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293 Cards in this Set
- Front
- Back
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Pharmacology is the study of:
*how drugs are dispensed. *pills and how to give them. *drugs and their interactions with living organisms. *plants, herbs, minerals, and animals. |
drugs and their interactions with living organisms
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*the prescription drug is too dangerous to use at its higher doses. *the patient can easily diagnose and monitor his/her own condition. *there is enough public pressure after a drug tragedy. *the over-the-counter drug has no side effects or toxicity and no potential for abuse. |
the patient can easily diagnose and monitor his/her own condition.
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Tylenol w/Codeine No. 2 and Vicodin are examples of Schedule _________ drugs.
*I *II *III *IV *V |
III
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Which ACT established the DEA?
*Kefauver-Harris Amendment *Controlled Substances Act *Food and Drug Act *Vaughn Act |
Controlled Substances Act
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As a result of a national tragedy, Congress passed the Food, Drug, and Cosmetic Act of 1938. One of the key parts of this act ______________.
*required manufacturers to list their drugs in the United States Pharmacopeia or National Formulary. *made it mandatory that drugs had a pleasing taste and odor. *required accurate labeling of drugs to prevent substitutions or mislabeling of ingredients. *stated that the government no longer needed proof of fraud to stop the sale of a drug. |
stated that the government no longer needed proof of fraud to stop the sale of a drug.
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A list of all drugs being used, their ingredients, their uses, and how to prepare them was known as ____________.
*a recipe. *pharmacology. * an apothecary. *a pharmacopoeia. |
a pharmacopoeia.
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In order to prescribe a controlled substance a physician must have a/an:
*prescription pad that is preprinted. *DEA number. *AMA control number. *FDA number. |
DEA number
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*AZT. *thalidomide. *Viagra. *Diclegis. |
Diclegis
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Which organization requires that a hospital develop its own list of acceptable medical and drug abbreviations to avoid drug errors?
*Drug Enforcement Agency *Joint Commission *Medicare *Food and Drug Administration |
Joint Commission
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In 1853, Dr. Alexander Wood of Scotland created the first ____________.
*polio vaccine. *prescription drug *hypodermic syringe. *antibiotic drug. |
hypodermic syringe
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*molecular pharmacology. *personalized medicine. *compounding. *human genome. |
compounding
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Which act defined prescription drugs as those drugs that could only be given to patients under the care of a physician?
*Food and Drug Act of 1906 *Kefauver-Harris Amendment *FDA Modernization Act *Durham-Humphrey Amendment |
Durham-Humphrey Amendment
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The first federal drug law was the:
*Food, Drug, and Cosmetic Act *Dietary Supplements and Health and Education Act. *Pure Food and Drugs Act *Food and Drug Administration Modernization Act |
Pure Food and Drugs Act
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In response to the tragedy of babies born with seal limbs because of thalidomide, this legislation required drugs to be both safe and effective before being marketed.
*Food and Drug Modernization Act of 1997 *Food, Drug, and Cosmetic Act of 1938 *The Food and Drugs Act of 1906 *Kefauver-Harris Amendment of 1962 |
Kefauver-Harris Amendment of 1962
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The government agency responsible for regulating the manufacturing and dispensing of controlled substances is called the ____________. *Drug Enforcement Administration (DEA)
*Food and Drug Administration (FDA) *United States Pharmacopeia. *Schedule Drug Agency. |
Drug Enforcement Administration (DEA)
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Aspirin was first introduced in the year:
*1806 *1899 *1912 *1941 |
1899
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Which of the following is NOT a drug derived from a plant source?
*Colchicine *Atropine *Premarin *Opium |
Premarin
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Which of the following statements concerning schedule drugs is TRUE?
*Schedule I drugs can be included-in small doses-in over-the-counter drugs. *Schedule I drugs have the highest potential for abuse and addiction, while Schedule V drugs have the lowest. *Schedule V drugs are not available under any circumstances, even with a prescription. *Schedule V drugs have the highest potential for abuse and addiction, while Schedule I drugs have the lowest. |
Schedule I drugs have the highest potential for abuse and addiction, while Schedule V drugs have the lowest.
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When analgesic drugs are used to control arthritis pain, this is an example of the ___________ use of drugs.
*therapeutic *pharmacologic *preventive *diagnostic |
therapeutic
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The Orphan Drug Act was passed to:
*facilitate the development of new drugs to treat rare disease. *make drug companies responsible for drug substitution and mislabeling that caused deaths. *require drug companies to provide an accurate list of the drug's ingredients *speed up the approval process of new drugs. |
facilitate the development of new drugs to treat rare disease.
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Prescription drugs are defined as those drugs that:
*meet clinical trial requirements and are approved by the FDA *are stronger than what is allowed for over-the-counter use. *are not safe to use except under professional medical supervision. *contain addictive properties that prevent over-the-counter use. |
are not safe to use except under professional medical supervision.
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It took a national tragedy to force a much-needed update of the Food and Drug Act of 1906. The drug that caused this national tragedy was:
*Ayer's Cherry Pectoral, which was used to treat respiratory ailments *Cocaine Toothache Drops, which was used to treat toothache pain *sulfonamide, an anti-infective drug *thalidomide, which was used to treat morning sickness |
sulfonamide, an anti-infective drug
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Which of the following has NEVER been the source of a drug used to treat diabetes mellitus? *lanolin from sheep
*ground-up pork pancreas *Gila monsters' saliva *recombinant DNA technology |
lanolin from sheep
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The drug Digoxin(Lanoxin) is derived from what plant?
*poppies *autumn crocus *belladonna *foxglove |
foxglove
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The use of drugs during radiological procedures and other medical tests to show evidence of a disease is known as: *a preventative use. *a diagnostic use. *treating symptoms and signs of a disease. *none of the above. |
a diagnostic use.
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List the 2 disadvantages encountered when administering some drugs by the oral route.
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It is difficult or some patients to swallow the largest tablets and capsules. Some drugs cannot be taken with certain foods b/c they produce severe adverse effects.
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A drug administered via the intravesical route would be administered into what organ?
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The bladder
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Pharmacology –
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Pharma comes from the Greek word pharma-kon, which means “medicine or drug”. The suffix logy means “the study of”. |
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Describe the steps of absorption, distribution, metabolism, and excretion of a drug that is administered orally. .
