Pharmacy Ii

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How often should Both custodians assures by physical inventory?

Back 1

At least weekly or more often if transactions warrant

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Perpetual Inventory of Narcotics, Alcohol, and Controlled Drugs (NAVMED 6710/5)

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Must be changed every 12 months;beginning of each CY
Accurate quality control data of bulk and working stock medicinals shall be annotated on each page. (MFR, Lot #, Exp Date, MFR Date)

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Bulk Stock custodian shall be

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Bulk Stock custodian shall be

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Controlled Substances Inventory Board (CSIB) shall inventory at least

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quarterly or more often if transactions warrant

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Minimum of ____ members must be present to conduct the inventory?

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3

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At least 1 member of the board must be a

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commissioned officer and the senior officer assigned will be designated as the senior member

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Who provides the senior member a copy of all issue documents of all controlled substances?

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Supply Dept

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All authorized prescribers must prescribe controlled substances either by:

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Electronic-order-entry or
DD 1289 or coded facsimile

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Prescription numbers for controlled substances:

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Preceded by the letter "C" and numbered sequentially
CO (or designated rep) must countersign IDC written prescriptions for controlled substances

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Use DEA form to report theft, lost or stolen of controlled substances?

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Form 108

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Send one copy of the DEA form 108 to the nearest representative, who would that be?

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Naval Investigative Service (NIS) representative

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Submit a DD 200 request to the CO for what reason?

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Identifying controlled substances to be destroyed
Reasons for destroying them:
- deterioration - sub-potency
- purity - identity compromised

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When request is CO approved, destruction must be?

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Presence of at least one CSIB member
For a two-person integrity

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The DD 200 form used for requesting destruction must contain:

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Complete nomenclature and qty to be destroyed
Method used to accomplish destruction
Signatures of the witnessing officer(s)

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Records are kept on file for how many years and destroyed at the beginning of a new calendar year.

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3

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Submit report to CO within how many working days after inventory?

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5

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Highest potential for abuse and no acceptable medical usefulness

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Schedule I substances

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High potential for abuse accepted medical usefulness

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Schedule II substances
Morphine (AMMAL
Pentobarbital
Meperidine (Demerol – some AMMALS)
Amphetamines
Codeine

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Have a lesser degree of abuse potential with accepted medical usefulness
Abuse leads to moderate dependence.

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Schedule III substances
Tylenol No.3 (AMMAL)

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Low abuse potential with accepted medical usefulness

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Schedule IV substances:
Diazepam (AMMAL INJ/TABS)
Isometheptine mucate, Acetaminophen, and Dichloralphenazone (AMMAL

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Lowest abuse potential, accepted medical usefulness

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Schedule V substances

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Perpetual Inventory of Narcotics, Alcohol, and
Controlled Drugs;

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Preparing a NAVMED 6710/5

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Assures proper labeling Assures that amounts and other non‑harmful ingredients used appear on the label

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Federal Food, Drug and Cosmetics Act

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Improve administration and regulation of:
Manufacturing
Distribution
Dispensing of Controlled substances

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Comprehensive Drug Abuse Prevention and Control Act of 1970

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Report of loss or theft must be made to the following agencies:

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NCIS
TYCOM
DEA

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a yellow water-soluble dibasic acid xanthine dye; produces intense green fluorescent color in alkaline (pH>5) solution

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Fluorescein sodium (Fluress)

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Relief of dry eyes, and eye irritation associated with deficient tear production

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Artificial tears:

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Contraindications:Flourescein sodium

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DO NOT use with soft contact lenses (resulting to contact lenses discoloration

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Route of Administration of Flourescein sodium:

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Topical strips

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Mechanism of Action for Otic Analgesic:

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Antipyrine is an analgesic while benzocaine is a local anesthetic

Also has glycerin (vehicle with emollient, hygroscopic and humectant properties

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used for its antiallergic, antipruritic and anti-inflammatory effects

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Hydrocortisone is a corticosteroid

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Mechanism of Action for Otic drugs Cont.

