HOSA Pharmacy Science

examples of ADCs:

-Pyxis (cardinal health) -AcuDose-Rx (McKesson) -Omnicell -Rx-Station (cerner) -Med-Select (Amerisource Bergen)

examples of some medications requiring MedGuide are:

-accutane -antidepressants -birth control -NSAIDs -medications for ADD including adderall, concerts, ritalin, and stattera

the labeling of unit doses must contain specific information:

-drug name -strength of medication -name of original manufacturer -original lot number and expiration date of manufacturer -bar code -facility expiration date

Benefits of unit dose are:

-easy for nurse dispensing to patients -cuts down on medication errors (each unit dose may be bar-coded) -less waste of medication

some examples of symtptoms requiring a PRN medication could be:

-fever -pain -anxiety or restlessness -itching -coughing -sneezing

the patient package insert includes:

-how the drugs works -what to do if a dose is missed -contraindications -warnings -side effects -overdose information -dosages and packing information -indications and use

parts of the prescription:

-inscription -signa -subscription -superscription

ISMP has created:

-medication errors reporting program (MERP)- a voluntary reporting program -list of unsafe abbreviations -list of look-alike/sound-alike drugs to be dispensed carefully

Patient profile contains the following information:

-name -address -phone number -DOB -gender -allergy information -medical information -insurance information -prescriptions filled -preference for child-resistant containers -may contain other preferences, such as generic substitution or large-print labels

Specific information is required to be print on the label including:

-pharmacy name, address, and telephone number -patient's name -date prescription was filled -prescriber's name -prescription Rx number -medication name and strength -directions for use -quantity of medication -refills allowed -initials of pharmacist dispensing prescription

examples of allergy indicators:

-rash -watery eyes -swelling -itching -wheezing

I

1

2.2 lb

1 kg

100 units

1 ml

1 mg

1, 000 mcg

1 L

1, 000 ml

1 g = _____mcg

1, 000,000

1 g = ________mg

1,000

1 kg = _______g

1,000

M

1,000

1 kg = _______mg

1,000,000

1 kg = _______mcg

1,000,000,000

X

10

C

100

1 gallon = _______fl oz

128

1 tblsp = _____ml

15

1 cup = ______tblsp

16

1 gallon = _______cups

16

1 pint = ________ fl oz

16

1 lb

16 oz

1 quart = ______tsp

192

1 fl oz = _______tblsp

2

1 pint = ________cups

2

1 quart = ______pints

2

II

2

XX

20

8 fl oz

240 ml

1 gallon = _______tblsp

256

III

3

1 tblsp

3 tsp

1 oz

30 g

1 fl oz

30 ml

1 pint = ________ tblsp

32

1 quart = ______fl oz

32

1 gallon = _______ quarts

4

1 quart = ______cups

4

IV

4

1 lb = ______g

454

1 cup = ______tsp

48

16 fl oz

480 ml

V

5

1 dram

5 ml

1 tsp

5 ml

L

50

D

500

1 fl oz = _______tsp

6

VI

6

1 quart = ______tblsp

64

1 grain

65 mg

VII

7

1 gallon = _______tsp

768

1 cup = ______fl oz

8

1 gallon = _______pints

8

VIII

8

IX

9

1 pint = ________ tsp

96

32 fl oz

960 ml

documentation required by the FDA for generic drug makers; requires generic drugs to demonstrate bioequivalence to the brand name product, but does not require the same testing and clinical trials

Abbreviated New Drug Application (ANDA)

ADME

Absorption, Distribution, Metabolism, Excretion/Elimination

Drug Class: ? Mechanism of Action: elevate the pain threshold and suppress prostaglandin synthesis Indication: can be used for mild to moderate pain and fever reduction Side effects: - Examples: - Special consideration: -can be taken during pregnancy- does not cause GI problems, but can cause liver damage if taking over 3,000 mg per day

Acetaminophen (Tylenol)

Brand Name: Tylenol with Codeine Drug Class: opioid analgesic Indication: treatment of mild to moderate pain Controlled: YES

Acetaminophen with Codeine Phosphate; C-3

Brand Name: Zovirax Drug Class: antiviral Indication: treatment of genital, herpes zoster (shingles), and other viral infections Controlled: no

Acyclovir

a product that may be contaminated, packaged under unsanitary conditions, prepared in containers that are composed of unsafe substances, have unsafe additives, or differ in strength, quality, or purity from what the drug is claiming to be

Adulterated Product

when a patient receives a medication at a normal dosage range but experiences a harmful reaction as a result of the medication

Adverse drug reaction (ADR)

-to increase access to healthcare for uninsured Americans -universal healthcare coverage to be in effect by 2014 for all citizens of the United States

Affordable Care Act of 2010 (ACA)

Brand Name: Proair HFA, Proventil HFA, Ventolin HFA Drug Class: bronchodilator, anti asthmatic (inhalation) Indication: treatment of asthma and bronchospasms Controlled: no

Albuterol Sulfate

Brand Name: Fosamax Drug Class: osteoporosis agent--bisphosphonate Indication: treatment of osteoporosis Controlled: no

Alendronate Sodium

Brand Name: Zyloprim Drug Class: agent for gout Indication: treatment of gout or kidney stones Controlled: no

Allopurinol

Drug Class: ? Mechanism of Action: block peripheral alpha receptors, which relaxes smooth muscle, especially in the prostate--this helps reduce urinary symptoms associated with benign prostatic hyperplasia (BPH) Indication: used for the treatment of prostate disease Side effects: - Examples: -alfuzosin-doxazosin-dutasteride-tamsulosin-terazosin Special consideration: -

Alpha Blockers

Drug Class: ? Mechanism of Action: inhibits bacterial protein synthesis Indication: life-threatening infections Side effects: nephrotoxicity and ototoxicity Examples: -gentamicin-amikacin Special consideration: doses are adjusted on a patient-specific basis and measured daily to ensure no toxicity is occurring

Aminoglycosides

Brand Name: Cordarone, Pacerone Drug Class: anti arrhythmic Indication: treatment of ventricular fibrillation and tachycardia Controlled: no

Amiodarone

Brand Name: Elavil (not available in U.S) Drug class: tricyclic antidepressant (TCA) Indication: treatment of depression

Amitriptyline Hydrochloride

Brand Name: Lotrel Drug Class: antihypertensive (combination calcium channel blocker and ACE inhibitor) Indication: treatment of hypertension Controlled: no

Amlodipine Besylate with Benazepril Hydrochloride

Brand Name: Amoxil, Trimox Drug Class: antibiotic--penicillin Indication: treatment of bacterial infections of the ear, nose, throat, skin, and respiratory tract, and for the treatment of gonorrhea Controlled: no

Amoxicillin Trihydrate

Brand Name: Augmentin, Augmentin ES-600, Augmentin XR Drug Class: antibiotic--penicillin Indication: treatment of bacterial infections, including sinusitis and otitis media Controlled: no

Amoxicillin with Clavulanate Potassium

Brand Name: Adderall Drug Class: CNS Stimulant Indication: treatment of attention deficit disorder with hyperactivity (ADHD) and narcolepsy Controlled: YES

Amphetamine and Dextroamphetamine Salts; C-2

a sealed container made from glass that has an elongated neck

Ampule

designated anabolic steroids as a C-2 substance due to misuse by athletes

Anabolic Steroid Control Act of 1990

Drug Class: ? Mechanism of Action: block ACE, which prevents the conversion of angiotensin I to angiotensin II, and thus reduces vasoconstriction and blood pressure Indication: used for the treatment of hypertension Examples: -benazepril-enalapril-lisnopril-quinapril-ramipril Special consideration: should be avoided in patients taking potassium sparing diuretics

Angiotensin Converting Enzyme (ACE) inhibitors

Drug Class: ? Mechanism of Action: block ARBs and vasoconstriction from occurring, thus lowering blood pressure Indication: used for treatment of hypertension Side effects: - Examples: -irbesartan-losartan-olmesartan-valsartan Special consideration: -

Angiotensin II receptors Blockers (ARBs)

Drug Class: ? Mechanism of Action: neutralize stomach acid Indication: used for treatment of gastroesophageal reflux disease (GERD), and heartburn Side effects: - Examples: aluminum hydroxide-magnesium hydroxide-simethicone(Mylanta, Maalox)-magnesium hydroxide (Milk of magnesium)-calium carbonate (Tums) Special consideration: available OTC

Antacids

area where pharmacy personnel prepare for sterile compounding. including: -garbing -hand washing -gathering supplies

Anteroom

Drug Class: ? Description of condition: Alzheimer's disease is a neurodegenerative disease that leads to dementia Indication: used to treat symptoms of Alzheimer's disease Side effects: - Examples: donepezil-gingko-memantine-rivastigmine Special consideration: drugs can slow disease, but not cure or reverse effects

Anti-Alzheimers disease agents

Drug Class: ? Description of condition: acne vulgarism generally starts at puberty due to an increase in sebum secretion fro sebaceous glands Indication: used for the treatment of acne Side effects: - Examples: -adapalene-clindamycine with benzyl peroxide-isotretinon Special consideration: products can come in many different dosage forms; isotretinoin patients must participate in the iPLEDGE program, which requires females to undergo pregnancy test and be on oral contraceptives prior to use

Anti-acne agent

Drug Class: ? Description of condition: Parkinson's disease is characterized by muscular difficulties, including tremors and loss of muscle control; generally affects patients over age 60 Indication: used to treat symptoms of Parkinson's disease Side effects: - Examples: levodopa-carbidopa--amantadine-benztropine-ropinirole Special consideration: side effects are a problem and sometimes require constant change in medication