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Also called pharmacokinetics - Following oral administration of a drug, the drug disintegrates, if necessary. It then dissolves in stomach or intestinal fluids, passes through the mucous membrane lining of the stomach or intestine into nearby capillaries, and then is absorbed into the blood. The presence or absence of food (particularly a large or fatty meal) can influence the rate of drug absorption. The presence of food in the GI tract can reduce absorption of a drug by 30 to 80 percent. Some drugs are not absorbed at all following oral administration. This drawback can be overcome by administering the drug via a different route. However; non-absorption of a drug via the oral route can also be turned into a therapeutic advantage. Once a drug has been absorbed into the blood, it is distributed throughout the body via the circulatory system. As a drug enters the blood, some of the drug binds to circulating plasma proteins. These large molecules have indentations in their molecular surfaces that permit drug molecules to bind to them. Drug molecules that are bound to plasma proteins are essentially pharmacologically inactive as they are carried through the blood. The other portion of the drug that does not bind to plasma proteins remains in the blood, moving through the circulatory system, passing through the wills of capillaries, and into body tissues. As this unbound portion of the drug leaves the blood, some of the bound drug is released by the plasma proteins, and this maintains a level of unbound drug in the blood. When a drug moves into body tissues, it comes in contact with a cell membrane and exerts an effect by interacting with one or more receptors. The process of metabolism is also known as biotransformation because the drug is gradually transformed or metabolized from its original active from to a less active or even inactive form. This process is accomplished in the liver, the principal organ of metabolism, by the action of liver enzymes. The excretion of drugs is primarily done in the kidney and drugs are excreted through the urine
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Which of the following drugs was derived from the stomach of a sick chicken? * Taxol *Streptomycin *Cephalosporin *Byetta |
Streptomycin
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What is the reason for manufacturing a drug as an enteric-coated tablet?
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It is a special coating that resists stomach acid, but dissolves in the alkaline environment of the small intestine to avoid irritation the stomach.
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What are caplets?
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Caplets are coated tablets shaped into the form of an elongated capsule
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Besides tablets and capsules, list 5 other forms in which drugs are manufactured.
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Lozenges, film, ointment, cream, and lotion
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Describe the difference between an elixir and a syrup.
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Elixirs are solutions that contain the drug in a water and alcohol base with added sugar and flavoring. Syrups are solutions that contain the drug in a thickened water base with added sugar and flavorings, but no alcohol. Syrups are sweeter and more viscous than elixirs.
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Which drug form contains a built-in drug reservoir?
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Transdermal patch, the patch is applied to the skin and releases a small amount of drug over a long period of time, usually for 1 to 2 days.
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How does this Transdermal patch drug form work?
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The drugs in transdermal patches are designed to exert a systemic effect throughout the body, not just a topical effect on the skin. A transdermal patch consists of a multilayered disk containing a drug reservoir, a porous membrane, and an adhesive layer to hold it to the skin. The porous membrane regulates the amount of drug entering the skin, releasing small amounts over time.
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What is an ampule?
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A small, slender glass container with a main body, a narrow indented neck, and an extended top. The color band near the neck of the ampule indicates the area where the ampule can be safely broken in two.
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What is a vial?
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A small glass bottle. The top has an aluminum or plastic cap that protects a rubber stopper beneath until the vial is opened.
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What can be done with a scored tablet that cannot be done with other tablets?
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It can be easily broken along an indented line (score) running across it, from one side to the other, so that 2 to 3 equal doses can be produced (depending on how many scores are on the tablet)
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What phrase is written on the drug label of a suspension that would not be on the drug label of a solution?
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“Shake Well Before Using”
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A suppository can only be given rectally. True or False?
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False
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Differentiate between the feel, the appearance, and consistency of an ointment versus a cream versus a lotion.
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An ointment is a semisolid emulsion of oil (lanolin or petroleum) and water, the main ingredient being oil. It feels greasy, it is clear, and firm. A cream is a semisolid emulsion of oil (lanolin or petroleum) and water, the mail ingredient being water. It feels non-greasy, it is opaque/milky, and is a semiliquid. A lotion is a suspension of a drug in a water base. It feels non-greasy, it is opaque/milky, and is a liquid.
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What do the abbreviations CR, LA, SR, and XL mean and what do they have in common?
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They are all abbreviations for a slow-release tablet or extended-release tablet.
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Ampule -
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a small, slender, glass container with a main body and a narrow, elongated neck. Contains certain liquid drugs used only for injection or intravenous administration
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Extended length tablet -
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a fluid or solution of a drug that is of a watery consistency
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Effervescent tablet –
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tablet form of a drug that is dissolved in a glass of water before being swallowed
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Elixir -
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drug form that is a liquid and contains the drug in a water and alcohol base with added sugar and flavoring
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Enteric-coated tablet -
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tablet form of a drug that is covered with a special coating that resists stomach acid but dissolves in the alkaline environment of the small intestine to avoid irritating the stomach
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Scored tablet -
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tablet form of a drug that has an indented line running across it, so that it can be easily broken into equal pieces to produce an accurate but reduced dose
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Reconstituted –
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action of making a drug in a powder form into a liquid
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Suppository –
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drug form that is composed of a solid base of glycerin or cocoa butter containing the drug. Suppositories are manufactured in appropriate sizes for rectal or vaginal insertion and also come in adult and pediatric sizes
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Transdermal patch –
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drug form that is a patch that is applied to the skin. The patch releases a small amount of drug over a long period of time, usually for 1 to 2 days. The drug in a transdermal patch is designed to exert a systemic effect in the body, not a topical effect on the skin
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Vial -
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A small glass bottle containing a liquid or powder drug for injection. The top is an aluminum in cap that protects a rubber stopper beneath until the vial is opened. The rubber stopper allows repeated doses of the drug to be drawn from the same vial
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Viscous –
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the thickness of the fluid or liquid form of a drug. A fluid or solution can be aqueous (watery) or viscous (thick)
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The sublingual route of administration provides more rapid absorption of a drug than the oral route. True or False?
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True
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A diabetic injects insulin via what route of administration?
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Subcutaneous
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Name 3 acceptable sites for an intramuscular injection in an adult.
