 trillion

Front 4

Biggest health care problem?

Back 4

37million w/o health insurance (15% of population)

Front 5

Medicaid patients are being moved into....(2) and problem with this

Back 5

managed care or HMO

provides incentive to not get minimum wage job that does not provide health insurance

Front 6

Biggest problem with hospitals todaY?

Back 6

move to "for profit" instead of "nonprofit"

Front 7

As a major component of the US Healthcare system, pharmacy is influenced...(5)

Back 7

1)in professional roles
2)patterns of practice
3)items dispensed
4)patterns of reimbursement
5)delineation of practice sites for entry-level practitioners

Front 8

____ defines what pharmacists can and can not do

Back 8

Pharmacy Practice Act

Front 9

Stats on the elderly concering their Rx's (3)

Back 9

1)$1,500 spent annually
2)consume 42% of Rx drugs
3)28.5 Rx's per year

Front 10

Elderly
a)# w/ medicare benefits
b)% of the US population

Back 10

a)39million
b)13%

Front 11

Compared to general population the elderly spend ___ as much on Rx drugs per year

Back 11

4x as much

Front 12

Where do our Social Security taxes go?

Back 12

into gov't spending accounts

Front 13

____ was first to have Rx drug benefit

Back 13

Medicare Part D

Front 14

Ppl on drug reviews boards are getting $ from drug companies, T or F?

Back 14

True

Front 15

Who owns OU Medical Center?

Back 15

HCA

Front 16

The # of old ppl are...

Back 16

INCREASING

Front 17

Who lives longer men or women?

Back 17

women

Front 18

Are ppl more or less educated than in the past?

Back 18

more educated

Front 19

Where and how do most old ppl live?

Back 19

in traditional community w/ spouse

Front 20

Trends in poverty levels among young and old

Back 20

poverty level of old in decreasing

poverty level of young is increasing

Front 21

Where do old get most of their income? What part of their income is increasing now and why?

Back 21

Social security

From income b/c elderly are going back to work

Front 22

What income ranges are most elderly ppl found?

Back 22

high/middle incomes

Front 23

The difference in life span b/w men and women is ___ and why?

Back 23

shrinking due to increasingly similar lifestyles b/w men and women

Front 24

#1 killer of old ppl, but is decreasing and why(3)?

Back 24

diseases of heart

decreased smoking, treating high cholesterol and monitoring BP

Front 25

Trends in cancer death rates among the old?

Back 25

neither rising or falling

Front 26

Top 3 chronic diseases in old ppl?

Back 26

1)HYPERTENSION
2)heart disease
3)arthritis

Front 27

Perception of the old is that they are ___ and ___ but it is FALSE

Back 27

depressed and living in nursing homes

Front 28

OBESITY is INCREASING in the elderly which leads to...(2)

Back 28

1)increased rates of DM
2)increased rates of arthritis

Front 29

Problem with the %age of women smoking (in elderly population)?

Back 29

It is not decreasing like the %age of men smoking is

Front 30

The majority of health care costs come from...?

Back 30

physicians

Front 31

The highest %age of drugs costs in the OLD are paid by...

Back 31

out of pocket

Front 32

4 distinct periods of development of US healthcare

Back 32

1)prefederal build up era
2)federal buildup era
3)federalization of system and cost containment
4)emergence of competitive market and de-federalization

Front 33

The 1989-1991 measels outbreak is attributed to...

Back 33

increased vaccine prices

Front 34

Main health concerns in the prefederal build up era (3)

Back 34

1)malnutrition
2)infectious disease
3)disease transmission b/w Euros, africans, indians

Front 35

Most common diseases in pre era (3) and they had epidemics of...(3)

Back 35

1)dysentery
2)malaria
3)respiratory infexns

1)smallpox
2)yellow fever
3)TB

Front 36

Cause of early war b/w colonist and indians was...

Back 36

malnutrition due to long drought and indians weren't sharing food anymore

Front 37

Major smallpox outbreak in the early americas was due to....