Anti-parkinson's agent

Drug Class: ? Description of condition: angina is a disease marker by severe chest pain due to an insufficient amount of blood carrying oxygen Indication: used for treatment of angina Type: -beta blockers-calcium channel blockers-nitrates Examples: - Special consideration: treatment of aimed at reducing angina attacks and preventing a heart attack

Antianginal agents

Drug Class: ? Mechanism of Action: anxiety is characterized by a state of uneasiness and apprehension about possible events Indication: used to treat anxiety resulting from either external events or internal neurological imbalance Side effects: - Examples: -benzodiazpines-buspirone Special consideration: some agents may cause dependence and are abused--many are controlled substances

Antianxiety agents

Drug Class: ? Description of condition: arrhythmias result when the ventricular and atrial contractions are not synchronized; can included tachycardia, atrial flutter, and fibrillation Indication: used for the treatment of arrhythmias Types:-channel blockers--membrane-stabilizing agents--potassium channel blockers Examples: - Special consideration: -

Antiarrhythmics

Drug Class: ? Description of condition: asthma is an inflammatory condition of the lungs that causes airway constriction; characterized by wheezing, coughing, and difficulty breathing Indication: used to treat asthma and breathing disorders Side effects: - Drug classes: -bronchodilators-corticosteroids-leukotriene inhibitors-mast cell stabilizers-xanthine derivatives

Antiasthmatics

Drug Class: ? Mechanism of Action: prevent the formation of clots of inhibiting clotting factors in the blood Indication: used for the prevention of blood clots Side effects: - Examples: -heparin-warfarin Special consideration: patients should avoid foods with Vitamin K when taking warfarin heparin is always given via IV or subcutaneously; patients must always be monitored while on this; cannot dissolve clots that are already present, but only prevent others from occurring

Anticoagulant

Drug Class: ? Description of condition: Type 1 diabetes--patient is unable to produce any insulin, requires insulin therapy. Type 2--patients body does not respond to insulin secretion, or has impaired insulin secretion. Gestational--results from pregnancy. Secondary--results from another medication Treatment methods: depends on type of diabetes; can be treated with insulin or oral hypoglycemic medications

Antidiabetics

Drug Class: ? Mechanism of Action: inhibit the impulse that goes from the chemoreceptor trigger zone, or part of the brain that induces vomiting to the stomach Indication: used for the treatment of nausea Side effects: Dizziness and drowsiness Examples: -metoclopramide-ondansetron-promethazine Special consideration: -

Antiemetics

Drug Class: ? Description of Condition: epilepsy is a disorder characterized by recurrent seizures Indication: used to treat epilepsy Side effects: - Examples: -carbamazepine-clonazepam-divalproex-lamotrigine-levetiracetam-pregabalin-topiramate-phenytoin sodium Special consideration: can cause sedation and loss of cognition, so poor compliance is an issue; large number of drug interactions can occur

Antiepileptic/Anticonvulsant

Drug Class: ? Mechanism of Action: kill fungal by exploiting key difference between fungal and human cells Indication: infections caused by fungus including athlete's foot, ringworm, oral candidiasis (thrush), and vaginal yeast infections Side effects: - Examples: -nystatin-amphotericin-clotrimazole Special consideration: many end in -zole

Antifungal

Drug Class: ? Mechanism of Action: block histamines from working on the H, in the respiratory system Indication: used to provide relief of allergy symptoms caused by the release of histamines Side effects: - Examples: -diphenhydramine-fexofenadine-loratadine Special consideration: can cause drowsiness and should not be taken by pregnant women

Antihistamines

Drug Class: ? Description: elevation of cholesterol levels; above 240 mg per 100 ml of blood is "at risk" Indication: used for the treatment of high cholesterol Side effects: - Types: -bile acid sequestrates-fibric acid derivatives-HM-CoA reductase inhibitors-combination drugs Special consideration: -

Antihyperlipidemics

Drug Class: ? Description of condition: hypertension is high blood pressure, which consists of pressure at least 140/90 mmHg or higher on a consistent basis Indication: used for the treatment of hypertension Side effects: - Types: -diuretics--angiotensin-converting enzyme (ACE) inhibitors--angiotensin-II receptor blockers (ARBs)--beta blockers--calcium channel blocker--combination products Special consideration: -

Antihypertensive

Drug Class: ? Description of condition: cancer is a disease of uncontrolled abnormal cellular growth Indication: used for the treatment of cancer Side effects: - Examples: -alkylating agents-antibiotics-antimetabolites-hormones-nitrogen mustards-plant alkaloids Special consideration: chemotherapy drugs must never be handled by technicians who are pregnant

Antineoplastics

Drug Class: ? Mechanism of Action: interfere with reaction that cause platelets to clot Indication: used for the prevention of blood clots Side effects: - Examples: -aspirin-clopidogrel Special consideration: patients should not start aspirin therapy without first consulting their doctors

Antiplatelet

Drug Class: ? Description of Condition: schizophrenia is a chronic psychiatric illness that may include delusions, hallucinations, and bizarre behavior. Mechanism of Action: block dopamine receptors in the brain, which helps control emotions Indication: used to treat schizophrenia Side effects: - Examples: Atypical: -aripiprazole-clozapine-olanzapine-quetiapine-risperidone-ziprasidone-Typical: -prochlorperazine-haloperidol Special consideration: antipsychotics have very desirable side effects, including tradeoff disking, which involves involuntary movements of the mouth, lips, and sometimes limbs; atypical antipsychotics are newer drugs that tend to have fewer side effects than typical antipsychotics

Antipsychotics

Drug Class: ? Indication: used to treat infections caused by HIV/AIDS Classes: -Nucleoside Reverse Transcriptase Ihibitors (NRTIs)-Nonnucleoside Reverse Transcriptase Inhibitors (NNRTIs)-Protease Inhibitors (PIs)-Fusion Inhibitors

Antiretroviral

Drug Class: ? Mechanism of Action: suppression of the cough, reflex in the brain or nerve receptors along the respiratory system Indication: used to provide relief of cough, especially dry or nonproductive coughs Side effects: - Examples: codeine-dextromethorphan-benzonatate Special consideration: codeine is a very effective agent, but is a controlled substance for its abuse potential

Antitussives

Drug Class: ? Mechanism of Action: inactivate enzymes needed for viral replication Indication: used to treat infections caused by viruses including herpes, hepatitis, and influenza Side effects: - Examples: acyclovir-valacyclovir-famciclovir Special consideration: many agents end in -vir

Antiviral

Brand Name: Abilify Drug Class: antipsychotic--atypical Indication: treatment of schizophrenia and bipolar disorder Controlled: no

Aripiprazole

the process used to prepare CSPs; this technique is vital to avoid microbial contamination of the medication being compounded

Aseptic Technique

Drug Class: ? Mechanism of Action: inhibit prostaglandin synthesis Indication: can be used for mild pain, fever reduction, and inflammation Side effects: - Examples: - Special consideration: -should not be given to children who have been exposed the chickenpox--can cause Reye's syndrome- should not be given to patients on warfarin-should not be taken by pregnant women

Aspirin

Brand Name: Tenormin Drug Class: Antihypertensive--beta blocker Indication: treatment of hypertension (high BP) Controlled: no

Atenolol

Brand Name: Asetlin Drug Class: antiallergic agent--antihistamine (nasal spray) Indication: treatment of seasonal rhinitis and allergy symptoms Controlled: no

Azelastine Hydrochloride

Brand Name: Zithromycin, Z-Pack, Z-max Drug Class: antibiotic--macrolide Indication: treatment of lower and upper respiratory tract infections, bacterial sinusitis, acute otitis media, and other bacterial infections Controlled: no

Azithromycin Dihydrate

Brand Name: Lioresal Drug Class: muscle relaxant Indication: used to control muscle spasms, especially those associated with multiple sclerosis Controlled: no

Baclofen

can also be used to measure larger volumes of liquid, but less accurate than a graduated cylinder

Beaker

Brand Name: Lotensin Drug Class: antihypertensive--ACE Inhibitor Indication: treatment of high BP Controlled: no

Benazepril Hydrochloride

Drug Class: ? Mechanism of Action: enhance the effect of the neurotransmitter game amino butyric acid (GABA), which results in sedation and relaxing properties Indication: used to treat anxiety Side effects: - Examples: -alprazolam-diazepam-lorazepam Special consideration: are all schedule IV controlled substances ; cause drowsiness and sedation

Benzodiazepines

Brand Name: Tessalon Perles Drug Class: antitussive Indication: relief of cough Controlled: no

Benzonatate

Brand Name: Cogentin Drug Class: Antiparkinson agent Indication: treatment of the symptoms of Parkinson's disease Controlled: no

Benztropine Mesylate

Drug Class: ? Mechanism of Action: block beta receptors, which decreases heart rate and lowers blood pressure Indication: used for the treatment of hypertension Side effects: - Examples: -atenolol-carvedilol-propanolol Special consideration: contraindicated in patients with asthma

Beta blockers

the date after which a product must not be dispensed or used (expiration date); this is determined by the pharmacist based on when the product is prepared and its storage conditions

Beyond Use Dating

Drug Class: ? Mechanism of Action: prevent the bone from being reabsorbed and broken down by osteoclasts Indication: used to treat osteoporosis Side effects: - Examples: -alendronate-ibrandronate-risedronate Special consideration: should be taken before the first meal of the day and with 6 to 8 oz of water--patient must also remain upright for a least half an hour after taking to prevent heartburn

Bisphosphonates

Drug Class: ? Mechanism of Action: draw a large amount of water into the bowels, which creates watery stools Indication: used for the treatment of nausea Side effects: - Examples: polyethylene glycol-electrolyte solution Special consideration: eight ounces is taken every 10 minutes until 4 liters can be consumer; food should not be eaten at least 3 hours prior to administration