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Deltoid (upper arm), Ventrogluteal (hip), Dorsogluteal (hip)
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I.V. push-
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all of the drug is drawn up into a syringe and injected over a short period of time (as a bolus) by pushing gently on the plunger of a syringe whose needle is inserted through a port located at the end of the IV tubing closest to the patient
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I.V. drip-
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the drug is injected into a large IV bag and administered continuously over several hours along with the IV fluid, at the same rate of flow prescribed for the IV fluid, also known as Continuous IV Infusion
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I.V. piggyback-
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the drug can be added to a very small IV bag whose tubing is connected (or piggybacked) into the main IV tubing. For some drugs, the small IV bag comes already premixed with the drug in it. Because the drug is mixed with a smaller amount of IV fluid, it is administered in an hour or less, even as the main IV continues at the prescribed rate of flow.
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What are the 3 names that can be assigned to a drug?
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Chemical name, Generic drug name, trade name – also known as brand name or proprietary name
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The spelling of the endings of genetic drugs may be similar if they belong to the same drug category. True or False?
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True
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Describe 6 ways in which drug companies select a trade name for a drug.
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1. The spelling of the trade name indicates what disease or symptom the drug is used to treat. However, the spelling of the drug is often different from the spelling of the disease. 2. The spelling of the trade name drug indicates what part of the body is being treated. 3. The spelling of the trade name drug simplifies the generic name while retaining parts of its phonetic sound . 4. The spelling of the trade name drug indicates the ingredients or source of the drug. 5. The spelling of the trade name drug indicates the therapeutic effect of the drug. 6. The spelling of the trade name drug indicates how often the drug is to be taken. |
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Describe 4 ways in which a new drug can be discovered or created.
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1. Ancient Sources – plant, animal, or mineral sources hundreds or thousands of years ago. 2. Totally new chemical can be discovered in the environment – from plants, animals, ocean, and or soil 3. Molecular manipulation of a drug that is already in use. 4. Genetic manipulation – recombinant DNA (rDNA), stem cell research |
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Describe the process of recombinant DNA technology and how it helps drug companies to produce certain drugs.
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Also known as gene splicing or genetic engineering, is done by using enzymes in a test tube (in vitro) to cut apart a segment of a DNA molecule from within the nucleus of a human cell. This segment specifically directs the production of a particular substance in the body. Another technique known as gene cloning then allows a large supply of this DNA segment to be produced. The DNA segments are then spliced together (recombined) with the DNA in a bacterial cell. As the bacterium multiplies, it carries the DNA within it as part of its genetic makeup and this is passed on to all subsequent generations of bacteria. Those bacteria are now preprogrammed and are used to make unlimited quantities of that particular substance that can them be used as a drug.
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What is meant by tests that are performed in vitro?
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In vitro means, “in glass” therefore; it is a test done outside of a living being.
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What is meant by tests that are performed in vivo?
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In vivo means, “in living” therefore; it is a test done inside of a living being.
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What types of drug characteristics/effects are studied during each of the 3 phases of human testing of a drug prior to FDA approval?
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Also known as “Clinical Drug Trials”, during Phase 1 – 10 to 100 healthy volunteers are used to study a safe dose range, evaluate side effects, and establish a final, correct dose. The pharmacokinetics of the drug (movement of the drug through the body during absorption, distribution, metabolism, and excretion) are also studied. Phase 2 – the drug is given on an experimental basis to 50 to 500 patients who actually have the disease that the drug will treat. This is dome to determine the extent of its therapeutic effect. Phase 2 testing usually takes 2 years. Phase 3 – the drug is administered to several hundred or several thousand ill patients in exactly the way in which it will be used once it is on the market. Comparative studies of the new drug and drugs already being used for the same diseases for effectiveness results. Also, double blind studies with the drug and a placebo are performed, in which neither the patients nor the doctors know which patients are receiving the drug or the placebo. Phase 3 usually takes 3 years. The entire process usually takes 12 years. |
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How do computers assist in the designing of new drugs?
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Computers can display the molecular structure of a drug and manipulate the chemicals without spending time and money in extensive testing. Computers can also identify chemicals that would probably not be successful in treating a particular disease.
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How can inert ingredients affect the bioavailability of a drug?
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In drugs with a low therapeutic index, the type of inert ingredient used greatly affects the bioavailability of the drug - causing it to range from toxic to sub therapeutic.
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According to the drug companies, what are the advantages to consumers of direct-to-consumer advertising of prescription drugs? According to consumer groups and insurance companies, what are the disadvantages?
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Consumers are more informed. Consumers end up on drugs they don't even need and pressure physicians to prescribe the more expensive advertised prescription drugs |
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Name 4 reasons a drug can be recalled.
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1. The drug does not contain the correct amount of active ingredient. 2. The drug does not remain stable until its expiration date. 3. The drug is contaminated with particulate matter from the manufacturing process. 4. The drug is linked with significant adverse effects. |
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Bioavailability -
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the rate at and the extent to which a nutrient is absorbed and used
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Clinical drug trials –
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Mandatory, 3 phase animal and human testing of a drug by the drug company before it can be approved for marketing by the FDA.
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Control group –
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group of patients during a drug trial who receive a placebo rather than the actual drug being tested.
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Desiccant –
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a packet of moisture absorbing silica gel that is added to a drug container to keep the individual tablets or capsules from deteriorating or losing strength if exposed to moisture.
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Drug recall –
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action by the FDA to remove all or certain batches of a drug from the market.
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Generic drug name –
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name given to a chemical substance by the drug company together with the US Adopted Names (USAN) Council.
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Half-life –
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the time required for a drug level in the blood to decrease from 100% to 50%
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In vivo testing –
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testing of a drug that is carried out in animals or humans. Latin, “in living”
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Isomer –
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a drug that has the same chemical formula as another drug, but has those atoms arranged in a different way.
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Pharmacogenetics –
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the study of how the genetic makeup of different people affects their response to certain drugs
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Placebo –
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a substance that exerts no pharmacologic, therapeutic, or side effects when administered.
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Recombinant DNA technology –
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enzymes used in a test tube to cut apart a segment of a DNA molecule from a human cell.
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Trade name drug –
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drug name selected by a drug company, upon approval of the FDA, for a drug to be marketed
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Medicine –
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The Latin word for drug is “medicine” which we derive the words medicine and medication.