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Wax dissolvers emulsify and disperse excessive build up of cerumen

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Otic Ear Wax Removal Agent

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Carbamide Peroxide (Debrox)

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Topical anesthetic for relief of pain from otitis media

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Auralgan:

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Used to treat infection of mastoidectomy and fenestration cavities (perforated tympanic membrane

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Neomycin-Polymixin B:

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Removal of excessive ear wax build up

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Carbamide Peroxide:

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Acts on nerve cell membranes
Paralyzing the parasites (ticks, mites and fleas)

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Permethrin (Nix, Elimite)

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Indications:
Permethrin (Nix, Elimite)

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Tick/Flea infestations

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Contraindications:
Permethrin

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Hypersensitivity to permethrin or synthetic pyrethoid drugs
Safety and efficacy in children less than 2 months (cream) or les than 2 years (liquid) have not been established

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Effectiveness due to their anti-inflammatory, antipruritic, and vasoconstrictor actions

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CORTICOSTEROIDS  (ANTI-INFLAMMATORY) DRUGS

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Dry skin problem is treated with

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ointment

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Wet, oozing lesion is treated with

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cream

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Indications:CORTICOSTEROIDS

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Atopic dermatitis
Eczema

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Route of administration High potency

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Fluocinonide (Lidex) Cream, ointment, gel 0.05%

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Hydrocortisone Valerate (Westcort) Cream, Ointment 0.2% is what potency?

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Medium potency:

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Hydrocortisone Cream, Lotion, Oint, Solution 1%
Triamcinolone Acetonide cream 0.1 is WHAT Potency?

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Low potency:

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Very high or high potency products are contraindicated for use on

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on the face, groin or axilla

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Strongly disinfects, cleanses, and bleaching agent

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Hydrogen Peroxide

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Disinfect intact skin preoperatively

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Povidone-Iodine (Betadine

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Prepare dental surfaces before filling

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Hydrogen Peroxide

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Topical treatment for impetigo due to:
Staphylococcus aureus, including MRSA and beta-lactamase producing strains, S. pyrogenes, S. epidermidis, S. saprophyticus, and Streptococcus

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Mupirocin

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No use in closed body spaces where O2 cannot escape

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Hydrogen peroxide

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“Hairy Tongue” from repeated use (reversible)

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Hydrogen Peroxide

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Topically, this balsamic resin extract acts as a skin protectant and adhesive

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Benzoin Tincture Compound

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Creates a waterproof barrier for skin ulcers

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Benzoin tincture compound

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Relief of itching, pain and discomfort of ivy, oak and sumac poisoning

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Calamine Lotion

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Liberates active oxygen producing an antibacterial, keratolytic and drying effect

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Benzoyl Peroxide

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Generic name for retinoic acid (vitamin A acid)

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Tretinoin (Retin-A)

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An irritant that stimulates epidermal cell turnover, causing peeling and extrusion of the comedones.

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Tretinoin (Retin-A)

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Treatment of mild to moderate acne vulgaris and oily skin

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Benzoyl Peroxide (benzagel)

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Indications:Pseudofolliculitis barbae (PFB)
Improvement of photoaged skin especially wrinkles and liver spots

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Tretinoin (Retin-A)

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Indications:
Dandruff
Seborrheic dermatitis of the scalp
Tinea versicolor

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Selenium Sulfide (Selsun

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Topical antimitotic drug thaht causes necrosis of visible wart tissue

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Podofilox (Condylox)

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Indications:
Topical solution is used in the treatment of external warts (Condylomata acuminata

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Salicylic Acid

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Mechanism of action:
Aluminum Acetate (domeboro tabs)

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Coagulates bacterial and serum protein

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Indications Aluminum Acetate (domeboro tabs

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Relief of inflammatory conditions of the skin,such as insect bites, poison ivy, swelling, allergy, bruises and athlete's foot

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Acts on nerve cell membranes
Paralyzing the parasites

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Permethrin (NIX)

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Indications for Permethrin (NIX)?

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Tick/Flea infestations

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Contraindactions for Permethrin?

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Hypersenstivity to permethrin or synthetic pyrethoid drugs
Allergy Chrysanthemums

Front 70

Mechanism of action of Corticosteriods drugs?

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Effectiveness due to their anit-inflammatory antipruitic and vasocontrictor actions

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Dry skin problem is treated with what?

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Ointment

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Wet, oozing lesions is treated with what?

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cream

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Corticosteriods sparys are used for what?

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acute weeping lesions
cooling, and antiprurtic effects

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Local effects of Topical steriods?

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skin eruptions
Atrophic stirae (streaks and lines)
Petechiae (minute red spots)

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Indications for Corticosteriods?

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Atopic dermatitis
Psoriasis
Eczema

Front 76

What potency is Fluocinonide (lidex)cream ointment gell 0.05%

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High potency

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What potency Hydrocotisone Valerate (Westcort) Cream Ointment .2%

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Medium

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What potency is Hydrocorticone Cream Lotion solution 1%?

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Low potency

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Contraindications for Corticosteriods?