Bowel Evacuant Laxatives

proprietary name given by a drug manufacturer and protected by a patient

Brand Name

Drug Class: ? Mechanism of Action: relaxes smooth muscle cells of the bronchioles, resulting in an increase in airway diameter Indication: used to treat asthma, COPD, and chronic bronchitis Side effects:- Examples: -albuterol-ipratropium-salmeterol-tiotropium Special consideration: -

Bronchodilators

Brand Name: Symbicort Drug Class: anti asthmatic (inhalation) Indication: treatment of asthma and COPD Controlled: no

Budesonide and Formoterol Fumarate Dihydrate

Drug Class: ? Mechanism of Action: increase stool size, which promotes intestinal movement and bowel movement Indication: used for the treatment of constipation Side effects: - Examples: -psyllium hydrophilic muciloid Special consideration: patient must drink plenty of water to avoid further constipation, can be taken on a daily basis

Bulk-forming laxatives

Brand Name: Bumex Drug Class: diuretic--loop Indication: treatment of edema and hypertension Controlled: no

Bumetanide

Brand Name: Wellbutrin, Wellbutrin SR, and Wellbutrin XL, Zyban Drug Class: tricyclic antidepressant (TCA) Indication: treatment of depression Controlled: no

Bupropion Hydrochloride

Brand Name: Buspar Drug Class: antianxiety agent Indication: treatment of anxiety Controlled: no

Buspirone Hydrochloride

Brand Name: Fioricet Drug Class: analgesic Indication: treatment of headache Controlled: no

Butalbital, Acetaminophen, and Caffeine

Mineral: ? Chemical Symbol: Ca Use in the body: nerve and muscle function, bone and tooth formation

Calcium

Drug Class: ? Mechanism of Action: inhibit calcium ions from entering channels of the heart muscle, resulting in relaxation of smooth muscle and vasodilation Indication: used for the treatment of hypertension Side effects: - Examples: -amlodipine-diltiazem-nifedipine-verapamil Special consideration: -

Calcium Channel Blocker

sizes range from 5 (smallest) to 000 (largest)

Capsule Sizes

Brand Name: Tegretol, Carbatrol, Epitol, Equetro, Tegretol XR Drug Class: anticonvulsant Indication: treatment of seizures and nerve pain, may also be used for treatment of bipolar disorder Controlled: no

Carbamazepine

Brand Name: Sinemet Drug Class: Antiparkinson agent Indication: treatment of symptoms of Parkinson's disease Controlled: no

Carbidopa with Levodopa

Brand Name: Soma Drug Class: muscle relaxant Indication: relief of musculoskeletal conditions Controlled: YES

Carisprodol; C-4

Brand Name: Coreg, Coreg CR Drug Class: antihypertensive--beta blocker Indication: treatment of hypertension (high BP) Controlled: no

Carvedilol

Brand Name: Celebrex Drug Class: non steroidal anti-inflammatory drug-COX-2 inhibitor Indication: treatment of symptoms of osetoarthritis, rheumatoid arthritis, and other inflammatory conditions Controlled: no

Celecoxib

oversees all Medicare and Medicaid services; establishes conditions for a facility to be reimbursed for any services provided

Centers for Medicare and Medicaid Services (CMS)

Brand Name: Keflex Drug Class: antibiotic--cephalosporin Indication: treatment of bacterial infections, such as those that cause otitis media, strep throat, UTIs, and skin infections Controlled: no

Cephalexin Monohydrate

Drug Class: ? Mechanism of Action: prevents bacteria from forming cell wall Indication: upper respiratory infections, sinus infections, pneumonia Side effects: diarrhea, 1% chance of cross allergies if allergic to penicillin Examples: -cephalexin-cefdinir

Cephalosporin

a voluntary process in which an organization recognizes that an individual has met specific standards required for certification.

Certification

when two or more drugs are combined and are not compatible, a chemical change occurs that may alter pH of a solution or cause the decomposition of a component

Chemical Incompatibilities

a scientific name based on the structure of the chemical compound

Chemical Name

a container that cannot be opened by 80% of children under age 5 but can be opened by 90% of adults

Child-Resistant Container

Brand Name: Tussionex Drug Class: Antitussive Indication: treatment of cough Controlled: YES

Chlorpheniramine with Hydrocodone; C-3

Alternative Supplement: ? Common Use: osteoarthritis

Chondroitin; Glucosamine

Brand Name: Cipro, Cipro XR Drug Class: antibiotic--fluoroquinolone Indication: treatment of bacterial infections such as those that cause UTI, infectious diarrhea and gonorrhea Controlled: no

Ciprofloxacin Hydrochloride

Brand Name: Celexa Drug Class: antidepressant--selective serotonin reuptake inhibitor (SSRI) Indication: treatment of depression Controlled: no

Citalopram Hydrobromide

probability exists that use of the product or drug will lead to serious adverse health events or death -example: label mix-up of a lifesaving drug

Class I Recall

probability exists that use of this products or drug may cause adverse health events that will be reversible or temporary -example: a drug labeled with an understrength that is not a lifesaving drug

Class II Recall

a two-pan balance that has a capacity of 15 to 120 grams -can be used to weigh small amounts in the range of +/-5 mg -used with pharmaceutical weights -weighing paper in placed on pans to prohibit contact of medication with the balance -weighing boat can be used to weigh a larger quantity of a chemical

Class III Prescription Balance

probability exists that the use of this product will most likely NOT cause an adverse health event -example: container defect, off taste or smell

Class III Recall

place where hoods are housed to be used during sterile compounding; personnel should not enter unless properly garbed

Clean Room

Brand Name: Cleocin Drug Class: antibiotic Indication: treatment of serious respiratory tract infections and other serious bacterial infections; reserved for penicillin-allergic patients Controlled: no

Clindamycin hydrochloride

Brand Name: Klonopin Drug Class: antiepileptic (benzodiazepine) Indication: treatment of seizures Controlled: YES

Clonazepam; C-4

Brand Name: Catapres Drug Class: antihypertensive Indication: treatment of hypertension Controlled: no

Clonidine Hydrochloride

Brand Name: Lotrisone Drug Class: antifungal (topical combination product) Indication: tinea pedis (athlete's foot), tinea cruris (jock itch), and tine carpers (ringworm) Controlled: no

Clotrimazole with Bethamethasone Dipropionate

-monitor use of products that can be used to produce methamphetamine: ----pseudoepherine, ephedrine, and phenylpropanolamine -3.6 g per day products limit, and patients must show valid ID to obtain -medications stored behind the counter

Combat Methamphetamine Epidemic Act of 2005

the ability to combine two or more products without creating a change in the physical, chemical, or therapeutic effectiveness of the drug

Compatibility

also known as compounded sterile product, any drug that is compounded under sterile conditions

Compounded Sterile Preparation (CSP)

used to record all entries of each compounded prescription so a reference can be available and easily accessible. Lists the following information: -date of compound -Rx number -names of specific ingredients used, along with: ----expiration date ----lot number ----manufacturer ----NDC number -amount weighed or measured -name of compound -procedures detailing how compound was prepared -name of preparer and pharmacist checking

Compounding Log

to combat drug abuse and regulate prescription drug use of narcotics and controlled substances

Comprehensive Drug Abuse Prevention and Control Act of 1970 (CSA)

inventory must be taken every 2 years (exact count on C-2s and estimated on C-3--5

Controlled Substances Inventory

drugs that have a high risk for physical and psychological dependence and abuse, placed into one of five schedules based on potential for abuse

Controlled substances

the accidental introduction of small pieces of rubber from the top of a vial into the solution of medication; if this occurs, must discard vial

Coring

Drug Class: ? Mechanism of Action: inhibit the immune system to suppress inflammation Indication: used to treat inflammatory conditions, and suppresses the immune response Side effects: - Examples: prednisolone-prednisone-methlyprednisolone-triamcinolone-fluticasone-fluticasone and salmeterol Special consideration: inhaled: -patients must rinse mouth after use to prevent thrush. Oral: -long-term use can cause weight gain, buffalo hump, and moon face or facial hair in females, and breast development in males

Corticosteroids

done by the pharmacist to communicate with a patient any questions regarding medication or warnings and precautions that should be addressed -a technician must never do this for patients, but can ask whether a patient has any questions for the pharmacist

Counseling

Drug Class: ? Mechanism of Action: inhibit cyclooxyrgenase-2 enzymes that are produced during inflammation Indication: used to help treat the symptoms of rheumatoid arthritis and osteoarthritis, and other mild to moderate pain Side effects: - Examples: celecoxib Special consideration: all other inhibitors that have been withdrawn from the market except celecoxib

Cox-2 Inhibitors

Brand Name: Flexeril, Amrix, Fexmid Drug Class: muscle relaxant Indication: treatment of muscle spasms Controlled: no

Cyclobenzaprine Hydrochloride

default used when dispensing a generic drug or when dispensing a brand name product that does not have generic available

DAW 0

prescriber indicates dispense as written

DAW 1

patient requests brand name product

DAW 2

pharmacist requests brand name proud be dispensed

DAW 3

generic is not in stock, so the brand name product must be dispensed

DAW 4

brand dispensed but priced as generic

DAW 5

brand name is necessary; used for prior authorization cases

DAW 6

substitution not allowed; brand mandated by law

DAW 7

generic is not currently available; either not being manufactured or not being distributed

DAW 8

"other" DAW code?