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Drug –
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This word is derived from the Dutch word “droog” which means dry and refers to the use of dried herbs and plants as the first medicines.
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Preventive agent -
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Prevent disease – Prophylaxis = to keep guard before Examples: Prevent motion sickness prior to traveling, prevent pregnancy, vaccinations
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Diagnostic agent -
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Diagnose disease – Use alone, use with/in addition to procedures and test – Examples: radiopaque contrast dye, cardiac stress test
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Therapeutic agent -
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To control, improve, or cure symptoms, conditions, or diseases Examples: Antibiotic drugs, Analgesic drugs, Insulin
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How are the definitions of drug and medicine the same? How are they different? |
The two words can be used interchangeably b/c they both refer to a nonfood chemical substance that affects the mind or the body in a preventive, diagnostic, or therapeutic way. Drug can also refer to chemical substances that do not have a preventive, diagnostic, or therapeutic use, for example: an illegal or street drug. |
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Give the meaning of and describe the origin and the symbol Rx.
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The symbol Rx, comes from the Latin word “recipere” and means to “take”, represents a prescription for a drug whose recipe contains one of more ingredients.
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Natural Source Drug - Foxglove plant
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Drug in current use that originated from the natural sources - Digoxin (Lanoxin)
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Natural Source Drug - Sheep’s wool
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Drug in current use that originated from the natural sources - Lanolin
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Natural Source Drug - Rose hips
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Drug in current use that originated from the natural sources - Vitamin C
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Natural Source Drug - Poppy
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Drug in current use that originated from the natural sources - Morphine
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Natural Source Drug - Mold
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Drug in current use that originated from the natural sources - Penicillin
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Natural Source Drug - Periwinkle
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Drug in current use that originated from the natural sources - Vincristine
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Pure Food and Drug Act of 1906 –
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Public outrage due to unscrupulous drug sellers, as well as from worthless, mislabeled, and dangerous drugs that were then on the market, being sold caused the passage of the Pure Food and Drug Act of 1906. It was the first federal drug law and prohibited the selling is mislabeled drugs across state lines and established the Food and Drug Administration (FDA).
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Food, Drug, and Cosmetic Act of 1938 –
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It took a national tragedy to force a needed update of the Pure Food and Drug Act of 1906. Sulfonamide, and anti-infective drug, was widely used in the U.S. in 1937. A Tennessee company marketed this drug in a raspberry-flavored base and called it Elixir of Sulfonamide. This base had been tested, by the company, for flavor and fragrance but not for safety. The base of this drug was made from in industrial-strength liquid solvent. A number of children died after taking less than 1 ounce of this drug, and over 350 individuals were poisoned. The FDA didn’t have to approve a drug company’s product before it was marketed, at that time. Because of this tragedy, congress passed the Food, Drug, and Cosmetic Act of 1938. As a result, the government no longer needed proof of fraud to stop the sale of a drug. It could seize any drug suspected of being toxic. Secondly, the burden of proof was shifted to the drug companies, who were required to provide data based on scientific experiments to show that their product was safe before they were allowed to market it. The FDA’s job was to review these data and evaluate the safety of drugs before they were marketed.
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Kefauver-Harris Amendment of 1962 –
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In the late 1950s, the drug thalidomide was developed in West Germany and was prescribed extensively to women during early pregnancy to treat morning sickness. The FDA refused to approve to its use in the U.S. without further studies. Evidence against the safety of the drug began to accumulate. Over 8,000 babies in Europe were born with deformed limbs, (seal limbs or phocomelia). This tragedy resulted in the passage of the 1962 Kefauver-Harris Amendment to the Food, Drug, and Cosmetic Act. It tightened control of existing prescription drugs and new drugs. It required that drugs must be shown to be both safe and effective before being marketed. It also required drug companies to report adverse effects from new drugs. Since that time, many drugs have been kept off the market or have been withdrawn from the market because of a lack of safety.
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FDA Modernization Act of 1997 –
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In the early 1990s FDA drug approval took about 34 months per drug approval. Certain critical drugs for HIV could be much shorter. The first drug approved for HIV was approved in just 107 days. Critics still pointed to a time lag in the approval of other new drugs that were available in other countries. In response to this criticism, the FDA made a concerted effort to streamline the approval process, particularly with respect to drugs used to treat life-threatening diseases. In 1996, indinavir, a drug used to treat HIV was approved in just 42 days. In 1997, the Food and Drug Administration Modernization Act was passed. It gave the FDA the authority to accelerate the approval process for certain types of drugs.
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What were 2 important parts of the 2012 FDA Safety and Administration Act?
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Due to 40% of the drugs and early 80% of the drug ingredients being imported to the US, the FDA passed the FDA Safety and Administration Act. This Act gave the FDA authority to enhance the safety of drug supplies by imposing larger penalties for refusing or limiting inspections and producing adulterated or counterfeit drugs. It also included a new drug development tool called “breakthrough therapy”. This tool allowed the FDA to help a drug company speed up the review of clinical evidence if a new drug showed a substantial improvement in therapy over other drugs already on the market.
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What federal agency is empowered to review data on a drug’s safety and clinical effectiveness before approving the drug for marketing?
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Food and Drug Administration (FDA)
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What is a Compassionate Use IND application?
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A physician applies for use of a drug when there is no other drug or therapy that can be used in a life threatening disease. The drug is still in the investigational stage of approval, but deemed necessary to help save a life.
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Define the following phrases: Prescription drug -
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drugs that are safe to use only under a Dr.’s supervision and can only be obtained with a written prescription or verbal order. Also known as legend drugs b/c the drug company and pharmacist add one of these 2 legends (inscriptions) to the drug package and to the filled proscription bottle: “Caution: Federal Law prohibits dispensing without a proscription” of “Rx Only”
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Describe how the Controlled Substances Act categorized drugs of potential abuse.
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There are five categories or schedules based on their potential for causing physical or psychological dependence. With schedule 1 drugs having the highest potential for abuse or most addictive.
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What is the purpose of the 1983 Orphan Drug Act?
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It offers incentives to induce companies to develop drugs and other medical products for the small market of individuals with rare disorders. What 3 incentives does if offer drug companies to develop orphan drugs? Federal grants to offset drug development costs, a tax credit that allowed the drug company to deduct up to 75% of the cost of clinical trials, a streamlined process for obtaining FDA approval, and exclusive marketing rights for seven years.