Back 37

steamboat going up the missouri river

Front 38

Early european colonists death rates
a)in virginia
b)in massachusetts

Back 38

a)80% died in first years
b)50% died in first winter

Front 39

Why were death rates so high in early americans? (4)

Back 39

1)british didn't implement public sewer/water policies
2)few physicians migrated to colonies
3)little medical training available in north america
4)few "doctors" had received formal training (didn't need a certificate to practice medicine)

Front 40

Due to epidemic outbreak what did the american colonies do? (3)

Back 40

1)enacted some health legislation
2)mostly consisted of blocking sick ppl from coming into town
3)used poor houses to quarantine sick poor ppl

Front 41

Medical treatments of the american colonies? (4)

Back 41

1)mercury
2)opium
3)natural, non-medical treatments
4)Rush's thunderclappers

Front 42

Rush thunderclappers ingredients (3)

Back 42

1)6 parts mercury
2)1 part chlorine
3)1 part jalap

Front 43

Medical kit for Lewis & Clark (8)

Back 43

1)50 dozen of Rush's thunderclappers
2)peruvian bark
3)opium and laudanum
4)glauber salts
5)saltpeter
6)tarter emetic
7)1lb of mercury
8)mercury ointment

Front 44

Focus of meds in Lewis & Clark's day...

Back 44

flush the body out

Front 45

# of ppl that died during the Lewis and Clark expedition?

Back 45

1

Front 46

Death in the 1800-1900s due to...(and top 4 causes)

Back 46

INFECTIOUS DISEASE

1)TB
2)dysentery
3)respiratory infexns
4)smallpox

Front 47

Top 5 leading causes of death from 1992-2003? (and what type of diseases)

Back 47

1)heart disease
2)cancer
3)stroke
4)pulmonary disease
5)accidents

CHRONIC DISEASES

Front 48

3 things that have creeped in to the top 10 causes of death since 1992?

Back 48

1)alzheimer's
2)nephritis
3)septicemia

Front 49

An increase in ____ has happened due to overuse of Abx

Back 49

MRSA infections

Front 50

Life expectancy in 2002 trends? (2)

Back 50

1)longer in whites than blacks
2)longer in females than males

Front 51

Primary reason for dramatic improvements in health? and what do most ppl think it is?

Back 51

a)changes in public health measures and lifestyle (clean sewers, water, air)
b)NOT, physicians practice of medicine & therapeutics

Front 52

Modern day health challenges: (5)

Back 52

1)chronic diseases
2)affect 1/2 of population
3)1/3 obese
4)1990 costs $470 billion
5)healthcare system geared toward acute disease

Front 53

How is the US health care system geared towards acute disease?

Back 53

doesn't prevent disease, treats it when it occurs

Front 54

Health in early america: (3)

Back 54

1)access to health was privilege and geographic dependent
2)had to self pay everything
3)general well being a fxn of wealth & social class

Front 55

Rural health (in early america) was usually given by...(3)

Back 55

1)Itinerant healers
2)medicine men
3)self care

Front 56

Orthodox physicians (in early america)
1)education...(2)
2)who they treated
3)____ type of medicine and desc
4)treatments (4)

Back 56

1)apprenticeship, some type of education/training
2)middle-upper class (urban)
3)heroic medicine, patients can see visible signs in secretions and excretions
4)leeches, bleeding, purging, puking

Front 57

Drug therapy in early americas:
a)overall aim
b)drugs must...
c)not for...
d)categorized by....(3)

Back 57

a)adjust body's internal equilibrium
b)MUST show visible changes
c)not for specific diseases
d)physiologic effect: diuretic, cathartic, narcotic

Front 58

First manufacturing of medicine's occured when?

Back 58

early 1800's

Front 59

a)Role of physicians w/ medicines
b)Role of pharmacists w/ medicines (3)

Back 59

a)prescribed and dispensed
b1)started apothecaries
b2)compound, diagnose, treat (either from physicians Rx or patient requests)
b3)sold own concoctions

Front 60

Most common ingredient in "concoctions"

Back 60

alcohol

Front 61

Colonial life expectancy

Back 61

25 years

Front 62

4 Health theories of 19th century america

Back 62

1)contagion therapy
2)disease-result of supernatural causes
3)health was individual responsibility not gov't
4)miasma theory

Front 63

Contagion theory (19th century policy)

Back 63

healthy ppl should avoid sick ppl so isolate the sick

Front 64

Disease-result of supernatural causes (19th century policy) (2)

Back 64

1)punishment from god for sin
2)therefore, do not intervene (especially if person is poor)

Front 65

Miasma theory (19th century policy)

Back 65

relationship b/w disease and atmosphere

Front 66

Emergence of hospitals
a)when?
b)aka...
c)fxn (2)
d)bad parts (2)

Back 66

a)pre-civil war period
b)poor houses
c1)charitable and welfare fxn
c2)protect community from "sick" persons
d1)NO antiseptic practices
d2)workers often former patients

Front 67

When did REAL hospitals come about and why?