DAW 9

submitted to the insurance company to determine if the proper brand name or generic medication is being dispensed

DAW codes

form completed by a pharmacy in the vent of a theft of a controlled substance. The pharmacy must notify the nearest DEA office and complete the form: theft of controlled substances

DEA Form 106

DEA Form used for ordering C-2 Medications--must be completed by a pharmacist only; ordering and returning C-2s

DEA Form 222

pharmacies must submit this form to register with the DEA prior to dispensing controlled substances; registering with the DEA

DEA Form 224

form must be submitter for destruction of controlled substances in the event of damaged or outdated medications; destruction of outdated or damaged controlled substances

DEA Form 41

Brand Name: Enablex Drug Class: urinary antispasmodic Indication: treatment of overactive bladder and urinary urgency and incontinence Controlled: no

Darifenacin Hydrochloride

Drug Class: ? Mechanism of Action: constrict the blood vessels in the nasal passages so mucous and fluid can drain and thus alleviate the feeling of stuffiness Indication: used to provide relief of nasal congestion from allergies sinusitis, and the common cold Side effects:- Examples: -pseudoephedrine-phenylephrine Special consideration: can increase blood pressure and heart rate, so should be avoided in patients with hypertension; can cause CSN stimulation. Pseudo ephedrine is regulated under the combat methamphetamine act, and its sale is limited to a certain quantity per month.

Decongestants

Brand Name: Pristiq Drug Class: antidepressant--serotonin and norepinephrine reuptake inhibitor (SNRI) Indication: treatment of depression Controlled: no

Desvenlafaxine

Brand Name: Valium Drug Class: antianxiety--benzodiazepine Indication: management of anxiety disorders Controlled: YES

Diazpam; C-4

Brand Name: Voltaren gel, Pennsaid, Solaraze Drug Class: NSAID- topical Indication: treatment of symptoms of osteoarthritis Controlled: no

Diclofenac Sodium

Brand Name: Voltaren, Voltaren-XR Drug Class: oral- non steroidal anti-inflammatory drug (NSAID) Indication: treatment of symptoms of osteoarthritis and rheumatoid arthritis Controlled: no

Diclofenac Sodium

Brand Name: Bentyl Drug Class: GI Antispasmodic Indication: treatment of irritable bowel syndrome Controlled: no

Dicyclomine Hydrochloride

-manufacturers of supplements are permitted to make claims not approved by the FDA, but they must still comply with purity and safety standards to protect patients and prevent adulteration

Dietary Supplement Health and Education Act of 1994 (DSHEA)

uses one pan and a digital or analytical readout for weighing ingredients -easier to use than a class III balance and more accurate

Digital Balance

Brand Name: Digitek, Lanoxin, Lanoxicaps Drug Class: cardiac glycoside Indication: used for treatment of heart failure, atrial fibrillation and flutter, and tachycardia Controlled: no

Digoxin

Brand Name: Cardizem, Cardizem SR, Cardizem CD, Cardizem LA, Cartia XT, Dilacor XR, Dilt-CD, Dilt-XR, Diltia XT, Diltzac, Taztia XT, Tiazac Drug Class: Antihypertensive--calcium channel blocker Indication: treatment of hypertension; can also be used for treatment angina Controlled: no

Diltiazem Hydrochloride

a liquid used to reconstitute a powder medication before it is injected into a patient or another IV solution -sterile water -normal saline

Diluent

Brand Name: Lomotil Drug Class: antidiarrheal Indication: treatment of diarrhea Controlled: YES

Diphenoxylate Hydrochloride; C-5

Brand Name: Aggrenox Drug Class: anti platelet agent Indication: reduce the risk of stroke and blood clots Controlled: no

Dipyridamole and Aspirin

Drug Class: ? Mechanism of Action: - Indication: to treat rheumatoid arthritis Side effects: - Examples: -abatacept-adalimumab-etanercept-methotrexate Special consideration: helps slow the progression of the disease, but use is limited by side effects

Disease-Modifying Antirheumatic Agents (DMARDs)

Drug Class: ? Mechanism of Action: used to maintain the balance of water, electrolytes, and acids and bases Types: -loop-potassium sparing-thiazides-combination Special consideration: should be avoided at bedtime to prevent frequent urination at night

Diuretics

Brand Name: Depakote, Depakote ER, Depakote Sprinkles Drug Class: antiepileptic Indication: treatment of seizures, bipolar disorders, and migraine prophylaxis Controlled: no

Divalproex Sodium

Brand Name: Aricept Drug Class: antipsychotic Indication: treatment of Alzheimer's dementia Controlled: no

Donepezil Hydrochloride

Brand Name: Cardura, Cardura XL Drug Class: antihypertensive/Prostate--anti-inflammatory Indication: treatment of high BP and benign prostatic hyperplasia (bhp) Controlled: no

Doxazosin Mesylate

Brand Name: Sinequan Drug Class: antidepressant--tricyclic Indication: treatment of depression Controlled: no

Doxepin Hydrochloride

Brand Name: Vibramycin Drug Class: antibiotic--tetracycline Indication: treatment of bacterial infections, including syphilis, gonorrhea, acne, and prophylaxis of malaria Controlled: no

Doxycycline Hyclate

agency created under the CSA to enforce all controlled substances laws of the United States

Drug Enforcement Administration (DEA)

-FDA assigned each drug a specific number to identify it: the National Drug Code (NDA) number

Drug Listing Act of 1972

-to encourage creation of generic drugs by streamlining the approval process for generic drugs -to encourage creation of new brand name drugs by extending patent licenses

Drug Price Competition and Patent Term Restoration Act of 1984

may be issued by the FDA to withdraw a drug from the marker to issued voluntarily by the manufacturer in the case of contamination or other liability concerns

Drug Recall

Brand Name: Cymbalta Drug Class: antidepressant--selective serotonin and norepinephrine reuptake inhibitor (SNRI) Indication: treatment of depression; also used for treatment of fibromyalgia, diabetic neuropathy, and other chronic pain Controlled: no

Duloxetine Hydrochloride

-amendment to the FDCA -distinguished between prescription and OTC medications -"Caution: Federal State Law prohibits dispensing without a prescription" -allowed verbal prescriptions to be given over the phone -allowed refills to be called in

Durham-Humphrey Amendment of 1951

Brand Name: Vasotec Drug Class: anithypertensive--ACE Inhibitor Indication: treatment of high blood pressure Controlled: no

Enalapril Maleate

Drug class: ? Description of condition: occurs when a man cannot keep an erection long enough or firm enough for sexual intercourse Indication: used for the treatment of ED Examples: -sildenafil-tadalafil-vardenafil Special considerations: these product should never be used in patients taking nitrates for chest pain--can cause unsafe drop in blood pressure

Erectile Dysfunction (ED) Medications

Brand Name: Lexapro Drug Class: antidepressant--selective serotonin reuptake inhibitor (SSRI) Indication: treatment of depression Controlled: no

Escitalopram Oxalate

Brand Name: Nexium Drug Class: antinuclear agent--Proton Pump Inhibitor (PPI) Indication: treatment of gastroesophageal reflux disease (GERD), ulcers, and other hypersecretory conditions Controlled: no

Esomeprazole Magnesium

Brand Name: Vivelle-Dot Drug Class: hormone replacement (topical) Indication: treatment of symptoms associated with menopause or estrogen replacement due to ovarian failure Controlled: no

Estradiol

Brand Name: Premarin, Cenestin, Enjuvia Drug Class: estrogen hormone Indication: treatment of symptoms of menopause, female hypogonadism, and prostate cancer Controlled: no

Estrogens (Conjugated)

Brand Name: Lunesta Drug Class: sedative Indication: treatment of insomnia Controlled: YES

Eszopiclone; C-4

according to the Poison Prevention Packaging Act, there are exceptions that do not require child-resistant containers. Exceptions: -if a patient requests a non-childproof resistant container (and signs a waiver) -drugs dispensed to institutionalized patients or those order as such by a prescriber Examples: -sublingual nitroglycerin -oral contraceptives -inhalation aerosols

Exceptions for child-resistant containers

used for flushing contaminants from the eye after exposure to a hazardous chemical

Eyewash

Brand Name: Zetia Drug Class: antihyperlipidemic Indication: treatment of high cholesterol Controlled: no

Ezetimibe

Brand Name: Vytorin Drug Class: entihyperlipidemic Indication: treatment of high cholesterol Controlled: no

Ezetimibe with Simvastatin

-change label on prescription drugs from "Caution: Federal Law Prohibits dispensing without a prescription" to" "Rx Only"

FDA Modernization Act of 2004

Brand Name: Pepcid Drug Class: antiulcer agent --H2 receptor blocker Indication: treatment of gastroesophageal reflux disease (GERD) and ulcer Controlled: no

Famotidine

excessive intake result in toxicity, as these vitamins can accumulate and are store in the body--Vitamins A, D, E and K

Fat soluble

Brand Name: Tricor Drug Class: antihyperlipidemic Indication: treatment of high cholesterol Controlled: no

Fenofibrate

Brand Name: Duragesic Drug Class: opioid analgesic (transdermal) Indication: management of chronic pain Controlled: YES

Fentanyl; C-2

Drug Class: ? Mechanism of Action: dissolving clots by binding to clotting agent and preventing it from holding the clot together Indication: used to dissolve preexisting blood clots Side effects: - Examples: -alteplase-reteplase-renecteplase Special consideration: all fibrinolytic are in powder form and must be reconstituted

Fibrinolytics

a needle used to withdraw fluid from an ampule; has a built-in filter to remove any glass particles that may have fallen into the medication

Filter Needle

Brand Name: Proscar, Propecia Drug Class: prostate--anti-inflammatory Indication: treatment of benign prostatic hyperplasia (BPH) Controlled: no

Finasteride

Brand Name: Diflucan Drug Class: antifungal Indication: treatment of vaginal candidiasis and other fungal infections Controlled: no