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What part of the wording of a drug label tells you that it is a prescription drug?
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“Caution: Federal law prohibits dispensing without a prescription” or “Rx only”
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Why was the drug thalidomide, which caused severe birth defects in thousands of babies, allowed on the market again?
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In 1997 it was discovered to be a useful drug in treating cancer and leprosy. It is only used as a treatment for life threatening diseases.
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Apothecary –
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A historic term used for a pharmacist. Now refers to a small drug store that sells herbs and drugs.
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Compounding –
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Preparing, mixing, and packaging drug ingredients often under sterile conditions
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Designer drugs –
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Drugs created by a slight modification of an existing illegal Schedule I drug or a legal Schedule II or a narcotic drug in order to create a similar drug effect while avoiding prosecution under existing drug laws.
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Drug –
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Any nonfood chemical that affects the mind or the body. A general category that can include both medicines and medications as well as illegal recreational and street drugs.
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Medicine -
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Any nonfood chemical that affects the mind or the body.
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Orphan drugs –
|
Drug that is specifically developed to treat rare diseases affecting fewer than 200,000 people. The drug company is given federal financial incentives by the Orphan Drug Act.
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Over-the-counter (OTC) drugs –
|
Drug that can be purchased without a prescription and is generally considered safe for consumers to use if the label’s directions are followed carefully and all warnings are heeded.
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Pharmacology –
|
The study of drugs and their interactions with living organisms and human beings
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Pharmacopeia –
|
An official list of all drugs, including their chemical structures, chemical names, generic names, trade names, indications for use, drug forms, routes of administration, and doses.
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Prescription drugs –
|
A drug that is not safe to use except under professional medical supervision. Prescription drugs can only be obtained with a written prescription or voice order from the physician, dentist, nurse practitioner, or other healthcare provider whose license permits this. Prescription drugs are also known as legend drugs because the drug company or pharmacist adds one of these 2 legends (inscriptions) to the drug package or to the filled prescription bottle. “Caution, Federal law prohibits dispensing without a proscription” or Rx only”.
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Prophylaxis –
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Prevention of a disease. This word is from the Greek meaning, “to keep guard before”.
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Schedule drugs –
|
A classification of drugs based on their potential for abuse and dependence (addiction). They are regulated by the DEA. They are divided into five categories or schedules I through V, based on their potential for physical or psychological dependence. These drugs are also known as controlled substances.
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Over-the-counter drug –
|
a drug that can be purchased without a prescription and is considered safe for consumers to use if the label’s directions are followed carefully and all warnings are heeded.
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Schedule drug –
|
drugs with the potential for abuse and dependence
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Designer drug –
|
created by doing a small molecular modification of an existing Schedule I illegal drug or a Schedule II legal drug creating one that has the same desired drug effect. The new drug is known as analog.
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Orphan drug –
|
drugs that treat rare diseases, that affect fewer than 200,000 people in the US.
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What is meant by the phrase first-pass effect?
|
The initial metabolism by the liver is referred to as the first-pass effect, because the drug must first pass through the liver before it can enter the general circulation to exert a systemic effect
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How do plasma proteins such as albumin regulate the amount of drug circulating in the blood?
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As the drug enters the blood, some of the drug binds to circulating plasma proteins such as albumin. These large molecules have indentations in their molecular surfaces that permit drug molecules to bind to them. Drug molecules that are bound to plasma proteins are essentially pharmacologically inactive as they are carried through the blood. The other portion of the drug that does not bind to plasma proteins remains in the blood, moving through the circulatory system, passing through the walls of capillaries, and into body tissues. As this unbound portion of the drug leaves the blood, some of the bound drug in released by the plasma proteins, and this maintains a level of unbound drug in the blood. When a drug moves into body tissues, it comes in contact with a cell membrane and exerts an effect by interacting with one or more receptors.
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Describe how the blood-brain barrier functions with respect to various drugs.
|
The brain is protected by the blood brain barrier that exists between the capillary walls of the blood vessels in the brain and the surrounding brain tissues. However, some drugs are able to pass through the blood brain barrier and exert a therapeutic effect. Some of these drugs are Ritalin, anesthetic, antihistamines, and drugs for pain. Sometimes it blocks drugs that are needed to treat diseases of the brain.
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Give 2 reasons why standard drug doses may need to be decreased for elderly patients?
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1. Decreased drug metabolism rates due to decreased liver function. 2. Decreased rates of drug excretion due to decreased kidney function. |
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Give 2 reasons why drugs reaching the kidney may not be immediately excreted in the urine.
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1. Drugs bound to albumin are not excreted. 2. Unbound molecules of fat-soluble drugs are more attracted to the lipid structure of the renal tubule walls than urine and return to the blood. |
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A.S. –
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left ear
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Describe the lock-and-key concept as it pertains to a drug and a receptor.
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An agonist drug (a key) unlocks and activates a receptor (the lock). An antagonist drug (a key) occupies and blocks a receptor (the lock), but does not activate it. An antagonist drug also keeps other substances or drugs from activating the receptor. |
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IM –
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intramuscular
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KVO –
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keep the vein open
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NG –
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nasogastric (tube)
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NPO –
|
nothing by mouth
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O.U. –
|
both eyes
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PO –
|
by mouth
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SQ –
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subcutaneous
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Describe the difference between local and systemic drug effects.
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A local drug effect is limited to the site of administration, and a systemic drug effect is one that is felt throughout the body.
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Give an example of a drug that can act either locally or systemically to produce a therapeutic effect, depending on the route of administration.
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Benadryl, lidocaine
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Differentiate between a drug’s therapeutic effect and a side effect.
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Desired drug effect alleviates symptom or conditions Side effect is the drug effect other than therapeutic, non- harmful
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List several common side effects that involve the GI tract.
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Anorexia, nausea, vomiting, and diarrhea List several that involve the central nervous system. Drowsiness, excitement, and depression
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How does a toxic effect differ from a side effect?
|
A toxic effect has an undesirable, poisonous, harmful, effect of a drug and could be life threating A side effect is a drug effect other than therapeutic, but is non-harmful
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What is the basis for all of the symptoms associated with an allergic reaction?
|
The release of histamine.