Back 67

Post-civil war

need to place to put ppl who are hurt

Front 68

Federal buildup era Acts (5)

Back 68

1)US Public Health Service
2)Pure Food and Drug Act
3)Federal Food, Drug and Cosmetic Act
4)National Cancer Act
5)NIH

Front 69

What act said that you have to say what is in your medicine?

Back 69

Pure Food and Drug Act

Front 70

From 1946 to 1970 what happened to make health care better? (6)

Back 70

Heavy Federal investment in healthcare:
1)basic and clinical research
2)health facilities
3)health providers
4)medical care financing
5)health care delivery system

Front 71

How did WW2 help create the drug industry?

Back 71

b/c massive amounts of penicillin were needed

Front 72

Hill Burton Act?

Back 72

Provided federal aid to states for purpose of hospital and health center construction

Front 73

Hill Burton Act led to construction of...(4)

Back 73

1)hospitals
2)nursing homes
3)emergency rooms
4)long term care facilities

Front 74

Development of US health system after WW2 was mainly done by:

Back 74

putting lots of $ into training more health professionals in the 1950s

Front 75

Acts that led to increased numbers of health professionals (6)

Back 75

1)Health Amendments Act
2)Health Professional Educational Assistance Act
3)Nurse Training Act
4)Allied Health Professions personnel Act
5)Health Training Improvement Act
6)Comprehensive Health Manpower Training

Front 76

Purpose of Health Amendments Act?

Back 76

increase # of physicians and other health care persons

Front 77

Trends in Pharmacy in the following fields:
a)Order fulfillment
b)Primary services (and def.)
c)2nd/tertiary services
d)indirect/other services

Back 77

a)DECREASE
b)major incr (MTM)
c)major incr
d)increase

Front 78

Largest mail order entity is....

Back 78

VA

Front 79

Where is the biggest shortfall of pharmacists predicted to occur?

Back 79

In primary/secondary/tertiary services

Front 80

Why is order fulfillment predicted to decrease? (4)

Back 80

due to:
1)information technology
2)automation
3)robotics
4)supportive personnel

Front 81

Most Americans encounter a pharmacist where?

Back 81

in community setting

Front 82

___ is greatest employer with the greatest demand of pharmacists (and % of pharmacists they employ)

Back 82

Retail settings

63%

Front 83

4 major components of community pharmacy industry include...

Back 83

1)independent pharmacy
2)chain drug stores
3)supermarket pharmacies
4)mass merchandiser pharmacies

Front 84

Independent pharmacy def.

Back 84

often owned by pharmacist w/ less than 4 outlets

Front 85

Chain drug store def.

Back 85

corporate ownership w/ 4 or more outlets

Front 86

Mass merchandiser pharmacies def.

Back 86

pharmacy in place like walmart, target

Front 87

The percent of pharmacists employed by retail and interesting thing about this

Back 87

HAS STAYED IN MID 60% FOR A WHILE NOW

Front 88

Total # of pharmacists #'s from 92-98 and affect on our income?

Back 88

has incr from 170,000 to 190,000 but income is going up faster than # new pharmacists in field

Front 89

Prescription drug spending trend (in $) from 93-05 and the % these make up of total health spending

Back 89

93- $50 billion, 5.6%
05- $185 billion, 10.3%

Front 90

Trends in national spending on
a)Rx drugs
b)physician services
c)hospital care
d)why are these trends occuring?

Back 90

a)major increase
b)decrease
c)decrease
d)have controls on latter 2 but not on Rx drugs

Front 91

Increase pharmacist demand via...(6)

Back 91

1)incr TP Rx coverage
2)growth of economy
3)intro of new drug therapies
4)direct-to-consumer marketing
5)greater freq of refills
6)incr # of Rx providers

Front 92

What is in part responsible for the large incr in mail order prescriptions?

Back 92

some insurace companies mandate use of online pharmacies

Front 93

Independent pharmacies fill what % of prescriptions?

Back 93

25%

Front 94

Mass merchants/Supermarkets make what % of their income on Rx's? and why?
And compare this % to independents?

Back 94

Only 5% for MM/10% for supermarkets, have Rx business just to get ppl in store

90% for independents

Front 95

# of Rx's increase in # and % from 92-98?

Back 95

1,900 million to 2,800 million, 44.1% INCREASE

Front 96

Problem with patient counseling in a retail setting?

Back 96

NO economic incentive to provide such services

Front 97

# of Rx's old use compared with other age groups?

Back 97

4-5x more

Front 98

Amount of busyness increase from 92-99

Back 98

10x increase in busyness

Front 99

If recent growth rates in Rx volume contine....(2)

Back 99

1)# of Rx's per community pharmacy will contine to incr
2)current shortage will worsen