Flucanazole

Drug Class: ? Mechanism of Action: inhibits bacterial DNA replication, causing bacterial cell death Indication: UTIs, upper respiratory infections, infectious diarrhea, bone/joint infections Side effects: nausea/vomiting, dizziness Examples: -ciprofloxacin-levofloxacin Special consideration: antacids interfere with absorption and will render medication ineffective when taken concurrently; should not be given to children or pregnant women

Fluoroquinolones

Brand Name: Prozac, Sarafem Drug Class: Antidepressant--selective serotonin reuptake inhibitor (SSRI) Indication: treatment of depression disorders (Sarafem used to treat PMDD) Controlled: no

Fluoxetine Hydrochloride

Brand Name: Flonase, Veramyst Drug Class: Antiallergic-steroid (nasal spray) Indication: treatment of seasonal allergies and rhinitis Controlled: no

Fluticasone Propionate

Brand Name: Advair Drug Class: anti asthmatic (inhalation) Indication: treatment of asthma and COPD Controlled: no

Fluticasone Propionate with Salmeterol Xinafoate

Brand Name: Flovent, Flovent Diskus, Flovent HFA Drug Class: anti asthmatic--steroid Indication: treatment for the prevention of asthma attacks Controlled: no

Fluticasone propionate

Brand Name: Folate Drug Class: vitamin Indication: treatment of anemia or folic acid deficiency Controlled: no

Folic Acid

Under the U.S. department of Health and Human Services; responsible for : -new drug review and approval -generic drug approval -issuing drug recalls if needed -OTC drug reviews

Food and Drug Administration (FDA)

-defined adulteration and misbranding -created the FDA -required manufacturers to submit new drug application (NDA) TO FDA

Food, Drug, and Cosmetic Act of 1938 (FDCA)

Temperature degrees-Farehnheit: -13 to 14 Temperature degrees-Celcius: -25 to -10

Freezer

Brand Name: Lasix Drug Class: Diuretic--loop Indication: treatment of edema and hypertension Controlled: no

Furosemide

Brand Name: Neurontin Drug Class: antiepileptic Indication: used as an adjunct in the treatment of partial seizures; can also be used to neuralgia (nerve pain) and restless leg syndrome (RLS) Controlled: no

Gabapentin

process must be followed strictly to prevent contamination; when finished, remove items in reverse order. Garbing order: 1. shoe covers 2. hair cover 3. face mask 4. wash hands 5. disposable gown 6. eye shield 7. sterile gloves

Garbing Process

Brand Name: Lopid Drug Class: antihyperlipidemic Indication: treatment of high cholesterol Controlled: no

Gemfibrozil

comparable to the brand name product in strength, dosage form, and route of administration; must also demonstrate similar effectiveness and efficacy, but is not protected by a patent

Generic Drug

a method that ensure equal distribution of ingredients -first, mix the ingredient in the smallest amount with an equal amount of the next ingredient in quantity -mix these throughly, then add another amount equal to that which is now in the mortar and mix again -continue this process, increasing in quantity until all ingredients are mixed evenly

Geometric Dilution

Drug Class: ? Description of condition: glaucoma is a disorder of the eye characterized by intraocular pressure that can destroy nerves and lead to vision loss Indication: used for the treatment of glaucoma Mechanism of action:lower pressure by increasing drainage or decreasing production of aqueous humor Side effects: - Examples: -bimatoprost-brimonidine-dorzolaminde-latanoprost-timolol Special consideration: -

Glaucoma agents

Brand Name: Amaryl Drug Class: Antidiabetic--oral hypoglycemic Indication: used as an adjunct in the treatment of type II diabetes Controlled: no

Glimepride

Brand Name: glucotrol Drug Class: antidiabetic--oral hypoglyemic agent Indication: used as an adjunct in treatment of type II diabetes Controlled: no

Glipizide

used as a quality assurance tool for sterile compounding procedures -detects the presence of microorganisms on the fingertips of gloves if a sterile compounding technician is using poor aseptic technique practices -an agar plate is used to detect the pathogens -should be completed on personnel prior to compounding CSPs and annually thereafter as a part of competency training

Glove Fingertip Sampling

Brand Name: Diabeta, Micronase Drug Class: antidiabetic--oral hypoglycemic Indication: used as an adjunct in the treatment of type II diabetes Controlled: no

Glyburide

a glass or plastic tool used for measuring liquid volumes -range in size from 5 mL to more than 1000 mL -for highest degree of accuracy, always choose the smallest size that can measure the volume desired (e.g. choose a 100 mL cylinder to measure 95 mL---don't choose a 250 mL cylinder)

Graduated Cylinder

Brand Name: Intuniv, Tenex Drug Class: antihypertensive/ADHD Treatment Indication: treatment of hypertension and ADHD in children over 6 years old Controlled: no

Guanfacine Hydrochloride

Drug Class: ? Mechanism of Action: block gastric acid and secretion from histamine through blockage at the H2 receptor Indication: used for treatment of gastroesophageal reflux disease (GERD), and heartburn Side effects: - Examples: -cimetidine-nizatidine-ranitidine-famotidine Special consideration: all are available OTC; important to take at bedtime

H2 receptor blockers

Drug Class: ? Mechanism of Action: inhibit the enzyme that is required for cholesterol production Indication: used to lower cholesterol Examples: -atorvastatin-lovastatin-pravastatin-rosuvastatin-simvastatin Special consideration: most work better when taken at night; patients should avoid drinking grapefruit juice

HMG-CoA Reductase Inhibitors

protect patient confidentiality of medical records, including prescription history

Health Insurance Portability and Accountability Act of 1996 (HIPAA)

used to minimize airborne contamination by filtering 99.97% of particles sized 0.3 microns and greater

High-Efficiency Particulate Airflow Filter (HEPA)

involves mixing more than three products and/or one of the products is not sterile or being compounded in an environment less than ISO class 5; these products must be sterilized before being injected into the patient -Example: using a non sterile ingredient in preparing a medication for a patient

High-Risk CSPs

a hood used to prepare CSPs that are not hazardous -air is pulled into the hood through a prefilter and then filtered through the HEPA filter before blowing horizontally across the work surface toward the worker -technicians must work 6 inches inside the hood to avoid mixing unfiltered air of the clean room with the HEPA filtered air of the LAFW

Horizontal Laminar Airflow Workbench (LAFW)

Drug Class: ? Description of condition: treatment helps relieve symptoms of estrogen deficiency resulting from menopause Symptoms: -severe hot flashes-vaginal atrophy-insomnia-irritability Examples: -conjugated estrogen--conjugated estrogen-medroxyprogesterone--premphase, estradiol-levonorgestrel

Hormone Replacement Therapy

Brand Name: HydroDiuril, Esidrix Drug Class: diuretic--thiazide Indication: treatment of edema and hypertension Controlled: no

Hydrochlorothiazide (HCTZ)

Brand Name: Lorcet, Lortab, Norco, Vicodin Drug Class: opiod analgesic Indication: relief of moderate to moderately severe pain Controlled: YES

Hydrocodone with Acetaminophen; C-3

Brand Name: Plaquenil Drug Class: antimalarial Indication: treatment of malaria, also used for SLE (systematic lupus erythematosus) and rheumatoid arthritis (RA) Controlled: no

Hydroxychloroquine Sulfate

Brand Name: Atarax Drug Class: antihistamine Indication: treatment of pruritus and other allergic conditions; can also be used to treat anxiety through sedating effects Controlled: no

Hydroxyzine Hydrochloride

Brand Name: Vistaril Drug Class: antihistamine Indication: treatment of anxiety, chronic urticaria, and atopic dermatitis; also used as sedative Controlled: no

Hydroxyzine Pamoate

Drug Class: ? Description of condition: overactive thyroid, which produces excessive amounts of thyroid hormones; may be caused by a tumor or excessive iodine intake Treated with: surgery or drug treatment Side effects: - Examples: -methimazole-propylthiouracil-radioactive iodine Special consideration: -

Hyperthyroidism

a solution that has more particles than the surrounding cells, which causes water to be drawn out of cells, and the cells to shrivel

Hypertonic Solution

Drug Class: ? Mechanism of Action: enhance the effect of the neurotransmitter GABA, which results in sedation Indication: used to treat insomnia and sleep disorders Side effects: - Examples: -eszopiclone-zalepion-zolpidem Special consideration: work the same way as the benzodiazepines, but quicker and have a shorter half-life; benzodiazepines can also be used to treat sleep disorders, especially when insomnia is driven by anxiety-related issues

Hypnotic and Sedatives

Drug Class: ? Description of Condition: underachieve thyroid, which produces insufficient amounts of thyroid hormones; characterized by weight gain and decreased heart rate in adults Treated with: thyroid replacement therapy Side effects: - Examples: -levothyroxine-thyroid(Armour Thyroid) Special consideration: -

Hypothyroidism

a solution that has fewer particles than the surrounding cells, which causes water to be drawn into the cells, and the cells to swell and sometimes burst

Hypotonic Solution

used when rapid administration of a drug is required; medication is pushed all at once, such as when patients receive epinephrine during cardia arrest; known as IV push

IV Bolus

used to provide administration of an intravenous drug over a longer period of time; medication is hung in bas, and the infusion rate is calculated to determine the quantity needed for the entire duration of therapy

IV Infusion

used for administration of an intravenous medication used the primary IV line already being used for IV infusion; a second bag is hung with the medication needed to be infused simultaneously as the main infusion

IV piggy back

Brand Name: Advil, Motrin Drug Class: nonsteroidal anti-inflammatory drug (NSAID) Indication: treatment of mild pain and inflammatory conditions Controlled: no