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Very high or high potency prodcuts are for use of face, groin or axilla
Primary bacterial or fungal infections

Front 80

Mechanisms of action of Hydrogen peroxide?

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Strongly disinfects cleanses and bleaching agent

Front 81

Indications for Povidone-iodine (Betadine)?

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Disinfect intact skin preoperatively

Front 82

Indications for Hydrogen Peroxide?

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prepare dental surfaces before filling

Front 83

Topical Treatment for Impetigo due to Staphylocococcus aureus including MRSA ect?

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Mupirocin

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Contrandicaitons for hydrogen peroxide?

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No use in closed body spaces where O2 cannot escape

Front 85

Patient information for Hydrogen peroxide?

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May cause Hairy tongue from repeated use (reversible)

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Prolonged use of mupirocin may cause?

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resutl in overgrowth of nonsusceptible organisms including fungi

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Mechanisms of actions of Benzion Tincture Compound?

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Topically this balsamic resin estract acts as askin protectant and adhesive

Front 88

Indcations for Benzoin tincutre?

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Protect skin from irritations
Creates a waterproof barrier for skin ulcers

Front 89

Mechanisms of action for Calamine lotion?

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Astringent and protectant

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Indcations of Calamine lotion?

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Releif of itching, pain and discomfort of ivy, oak and sumac poisoning?

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Mechanisms of action of Benzoyl Peroxide?

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Liberates active oxygen producing an antibaterial keratolytic and drying effect

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Generic Name for Retinoic Acid?

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Vit A acid

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Retin - A is what other name?

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Tretinoin

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Mechanisma of action of Retin A(tretinoin)?

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AN irritant that stimulates epidermal cell turnover, causing peeling and extrusion of the comedones?

Front 95

What are the indications for Benzoyl Peroxide (Benzagel)?

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Treatment of mild to moderate acne vulgaris and oily skin

Front 96

What do you use for treatment of PFB (pseudofolliculitits barbae) for improvement of photoaged skin especially wrinkles and liver spots?

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Tretinoin (Retin A)

Front 97

It is a topical antimitotic drug that causes necrosis of visible wart tissue?

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Podofilox (condylox)

Front 98

This drug causes cells to slough off and prevents pores from clogging?

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Salicylic acid

Front 99

Indications for COndoloyx

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Topcial solution is used in the treament of external warts (Condylomata acuminata)

Front 100

Mechanism of action of Aluminum Acetate (Domeboro tabs)?

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Coagulates bacterial and serum protein

Front 101

Indications of Aluminum Acetate?

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Relief of inflammatory conditions of the skin, such as insect bites, poison ivy, swelling allergy, bruises and athlete's foot

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Indications of Silver Nitrate?

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Causti---Destory warts , condylomate Keratoses, cetain moles Hyperplastic tissues

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Contraindications of Silver Nitrate?

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Corrosive substance on mucous membranes

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What pancreatic hormone is classified as a hypoglycemic drug: lowers blood glucose levels?

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Insulin

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Insulin is produced where?

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by the beta cells of pancreas

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Insulin is an anabolic, or building hormone that promotes what?

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Storage of glucose as glycogen
Increase in protein and fat synthesis
slowing the breakdown of glycogen protein and fat

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Insuline hormone can correct what?

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Polyuria (excessive urination
Polydipsia (excessive thirs)
FACLIITATES THE MOVEMENT OF POTASSIUM FROM THE EXTRACELLUR FLUID INTO THE CELL

Front 108

Potassium is necessary for what reason?

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Nerve impules transmission
COntraction of muslce
Tissue growth and repair
Acid-base balance maintence

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What are some indications for Insulin?

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Diabetic Ketoacidosis
Servere hyperkalemia

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Indications for Potassium?

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Replacment therpay for hypokalemia due to condition that increase potassium excretion or depletion

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Contraindications of Insulin?

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Episodes of hypoglycemia
Sensitive to any ingredient of the product

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Contrandications for Potassium?

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Acute Dehydrations
Severe renal impairment with oliguria

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Patient information should be give to patient about INSULIN?

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Monitor blood and urine glucose levels and keep results

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Patient information for Potassium ?

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May cause GI upset
take after meals or with food
full glass of water

Front 115

Mechanisms of actionof Estrogens?

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Estriadiol most potent estrogen produced

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Indications for Progestins?

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Amenorrhea and dysmenorrhea
Endometriosis

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Indications for Estrogens?

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Estogen deficiency
Atrophic vaginitis
Female hypgonadism
Abnormal uterine bleeding

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Contraindications for Progestins?