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Using computers to design new drugs involves _____________, which is the study of the chemical structures of drugs and their actions at the molecular level within a cell. *genetics *molecular pharmacology *pharmacodynamics *recombinant DNA technology |
molecular pharmacology
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The trade name of the drug Lithobid was selected to indicate: *the name of the drug company. *the amount of active ingredient. *the disease the drug is used to treat *how often the drug is to be given. |
how often the drug is to be given.
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The patent on a new drug is in effect for ______ years. *5 *12 *17 *23 |
17
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Which of the following involves using a drug on several hundred or several thousand ill patients in exactly the same way as it will be used once it is on the market? *clinical trials, phase I *clinical trials, phase II *clinical trials, phase III *in vivo testing |
clinical trials, phase III
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Azmacort was purposefully named to indicate: *The duration of the drug's action *The disease or symptom it is used to treat *The therapeutic effect of the drug *The ingredients of the drug |
The disease or symptom it is used to treat
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A drug that has the same chemical formula as another drug, but has some atoms arranged in a different way is called: |
Isomers
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What does the therapeutic index indicate? |
the margin of safety between the therapeutic and toxic doses
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The time required for the drug level in the blood to decrease from 100% to 50% is the:
|
Half-life
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In phase I of human testing:
|
Only healthy volunteers are used
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The advertising of over-the-counter drugs is regulated by:
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Federal Trade Commission
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A moisture-absorbing packet of silica gel, known as _________, is something that would be added to a drug container to keep tablets from deteriorating.
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a desiccant
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The three phases of human testing are known as:
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Clinical trials
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In a double-blind study, every patient receives both the drug and a placebo. True or False?
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False
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The __________ of the active drug ingredient can be particularly crucial in drugs with a low therapeutic index.
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bioavailability
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Chemical analysis of a drug done in laboratory test tubes is called:
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In vitro testing
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Which of the following drugs indicates the therapeutic effect of the drug? *Lithobid *Premarin *Boniva *Elimite |
Elimite
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A dose at which 50% of animals tested show a therapeutic response is called the:
|
median effective dose
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Who is responsible for notifying customers of a drug recall? |
drug company
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Which name accurately describes the molecular structure of a drug and distinguishes it from all other drugs? *brand name *chemical name *generic name *trade name |
chemical name
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80% of New Drug Applications filed with the FDA are approved. True or False?
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False
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Each drug is assigned a 10-digit code, broken up into three segments. Which of the following is NOT information that can be obtained from the 10-digit National Drug Code? *the drug category *the name of the drug company *the drug's specific strength/dose *the package size and type |
the drug category
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In which phase of testing are the pharmacodynamics of a drug explored? *animal testing *Phase I human testing *Phase II human testing *Phase III human testing |
animal testing
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Due to Penicillin G being destroyed by stomach acid, its chemical structure was changed by molecular manipulation to Ampicillin. This is an example of: |
an isomer
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Drugs can be created or designed using all of the following techniques, EXCEPT: |
observing the toxic effects
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Which of the following is NOT one of the four large muscles recommended for intramuscular injection in adults? *triceps *deltoid *ventrogluteal *vastus lateralis |
triceps
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When a tablet is scored across its top surface, that indicates:
|
that it can be broken into two or more doses
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Monica Thompson's antacid drug bottle has this printed on the label: "Shake Well Before Using." That is because this drug is a/an:
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suspension
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A film is a thin drug form about the size of a postage stamp that is given by the________ route of administration. a. transbuccal b. topical c. sublingual d. both a and c |
both a and c
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The drugs in transdermal patches are designed to have only a topical, local effect on the skin in that area. True or False?
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False
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A child with high fever and severe nausea and vomiting might receive Tylenol in the form of a:
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Suppository
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Syrups and elixirs
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Solutions in which the drug is dissolved in a liquid base and used for topical or oral administration
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Vials and ampules
|
Solutions in which the drug is dissolved in sterile water or saline for injection into the body tissue or the blood.
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Gels and emulsions
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Solutions in which the drug form remains separate from the base, but is still evenly distributed throughout the solution
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Which of the following describes a drug form which is a semisolid emulsion of oil and water, the main ingredient being oil? *ointment *cream *lotion *gels |
ointment
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|
Why are many over-the-counter drugs now in caplet or tablet form instead of a capsule?
|
Tylenol capsules were contaminated with cyanide in the 1980's
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Which of the following drug trade names is NOT in the form of a pellet, bead, wafer, or insert? *Muse *Nexium *Mirena *Septopal |
Nexium
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The word aqueous means _________, while the word viscous means __________. *topical; skin *liquid; solid *intravenous; oral *watery; thick |
watery; thick
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|
Enteric-coated tablets:
|
are made to dissolve in the alkaline environment of the small intestine
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A __________ is an oblong tablet that has a base of sugar and disintegrates into a paste to release the drug topically in the mouth.
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troche
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Which of the following is designed to contain multiple doses of a drug. It comes in a small glass bottle with a rubber stopper on top.
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vial
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A. D.
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right ear
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A. S.
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left ear
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A. U.
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both ears
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O. D.
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right eye
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O. S.
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left eye
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O. U.
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both eyes
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oral
|
most commonly used
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topical
|
applying a drug directly on the skin or in eyes and ears
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transdermal
|
effect is systemic and is given in the form of a patch
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inhalation
|
given in a liquid, powder, or gas form, absorbed through the alveoli
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|
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intravesical
|
used to treat pain burning and inflammation of the bladder
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intradermal
|
used for allergy skin tests and TB skin tests
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subcutaneous
|
used to give shots of insulin
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intravenous
|
injection of a liquid drug into a vein
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intra-articular
|
administering a drug into a joint
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|
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intrathecal
|
administering drugs into the cerebrospinal fluid
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|
|
intra-arterial
|
used to administer chemotherapy drugs directly into the area of a cancerous tumor
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|
|
sublingual
|
given under the tongue
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|
|
When intravenous fluids are accidently administered into the subcutaneous tissues instead of into a vein, this is known as:
|
extravasation
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|
|
Trace amounts of a drug can be excreted in all of the following except: *saliva and tears *breast milk. *sputum *sweat |
sputum
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|
Which of the following is not one of the steps involved in the drug cycle? *absorption *distribution *metabolism *secretion |
secretion
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|
|
The first-pass effect describes the:
|
metabolism of drugs by the liver
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|
|
Oral drugs that are in liquid form do NOT go through which of the following steps? *absorption *disintegration *dissolving *excretion |
disintegration
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|
|
Drugs that are not absorbed after oral administration:
|
can be used to treat diseases of the stomach and intestine
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|
|
Drug doses for an elderly patient are decreased because of the patient's decreased:
|
liver and kidney function.