Ibuprofen

intended to be used only for emergency situations or when a patient requires the immediate use of a CSP; must be administered within one hour of preparation -Example: emergency medications for cardiopulmonary resuscitation

Immediate Use CSP

Drug Class: ? Mechanism of Action: lowers blood sugar in patients who are unable to make insulin Indication: used to treat diabetes Side effects: - Examples: Rapid--lispro, aspart, regular. Intermediate--humulin N, Humulin 70/30. Long--detemir,glargine Special consideration: must be given subcutaneously; injection site should be rotated

Insulin

Brand Name: Novolog Drug Class: antidiabetic Indication: treatment of insulin-dependent (type 1) diabetes or type 2 diabetes not properly controlled, may be used in conjunction with long-acting insulin Controlled: no

Insulin Apart (rDNA origin)

Brand Name: Levemir Drug Class: antidiabetic Indication: treatment of insulin-dependent (type 1) or type 2 diabetes not properly controlled Controlled: no

Insulin Detemir

Brand Name: Lantus Drug Class: antidiabetic Indication: treatment of insulin-dependent (type 1) diabetes or type 2 diabetes not properly controlled Controlled: no

Insulin Glargine

Brand Name: Humalog Drug Class: antidiabetic Indication: treatment of insulin-dependent (type 1) diabetes and type 2 diabetes not properly controlled Controlled: no

Insulin Lispro

system for describing the maximum number of particles in the air allowed in a room where sterile products are compounded

International Organization for Standardization (ISO)

documentation required by the FDA to be completed before drugs are rested in clinical trials on humans

Investigational New Drug Application (INDA)

Mineral: ? Chemical Symbol: I Use in the body: Thyroid function

Iodine

Brand Name: Combivent (MDI Inhaler) and Duoneb (solution with inhalation) Drug Class: anti asthmatic--combination bronchodialator Indication: treatment of COPD Controlled: no

Ipratropium Bromide with Albuterol Sulfate

Mineral: ? Chemical Symbol: Fe Use in the body: red blood cell formation

Iron

used for disinfecting and cleaning several areas: -work surfaces of compounding area -tops of vials prior to needle puncture -gloved hands when necessary

Isopropyl Alcohol 70% (IPA)

Brand Name: Imdur Drug Class: antianginal agent Indication: treatment of prophylaxis of angina Controlled: no

Isosorbide Mononitrate

a solution tha has the same amount of particles as the surrounding cells, so no water will move in or out, and the cell will stay the same

Isotonic

Alternative Supplement: ? Common Use: stress and anxiety, sedative effects

Kava Kava

-requires all medications to be safe and effective -passed in response to the thalidomide birth defects -requires drug manufacturers to file investigational new drug application (INDA)

Kefauver-Harris Amendment of 1962

Brand Name: Lamictal Drug Class: antiepiletic--anticonvulsant Indication: used as an adjunct in treatment of epilepsy and seizures Controlled: no

Lamotrigine

Brand Name: Prevacid Drug Class: antinuclear agent--Proton Pump Inhibitor (PPI) Indication: Treatment of gastroesophageal reflux disease (GERD), ulcers, and other hypersecretory conditions Controlled: no

Lansoprazole

an IV fusion of greater than 250 mL (most commonly given as 500 mL or 1000 mL) -used for electrolyte replacement and hydration -given as a continuous infusion or IV drip

Large Volume Parenteral

Drug Class: ? Description of condition: constipation is the difficulty or inability to pass bowel movements Indication: used for treatment of constipation Side effects: - Types:-bulk-forming-saline-stimulant-stool softners-bowel evacuants Special consideration: -

Laxatives

drugs that require a prescription in order to be dispensed

Legend Drugs

Drug Class: ? Mechanism of Action: block leukotrienes, which results in the blocking of inflammatory responses Indication: used for prophylactic treatment of asthma Side effects: - Examples: montelukast Special consideration: Singulair can be used in patients as young as 12 months old

Leukotriene Inhibitors

Brand Name: Xopenex Drug Class: bronchodialator--antiasthmatic Indication: treatment of asthma and COPD Controlled: no

Levalbuterol Hydrochloride

Brand Name: Keppra Drug Class: antiepileptic, anticonvulsant Indication: used as an adjunct in the treatment of partial seizures Controlled: no

Levetiracetam

an agent is added to a triturated powder slowly to make a paste. -mineral oil -castor oil -vegetable oil -glycerin

Levigation

Brand Name: Levaquin Drug Class: antibiotic--fluoroquinolone Indication: treatment of bacterial infections, such as those that cause community-acquired pneumonia, acute sinusitis, UTIs, among others Controlled: no

Levofloxacin

Brand Name: Levoxyl, Synthroid, Unithroid, Levothroid Drug Class: thyroid hormone Indication: treatment of hypothyroidism Controlled: no

Levothyroxine Sodium

permission by the state board for an individual to practice in a given occupation; individual must demonstrate a minimum competency in order to practice

Licensure

Brand Name: Lidoderm Drug Class: topical analgesic (transdermal) Indication: relief of pain associated with neuralgia Controlled: no

Lidocaine

Brand Name: Prinizide, Zestoretic Drug Class: antihypertensive--combination of ACE inhibitor and diuretic Indication: treatment of hypertension Controlled: no

Lisinopril with Hydrochloride

Brand Name: Eskalith, Lithobid, Lithonate Drug Class: antipsychotic Indication: treatment of bipolar disorder Controlled: no

Lithium Carbonate

a larger dose of a medication given to a patient to bring the concentration of drug in the blood to a therapeutic level more rapidly than a single dose; maintained at the therapeutic level with a maintenance dose

Loading dose

Drug Class: ? Mechanism of Action: inhibit the reabsorption of sodium and chloride in the loop of Henle, which results in excretion of water Indication: used for the treatment of hypertension, edema, and congestive heart failure (CHF) Side effects: - Examples: -furosemide-bumetanide-torsemide Special consideration: -

Loop Diuretics

Brand Name: Ativan Drug Class: antianxiety--benzodiazepine Indication: treatment of anxiety Controlled: YES

Lorazepam

Brand Name: Cozaar Drug Class: antihypertensive--angiotensin II receptor blocker Indication: treatment of hypertension Controlled: no

Losartan Potassium

Brand Name: Hyzaar Drug Class: antihypertenive (combination of ARB and diuretic) Indication: treatment of hypertension Controlled: no

Losartan Potassium with Hydrochlorothiazide

Brand Name: Mevacor Drug Class: antihyperlipidemic--HMG-CoA Reductase Inhibitor Indication: treatment of high cholesterol Controlled: no

Lovastatin

involves the mixing of no more than three sterile products within an ISO class 5 workbench -example: single transfer of a dosage from a vial into an IV bag

Low-risk CSPs

Brand Name: Lyrica Drug Class: anticonvulsant Indication: used as an adjunct in treatment of epilepsy and seizures; can also be used for neuropathic pain and fibromyalgia Controlled: YES

Lyrica; C-5

Drug Class: ? Mechanism of Action: inhibits protein synthesis in bacteria Indication: respiratory infections, chlamydia Side effects: GI distress Examples: -azithromycin-clarithromycin-erthromycin Special consideration: -

Macrolides

Mineral: ? Chemical Symbol: Mg Use in the body: muscle function

Magnesium

Drug Class: ? Mechanism of Action: inhibit inflammatory cells Indication: used for prophylactic treatment of asthma Side effects: - Examples: -cromolyn-nedrocromil Special consideration: a bronchodilator is used first so that airways are opened prior to use, which may cause poor compliance; also has unpleasant taste and cause hoarseness and dry mouth

Mast cell stabilizers

provided to the pharmacy about each chemical; contains important information on the hazards of particular substances, including flammability and reactivity of chemicals. Also includes informations on how to store chemicals and what god in the event of a spill or accidental ingestion

Material Safety Data Sheets (MSDS)

-also known as Medicare Part D, provided prescription drug coverage to patients eligible for Medicare

Medicare Prescription Drug, Improvement, Modernization Act of 2003 (MMA)

involves more complex sterile compounding procedures than low risk, such as mixing more than three sterile products or administering to multiple patients -Example: preparation of total parenteral nutrition (TPN)

Medium-risk CSPs

voluntary program run by the FDA that allows any healthcare professional or patient to report a serious adverse event associated with the use of a specific drug

Medwatch

Brand Name: Mobic Drug Class: NSAID Indication: relief of symptoms associated with arthritis Controlled: no

Meloxicam

Brand Name: Namenda Drug Class: agent for alzheimer's disease Indication: treatment for Alzheimer's disease Controlled: no

Memantine Hydrochloride

curve at the upper surface of a liquid caused by surface tension -the liquid at the bottom of it should be measured at eye level

Meniscus

Brand Name: Skelaxin Drug Class: muscle relaxant Indication: treatment of painful musculoskeletal conditions Controlled: no

Metaxalone

Brand Name: Glucophage, Glucopage XR Drug Class: antidiabetic Indication: used for lowering of blood sugar in type 2 diabetes, sometimes used in combination with insulin or non-insulin dependent diabetes mellitus (NIDDM) Controlled: no

Metformin Hydrochloride

Brand Name: Dolophine Drug Class: opioid analgesic Indication: used for relief of severe pain, and for the detoxification or temporary maintenance of narcotic addiction Controlled: YES

Methadone Hydrochloride; C-2

Brand Name: Robaxin Drug Class: muscle relaxant Indication: relief of painful musculoskeletal conditions Controlled: no

Methocarbamol

Brand Name: Rheumatrex, Trexall Drug Class: antimetabolite Indication: treatment of specific types of cancer, management of severe rheumatoid arthritis and psoriasis Controlled: no