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Breast cancer
LIVER disorders
Thromboemolic disease

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Patien information for Estrogens?

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Notify physician if Weakness or numbnes in arm or legs
Severe abd pain

Front 120

Mechanism of action for Levonorgetrel and Ethinyl estradiol (LEVLEN)?

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Combination of progestin and estrogen hormone

Front 121

Indcations for LEVLEN?

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Emergeny contraception for pregancy prevention following unprotected intercourse or suspected contraceptive failure

"MORING AFTER PILL" PLAN B

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Patient information ofr LEVLEN?

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Take exactly as direceted at intervals not exceed 24 hours, preferably at the same time each day
Missing a pill info can cause spotting and light bleeding

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Isometheptine mucate, Acetaminophen, and Di-chloralphenazone (MIDRIN)? Mechanisma of action?

Back 123

Schedule of IV drug
Migraine headaches

Front 124

Mechanisms of action of Isometheptine Mucate?

Back 124

unsaturated aliphatic amine with sympahtomimetic properties.
Constrictes dilated crainal and cerebral arterioles
Reducing the stimuli that lead to vascular HA

Front 125

What is the Mechanism of ACtion for Dichloraphenazone?

Back 125

Mild Sedative
Reduce patients emotional to the pain of both vascular and tension headaches

Front 126

Contraindications for Midrine?

Back 126

Hypertension
Glaucoma
Servere case of renal disease

Front 127

What is the minimum number of safes required for security of controlled medicinals?

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2 Working an Bulk

Front 128

Who holds the Bulk stock safe conbinations?

Back 128

Bulk custodian (officer)

Front 129

Comination changes will be on what envelope and shall be used and placed in the custody of the CO or officer designated in writing?

Back 129

SF 700

Front 130

What form is Prepetual Inventory Of Narcotics, Alcohol and controlled Drugs?

Back 130

NAVMED 6710/5

Front 131

How often do you change the 6710/5?

Back 131

every 12 months beginning of each CY

Front 132

Custiodian inventories should be done how often?

Back 132

at least weekly or more often if transaction warrante

Front 133

CSIB inventory should be looked at how often?

Back 133

at least quarterly or more often if transaction warrante

Front 134

How many board members are there?

Back 134

at east 3, and must be present to conduct inventory

Front 135

If a transaction occurred since the last report, the CSIB shall accomplish an inventory how often?

Back 135

within 1 month

Front 136

CSIB completes an inventory ASAP after a change of custody of what personnel?

Back 136

CO
XO
BSC
WSC

Front 137

All authorized prescribers must prescribe controlled substances either by what means?

Back 137

Electronic-order-entry or
DD 1289
NAVMED 6710/5 Polyprescription (only one drug)

Front 138

What should you must do Upon discovery of loss or theft of controlled medicimals?

Back 138

CO immediately notified
CSIB shall conduct an inventory

Front 139

Report of Loss or theft must be made to the following?

Back 139

NCIS
TYCOM
DEA

Front 140

What form do you use for report of theft, lost or stolen of controlled substnaces?

Back 140

DEA FORM 108

Front 141

You prepare the original and 3 copes, send the original and one compy to theDEA, 1 to BUMED and the last copy to where?

Back 141

NIS rep

Front 142

Deterioration of controlled substnace, submitting DD 200 request to the CO, you must have what on the form?

Back 142

Identifying controlled substnace to be destroyed
Reaons for destroying (deterioration, purity, sub-potency, identity compromised)

Front 143

When request is CO apporved, destruction must be perfomed how?

Back 143

Presence of at least 1 CSIB member
for a two-person integrity

Front 144

How long are records kept?

Back 144

3 years and destroyed at the beginning of a new calendar year

Front 145

Controlled drug inventory report is submitted to CO within how many working days after inventory?

Back 145

5

Front 146

Prep of letter, the From line will have whom on that lin?

Back 146

Senior Member CSIB

Front 147

The body of report must address what things?

Back 147

Date of inventory
Discrepancies found
Accounting records
DATES OF LAST BULK AND WORKING STOCK SAFE COMBO CHANGES
Names of BSC and WSC

Front 148

Produces vomitting by local irritant effects of GI Mucosa and Central Medullary Effect?

Back 148

Syrup of IPECAC

Front 149

Contraindications of Ipecac?

Back 149

DO NOT use in cetain ingestions of
Strychnine
Corrosives (alkalis and strongs acids
Petroleum distillates

Front 150

Patinet information for Ipecac?

Back 150

always consult physician or poison control center in case of accidental ingestion