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|
|
Drugs circulate in the blood bound to:
|
plasma proteins platelets
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|
|
Drugs given by _____________ administration entirely bypass the step of absorption.
|
intravenous
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|
|
As a drug leaves the blood and moves through all the body tissues, it comes in contact with:
|
receptors
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|
|
Which type of drug would have the therapeutic effect to bind to receptor sites and block body hormones, enzymes, neurotransmitters or other drugs from unlocking and activating the receptor?
|
antagonist
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|
|
The principal organ of drug excretion is the kidney. True or False?
|
True
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|
|
A drug that is actually administered in an inactive form and remains inactive until they are metabolized by the liver is a/an;
|
Prodrug
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|
|
One area of the body where drugs are not readily distributed Is the:
|
Blood-brain barrier
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|
|
A drug that is able to unlock or activate a receptor and produce an effect is known as a/an _____________ drug.
|
agonist
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|
|
A black box warning in the drug's package insert is used to call attention to:
|
fatal adverse reactions
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|
|
Which of the following is an example of a paradoxical drug effect? *pollen and antibodies combine to produce an allergy *antibiotic drug producing ototoxicity *a drug for irritable bowel being taken off the market *amphetamine stimulant drugs used to decrease hyperactivity in children |
amphetamine stimulant drugs used to decrease hyperactivity in children
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|
|
Which of the following drugs given in different forms can produce a local or systemic effect? *Nitroglycerin *Prozac *Benadryl *Lipitor |
Benadryl
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|
|
Which type of receptor responds to histamine?*Adrenergic Alpha 1, *Alpha 2 *H1, H2 *Beta 1, Beta 2 |
H1, H2
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|
|
Which type of receptors respond to epinephrine?
|
Beta 1, Beta 2
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|
|
Accutane, a drug approved by the FDA for cystic acne, was found to have possible links to:
|
Suicide
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|
|
A drug that has a low therapeutic index, such as Digoxin, has a high probability to exert a/an ___________ effect.
|
toxic
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|
|
A drug's main action for which it was prescribed by the physician or other healthcare provider is the :
|
Therapeutic effect
|
|
|
Drugs administered by inhalation can exert a topical effect or a systemic effect. True or False?
|
True
|
|
|
The placenta does not allow any drugs to pass from maternal circulation to the fetus. True or False? |
False
|
|
|
Which type of receptors are activated by the neurotransmitter acetylcholine from the parasympathetic division of the nervous system?
|
Cholinergic receptors
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|
|
Drug formulary –
|
a list of all the drugs that are approved for use in the hospital and are stocked by the hospital pharmacy. Also a list of drugs that are approved by a patient’s insurance plan.
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|
|
Agonist drug –
|
category of drugs that takes the place of a substance normally produced by the body, or stimulates a specific receptor on the cell membrane normally activated by that substance. Unlocks the receptor, and activates a response. The response is like that of the substance that normally activates that receptor.
|
|
|
Adverse drug reaction –
|
A drug effect that is a severe and dangerous side effect. Adverse effects are not as common as side effects, and so some adverse effects of a drug become apparent only after the drug has been taken by a large number of patients over time.
|
|
|
Anaphylaxis –
|
The most severe form of an allergic reaction. The release of massive amounts of histamine causing bronchospasm, shock, and even death.
|
|
|
Antagonism –
|
Condition in which 2 drugs taken together combine to produce an effect that is less than the intended effect for either drug.
|
|
|
Antagonist drug –
|
Category of drugs that binds to specific receptors on the cell membrane and blocks the substance in the body that normally activates that receptor, also can block another drug from activating that receptor.
|
|
|
Black box warning –
|
warning information about a serious adverse effect associated with a particular prescription drug.
|
|
|
Chronotherapy –
|
method of drug therapy that attempts to coordinate the administration and metabolism of a drug to the body’s own biological rhythms.
|
|
|
Metric system –
|
the predominant system of measuring drug doses that is used in the United States and internationally. Weight is measured in kilograms, grams, and micrograms. Volume is measured in liters and milliliters. Length is measured in meters, centimeters, and millimeters. Officially known as the International System of Units.
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|
|
Milliequivalent –
|
unit of measurement from the metric system for drug doses. Doses of potassium are measured in milliequivalents. Abbreviated as mEq.
|
|
|
Pharmacodynamics –
|
the mechanism of action by which drugs produce their effects (desired or undesired) based on time and dose.
|
|
|
Pharmacogenetics –
|
The study of how the genetic makeup of different people affects their response to certain drugs.
|
|
|
Pharmacotherapy –
|
using drugs to affect the body therapeutically to prevent disease, to diagnose disease, or to treat disease.
|
|
|
Polypharmacy –
|
situation in which the physician prescribes more prescription drugs for a patient that are needed, or the patient is taking many different prescription and over the counter drugs at the same time without the knowledge of the physician. This increases the likelihood of a drug-drug interaction.
|
|
|
Receptor –
|
structure on the cell membrane that binds to substances in the body or to substances introduced into the body. Binding to a substance causes the receptor to be stimulated or to be blocked so that other substances cannot bind to it
|
|
|
Synergism –
|
condition in which 2 drugs take combine to produce an effect that is greater than the independent effect of each drug and can be either beneficial or detrimental.
|
|
|
Therapeutic effect –
|
drug action that is the intended action to prevent, control, improve, or cure symptoms or diseases of a physiological or psychological nature. The main effect for which the drug was prescribed.
|
|
|
Automatic stop order –
|
a drug order that originates with the hospital pharmacy has a limited duration. Drug is stopped until the physician writes another order. All medications are stopped when a patient is discharged.
|
|
|
Compounding –
|
preparing, mixing, and packaging drug ingredients, often under sterile conditions.
|
|
|
Stat order –
|
drug that the physician orders to be dispensed and administered immediately.
|
|
|
e-prescribing –
|
The use of an electronic prescription that is generated by a computer and signed with the physician’s digital electronic signature.