Methorexate Sodium

Brand Name: Ritalin, Metadate ER, Concerta Drug Class: CNS Stimulant Indication: treatment of ADHD and narcolepsy Controlled: YES

Methylphenidate Hydrochloride; C-2

Brand Name: Medrol, Medrol Dosepack Drug Class: anti-inflammatory (corticosteroid) Indication: treatment of inflammatory conditions Controlled: no

Methylprednisolone

Brand Name: Reglan Drug Class: antiemetic Indication: prevention of nausea and vomiting Controlled: no

Metoclopramide Hydrochloride

Brand Name: Zaroxolyn Drug Class: diuretic Indication: treatment of edema and hypertension Controlled: no

Metolazone

Brand Name: Toprol XL Drug Class: antihypertensive--beta blocker Indication: treatment of hypertension (high BP) and angina Controlled: no

Metoprolol Succinate

Brand Name: Lopressor Drug Class: antihypertensive--beta blocker Indication: treatment of hypertension (high BP) and angina Controlled: no

Metoprolol Tartate

Drug Class: ? Indication: bacterial infections caused by anaerobic bacteria, protozoa infections, gynecologic, and as part of a multi drug regimen for H. Pylori Special Consideration: patient must be counseled to not drink alcohol while taking this medication--if taken with alcohol, patient will develop severe nausea and vomiting

Metronidazole (Flagyl)

Brand Name: Remeron Drug Class: antidepressant-tetracyclic Indication: treatment of depression Controlled: no

Mirtazapine

a product that has been labeled incorrectly, or whose label may include false or misleading statements about the ingredients of the drug

Misbranded Product

Drug Class: ? Mechanism of Action: block the enzyme that breaks down serotonin and norepinephrine Indication: used to treat depression Side effects: - Examples: -selegiline-phenelzine Special consideration: have many drug interactions; should not take with ephedrine, amphetamine, methylphenidate, levodopa, or meperidine; patients need to avoid aged cheeses and certain meats and vegetables; patients require a 2-week washout period after discontinuing medication before a new therapy begins.

Monoamine Oxidate Inhibitors (MAOI)

Brand Name: Singulair Drug Class: antiasthmatic--Leukotriene Inhibitor Indication: treatment of asthma, bronchospasms, and seasonal allergies Controlled: no

Montelukast Sodium

Brand Name: MS Contin, Kadian, Avinza, Oramorph SR, MSIR Drug Class: opioid analgesic Indication: management of moderate to severe pain Controlled: YES

Morphine Sulfate; C-2

used in non sterile compounding to grind substances

Mortar and Pestle

Brand Name: Bactroban Drug Class: antibacterial (topical) Indication: treatment of impetigo, MRSA, and other bacterial skin infections Controlled: no

Mupirocin

Drug Class: ? Mechanism of Action: - Indication: to reduce muscle tension Side effects: - Examples: -baclofen-carisoprodol-cyclobenzaprine Special consideration: carisoprodol is a schedule IV controlled substance

Muscle Relaxants

Brand Name: Naprosyn, EC-Naprosyn, Aleve Drug Class: non steroidal anti-inflammatory drug Indication: treatment of mild to moderate pain, including pain from arthritis and other inflammatory conditions Controlled: no

Naproxen

Drug Class: ? Mechanism of Action: activate opiate receptors, which helps inhibit the pain pathway Indication: used to treat moderate to severe pain Side effects: - Examples: -fentanyl-hydromorphone-meperidine-morphine-oxycodone-oxycodone with acetaminophen Special consideration: all are controlled substances and have abuse potential

Narcotic Analgesic

represents all 50 state boards of pharmacy; has no regulatory authority

National Association of Boards of Pharmacy (NABP)

number assigned to each drug by the FDA: -first five numbers = drug manufacturer -second four numbers = drug product -third set of two numbers = package size

National Drug Code (NDC)

Brand Name: Bystolic Drug Class: antihypertensive--beta blocker Indication: treatment of hypertension (high BP) Controlled: no

Nebivolol Hydrochloride

a machine used for administering medication into the lungs of children or other patients requiring a breathing treatment; patients will wear a mask, and the medication is delivered as a fine mist that the patient breathes in to make sure it reaches the lungs

Nebulizer

used to puncture containers of medication and to withdraw or inject fluid

Needle

the size of a needle is determined by its gauge

Needle Gauge

documentation required by the FDA to be filled with each new drug prior to marketing

New Drug Application (NDA)

Brand Name: Niacin, Niacin SR, Niacor, Niaspan ER, Slo-Niacin Drug Class: antihyperlipidemic Indication: treatment of high cholesterol, may also be used to treat coronary artery disease (atherosclerosis) Controlled: no

Niacin (Extended Release)

Brand Name: Procardia, Nifedical XL Drug Class: antihypertensive--calcium channel blocker Indication: treatment of hypertension and angina Controlled: no

Nifedipine

Drug Class: ? Mechanism of Action: relax the smooth muscle of the heart and dilate the surrounding blood vessels to increase blood flow Indication: used for the treatment of angina Side effects: - Examples: -isosorbide dinitrate-isosorbide mononitrate-nitroglycerin Special consideration: nitroglycerin is used sublingually as the drug of choice for an acute attack of angina; nitrates should not be used if taking specific medications for erectile dysfunction--can cause an unsafe drop in blood pressure

Nitrates

Brand Name: Macrobid, Macrodantin Drug Class: antibacterial Indication: treatment of urinary tract infections (UTIs) Controlled: no

Nitrofurantoin

Drug Class: ? Mechanism of Action: inhibit prostaglandin synthesis, which helps prevent inflammation from occurring Indication: used to lower inflammation and fever, and for mild to moderate pain relief Side effects: - Examples: -ibuprofen-naproxen-diclofenac-ketorolac-indomethacin Special consideration: can cause of GI distress due to the inhibition of prostaglandin synthesis

Non-Steroidal Anti-Inflammatory Drugs (NSAIDs)

Drug Class: ? Mechanism of Action: used to treat mild to moderate pain Indication: - Side effects-: Examples: -NSAIDs-cyclooxygenase-2 inhibitors-aspirin-acetaminophen Special consideration:-

Non-narcotic Analgesic

Brand Name: Pamelor Drug Class: antidepressant--tricyclic Indication: treatment of depression Controlled: no

Nortriptyline Hydrochloride

Brand Name: Nystop (powder), Mycostatin (cream, suspension) Drug Class: antifungal Indication: treatment of fungal infections including oral candidiasis (thrush) Controlled: no

Nystatin

drugs that are available for purchase without a prescription

OTC Drugs (Over The Counter)

-to ensure a safe workplace for employees -affects pharmacy employees by ensuring compliance for protection from air contamination, needle sticks, and hazardous chemical exposure

Occupational Safety and Health Act of 1970

a flat surface used for mixing compounds such as creams, ointments, pastes, or gels -usually made from ground glass, so it is nonabsorbent

Ointment Slab

Brand Name: Zyprexa Drug Class: antipsychotic--atypical Indication: treatment of schizophrenia and bipolar disorder Controlled: no

Olanzapine

Brand Name: Patanol, Pataday Drug Class: antiallergic (ophthalmic) Indication: treatment of allergic conjunctivitis Controlled: no

Olaptadine Hydrochloride

Brand Name: Benicar Drug Class: Antihypertensive--angiotensin II receptor blocker (ARB) Indication: treatment of hypertension Controlled: no

Olmesartan Medoxomil

Brand Name: Lovaza Drug Class: antihyperlipidemic Indication: treatment of high cholesterol Controlled: no

Omega-3-Acid Ethyl Esters

-any participant in Medicaid reimbursement program must undergo drug utilization review (DUR) by the pharmacist -every patient must receive an offer to be counseled by the pharmacist -failure to do so can result in loss of Medicaid reimbursement

Omnibus Budget Reconciliation Act of 1990 (OBRA-90)

Brand Name: Zofran, Zofran ODT Drug Class: antiemetic Indication: prevention of nausea and vomiting usually caused by cancer treatment Controlled: no

Ondanastron Hydrochloride

one of the older natural drugs; found in the poppy plant -produces a feeling of euphoria and is therefore useful in treating pain -can also be used for cough suppression -common side effects are constipation and nausea/vomiting

Opioids

Drug Class: ? Mechanism of Action: suppress ovulation by interfering with hormone production Indication: used to prevent pregnancy Side effects: - Examples: -ethinyl estradiol with levonorgestrel-ethinyl estradiol with norgestimate-ethinyl estradiol with norgestrel-ethinyl estradiol with drospirinone Special consideration: most are combination of estrogen and progesterone

Oral Contraceptives

Drug Class: ? Mechanism of Action: improve response to insulin and glucose Indication: used to treat non-insulin dependent diabetes Side effects: - Examples: -glimepride-glipizide-glyburide-metformin-pioglitazone Special consideration: because they improve the response of the body to insulin, and type 1 diabetes do not produce insulin, these drugs are not indicated for type 1 diabetes; changing of diet and increasing exercise should also be included in therapy

Oral Hypoglycemic Agents

an online resources published by the FDA that proves information on therapeutic equivalencies and TE codes

Orange book

a drug that is used to treat a disease that affects less than 200,000 patients

Orphan Drug

-provide tax incentives and expedited review and approval to manufacturers producing drugs for serious or life-threatening disease affected less than 200,000 patients

Orphan Drug Act of 1983

Drug Class: ? Description of condition: decrease bone density resulting from a deficiency in estrogen, calcium, and/ or vitamin D Examples: -bisophosphonates--OTC calcium--calcitonin-salmon nasal spray--raloxifene