|
|
|
Generic substitution –
|
Even if a physician orders a trade name drug, pharmacies will fill a prescription with a generic drug unless the physician indicates “Brand Medically Necessary” or checks a box that says, “Dispense as Written” or “No Substitutions” on the prescription form.
|
|
|
Medication Administration Record –
|
record in which the nurse charts any drugs administered to the patient.
|
|
|
Medication order –
|
a written record of a physician’s order to the pharmacist to dispense a drug to a patient who is in a hospital or other healthcare facility y writing on the physician’s order sheet or physician’s order record in the paper medical record in an electronic patient record, it is typed into the computer on a designated screen.
|
|
|
Medication therapy management –
|
group of services that helps manage a patient’s drug therapy by facilitating communication between the patient, pharmacist, and physician to coordinate drugs, prevent medication errors, and improve patient compliance
|
|
|
Off-label use –
|
use of an FDA – approved drug to treat a different disease or to give by a different route or dose from what it was originally approved for. This often results in a good therapeutic effect and its use in that way becomes commonly known and widespread.
|
|
|
Pharmacist –
|
healthcare professional with an advanced degree in pharmacy
|
|
|
Pharmacoinformatics –
|
the use of a computerized data base to store drug information and automate its retrieval when needed.
|
|
|
Pharmacy –
|
a site where drugs are stored, prepared, and dispensed to patients or consumers.
|
|
|
Pharmacy technician –
|
person who has training, knowledge, and skills in drugs
|
|
|
Prescription –
|
a handwritten, computerized, electronic, or verbal order from a physician or other qualified healthcare provider to a pharmacist, giving instruction on how to dispense a drug to a specific patient.
|
|
|
Standing order –
|
group of specific drug orders that are part of a preprinted protocol of standardized, commonly used orders that are the same for any patient who has the same disease or is scheduled for the same surgical procedure.
|
|
|
In vitro testing –
|
testing of a drug that is done in a lab in a test tube. Latin, “in glass”
|
|
|
Give an example of a synergistic drug-drug interaction
|
Tylenol is combined with Codeine to provide more complete pain relief than either drug alone can provide.
|
|
|
Give an example of an antagonistic drug-drug interaction.
|
Tetracycline taken with an antacid drug combine in the stomach and they form an insoluble compound that prevents either drug from exerting a therapeutic effect
|
|
|
To what system measurement do the words cubic centimeter and milliliter belong?
|
The metric system.
|
|
|
What is the only system of measurement that uses fractions?
|
Inch
|
|
|
Name a drug that is measured in units, one that is measured in inches, and one that is measured in milliequivalents?
|
Units - Insulin, Inches - Nitroglycerin Ointment, Milliequivalents – Potassium
|
|
|
A milliliter is equivalent in volume to a cubic centimeter. True or False?
|
True
|
|
|
p.r.n. –
|
as needed
|
|
|
a.c. –
|
before meals
|
|
|
b.i.d. –
|
twice a day
|
|
|
g –
|
gram
|
|
|
h.s. –
|
at bedtime (hour of sleep)
|
|
|
mcg –
|
microgram
|
|
|
mg –
|
milligram
|
|
|
mL –
|
milliliter
|
|
|
mEq. –
|
milliequivalents
|
|
|
t.i.d. –
|
three times a day
|
|
|
How is a pediatric drug dose calculated for a premature baby?
|
The baby’s weight in kilograms. Drugs are weighed in milligrams and sometimes in micrograms. They use the weight of each to determine the dosage. The dosage is expressed as mg/kg/day, due to babies weight changing frequently.
|
|
|
How is a chemotherapy drug dose calculated for an individual patient with cancer?
|
Doses are calculated on the patients’ total body surface area. They are expressed as mg/m2 – milligrams of drug per meter squared of body surface area.
|
|
|
Name the 14 components of a Prescription.
|
a. Identifying information about the physician b. Identifying information about the patient c. Patient’s age and weight d. Date e. Rx f. Drug name g. Drug strength h. Drug form i. Quantity to be dispensed j. Directions for use k. Signature l. Refills m. Generic substitution n. DEA number
|
|
|
What precautions should be taken to prevent the theft of prescription pads from a medical office?
|
Store extra prescription pads in a locked drawer or closet. Have the dr. carry just one prescription pas on his or her person from examining room to room. Never leave a prescription pad on the counter or in an unlocked drawer in the examining room. The dr. should sign the prescription form only at the time he or she writes the prescription. It is against federal law for a dr. to pre sign blank prescription for schedule drugs. The use of an electronic patient record and e-prescribing decreases the need for written prescriptions and prescription pads and eliminates these problems.
|
|
|
What precaution is taken to prevent prescriptions from schedule drugs from being written by an unlicensed individual?
|
It is against federal law for a dr. to pre sign blank prescription for schedule drugs.
|
|
|
What precaution is taken to prevent additional medication orders from being illegally inserted after the physician signs a paper physician’s order sheet?
|
The dr. signs his or her name and M.D. directly below the last medication order, not at the bottom of the page. This prevents any from illegally inserting additional medication orders at a later time because of blank space left above the dr.’s signature.
|
|
|
How can a physician indicate on the prescription that the patient should receive a trade name drug and not a generic drug equivalent?
|
Checking a preprinted box that says “dispense as written” “DAW” or by writing or checking a box for “No Substitution” or “Do Not Substitute” or “Brand Necessary” or “Brand Medically Necessary”
|
|
|
What would you tell a patient about how to safely store and dispose of his/her drugs?
|
Most pharmacies will accept your unused drugs and dispose of them properly, often by incinerating them. For narcotic or schedule drugs, the police department may have a program to dispose of them properly. If you need to dispose of drugs yourself, do not put them in the trash or flush them down the toilet. Instead, crush or dissolve the drugs in a small amount of water and them mix them with coffee grounds, kitty litter, or another inedible substance. Put this in a plastic bag, seal it, and put it in the trash.
|
|
|
DEA –
|
Drug Enforcement Administration
|
|
|
Rx -
|
prescription
|
|
|
Sig. –
|
write or print on these instructions on the drug label
|
|
|
# -
|
number, pounds
|
|
|
NR –
|
no refills
|
|
|
DAW –
|
dispense as written
|