Osteoporosis Agents

Brand Name: Trileptal Drug Class: antiepileptic--anticonvulsant Indication: treatment of seizures Controlled: no

Oxcarbazepine

Brand Name: Ditropan, Ditropan XL, Urotrol Drug Class: Urinary Antispasmodic Indication: treatment of overactive bladder and bladder instability Controlled: no

Oxybutynin Chloride

Brand Name: Perocet, Roxicet, Endocet, Tylox, Xolox, Primalev Drug Class: opioid analgesic Indication: relief of moderate to moderately severe pain Controlled: YES

Oxycodone Hydrochloride with Acetaminophen; C-2

Brand Name: Oxycontin, Roxicodone Drug Class: Opioid analgesic Indication: relief of moderate to moderately severe pain Controlled: YES

Oxycodone Hydrochloride; C-2

Brand Name: Protonix Drug Class: antinuclear agent--Proton Pump Inhibitor (PPI) Indication: treatment of gastroesophageal reflux disease (GERD), ulcers, and there hypersecretory conditions Controlled: no

Pantoprazole Sodium

Brand Name: Paxil, Paxil CR, Pexeva Drug Class: antidepressant Indication: treatment of depression, can also be used for obsessive compulsive disorder, panic disorder, and social anxiety disorder Controlled: no

Paroxetine Hydrochloride

Drug Class: ? Mechanism of Action: prevents bacteria from forming cell wall Indication: otitis media, strep throat, respiratory infections, gonorrhea, and syphilis Side effects: diarrhea (most common), allergy in approximately 10% of the population Examples: -amoxicillin-ampicillin

Penicillin

essential for infection controls and to protect that technician from blood borne pathogens as well as exposure to hazardous chemicals. -gloves to protect the hands -masks and respirator to protect the respiratory tract as well as the nose and mouth -goggles to protect the eyes in the event of any splashing -face shields

Personal Protective Equipment (PPE)

weights used to calibration of class III prescription balance and for weighing ingredients -must be handled with forceps to avoid the transfer of any oils or dirt from the hands

Pharmaceutical Weights

Brand Name: Adipex-P, Lonamin Drug Class: weight management Indication: used for weigh reduction Controlled: YES

Phentermine Hydrochloride; C-3

Brand Name: Dilantin, Phenytek Drug Class: antiepileptic--anticonvulsant Indication: control of seizures Controlled: no

Phenytoin Sodium (Extended)

when two or more drugs than are compatible are combined, a physical change occurs that can be detected, including cloudiness, temperature, or a color change

Physical Incompatibilities

Brand Name: Actos Drug Class: antidiabetic--oral hypoglycemic agent Indication: used as an adjunct in treatment of type II diabetes Controlled: no

Pioglitazone Hydrochloride

prevent accidental childhood poisonings from both prescription and OTC Drugs

Poison Prevention Packaging Act of 1970

a manual with written instructions for the pharmacy staff (both technicians and pharmacists) on all operations within the pharmacy

Policies and Procedures Manual

Mineral: ? Chemical Symbol: K Use in the body: heart and nerve function, cellular balance

Potassium

Brand Name: K-Dur, Klor-Con, Micro-K, many others Drug Class: potassium supplement (oral) Indication: treatment and prevention of potassium deficiency (hypokalemia) Controlled: no

Potassium Chloride

Drug Class: ? Mechanism of Action: block sodium and potassium exchange at the distal convoluted tubule, or competitively inhibit aldosterone Indication: used for adjunctive treatment of hypertension and edema Side effects:- Examples: -spironolactone-triamterene(can be given with hydrochlorothiazide) Special consideration: should be avoided in patient take ACE inhibitors (both have potassium-sparing effect and can cause hyperkalemia--excessive potassium in the blood

Potassium-Sparing Diuretics

Brand Name: Mirapex Drug Class: antiparkinson agent Indication: treatment of symptoms of Parkinson's disease Controlled: no

Pramipexole Dihydrochloride

Brand Name: Pravachol Drug Class: antihyperlipidemic--HMG-CoA Reductase Inhibitor Indication: treatment of high cholesterol Controlled: no

Pravastatin Calcium

Brand Name: Deltasone Drug Class: anti-inflammatory Indication: treatment of inflammatory conditions Controlled: no

Prednisone

-prohibits the reimportation of a drug into the United States by means other than by the manufacturer -prohibits the sale of drug samples and the distribution of samples to anyone other than those who are licensed to prescribe them

Prescription Drug Marketing Act of 1987

Brand Name: Compazine Drug Class: antipsychotic-typical Indication: treatment of schizophrenia; can also be used to control severe nausea, vomiting, and excessive anxiety Controlled: no

Prochlorperazine

Brand Name: Phenergan Drug Class: antihistamine Indication: treatment of seasonal allerigies, nausea and vomiting, and preoperative sedation Controlled: no

Promethazine HCl

Brand Name: Phenergan with codeine Drug Class: antitussive Indication: treatment of cough Controlled: YES

Promethazine Hydrochloride with Codeine Phosphate; C-5

Brand Name: Inderal, Inderal LA, Innopran XL Drug Class: antihypertensive--beta blocker Indication: treatment of hypertension (high BP) Controlled: no

Propanolol Hydrochloride

Drug Class: ? Mechanism of Action: block the proton pump, which normally pumps acidic ions into the stomach--this reduces stomach acidity Indication: used for treatment of gatroesophageal reflux disease (GERD) and heartburn; can also be used in ulcer therapy Side effects:- Examples: -esomaprazole-lansoprazole-omeprazole-pantoprazole Special consideration: must be taken on a daily basis for effectiveness

Proton Pump Inhibitor

a method for hand-filling capsules -the powder to be filled is placed on a surface, and the capsule is punched into the powder repeatedly until full

Punch Method

prohibit interstate transportation of misbranded and adulterated food and drugs

Pure Food and Drug Act 1906

Brand Name: Seroquel Drug Class: antipsychotic--atypical Indication: treatment of schizophrenia and bipolar disorder Controlled: no

Quetiapine Fumerate

Brand Name: Accupril Drug Class: antihypertensive--ACE Inhibitor Indication: treatment of high BP Controlled: no

Quinapril Hydrochloride

Brand Name: Evista Drug Class: osteoporosis agent Indication: treatment of osteoporosis in postmenopausal women Controlled: no

Raloxifene Hydrochloride

Brand Name: Altace Drug Class: antihypertensive--ACE Inhibitor Indication: treatment of high BP Controlled: no

Ramipril

Brand Name: Zantac Drug Class: antinuclear agent--H2, receptor blocker Indication: treatment of gastoesophadeal reflux disease (GERD), ulcers, and other hypersecretory conditions. Controlled: no

Ranitidine Hydrochloride

Temperature degrees-Farehnheit: 36 to 46 Temperature degrees-Celcius: 2 to 8

Refrigerator

enrolling on a list created by the state board of pharmacy

Registration

-defined by the USP chapter <797> -assigned according to the probability of contaminating a CSP

Risk Levels

Brand Name: Risperdal Drug Class: antipsychotic Indication: treatment of schizophrenia; can also be used for bipolar treatment of irritability associate with autism Controlled: no

Risperidone

Temperature degrees-Farehnheit: 59 to 86 Temperature degrees-Celcius: 15 to 30

Room temperature

Brand Name: Requip, Requip XL Drug Class: antiparkinson agent Indication: treatment of signs and symptomss of Parkinson's disease as well as restless leg syndrome Controlled: no

Ropinirole Hydrochloride

Brand Name: Crestor Drug Class: Antihyperlipidemic--HMG-CoA Reductase Inhibitor Indication: treatment of high cholesterol Controlled: no

Rosuvastatin Calcium

Drug Class: ? Mechanism of Action: draw water into the colon to promote bowel evacuation Indication: used for the treatment of constipation Side effects: - Examples: -lactulose-magnesium hydroxide milk-sodium phosphate Special consideration: patient must drink plenty of water to avoid further constipation

Saline Laxatives

Abuse Potential: has no accepted medical use in the United States (for research purposes only) Examples: -crack cocaine-ecstasy-heroin-LSD-marijuana

Schedule I Narcotics

Abuse Potential: has high potential for abuse Examples: Adderall-Demerol-Dilaudid-Oxycontin-Percocet-Ritalin Restriction: no refills-cannot be phoned in except for emergencies

Schedule II Narcotics

Abuse Potential: less potential for abuse than C-2 Examples: -Tylenol 3-anabolic steroids Restrictions: can only be refilled a maximum of 5 times within 6 months

Schedule III Narcotics

Abuse Potential: less abuse potential than C-2 and C-3 Examples: -benzodiazepines(Xanax, Valium, Ativan)-ambien-lunesta-soma Restrictions: can only be refilled a maximum of 5 times within 6 months

Schedule IV Narcotics

Abuse Potential: lowest possible abuse potential Examples:-lomotil-lyrica-cough syrups with codeine Restrictions: some states allow dispensing without a prescription (must be 18 and sign a log)

Schedule V Narcotics

Drug Class: ? Mechanism of Action: block the reuptake of serotonin, which increases serotonin levels in the brain Indication: used to treat depression and obsessive-compulsive disorders Side effects: -citalopram-escitalopram-fluoxetine-paroxetine-sertraline Examples:- Special consideration: serotonin syndrome can occur if an SSRI is taken with another drug that increases serotonin levels in the brain-rare, but can be fatal

Selective Serotonin Reuptake Inhibitors (SSRI)

Brand Name: Zoloft Drug Class: antidepressant--Selective Serotonin Reuptake Inhibitor (SSRI) Indication: treatment of depression Controlled: no

Sertraline Hydrochloride

a red container used to safely dispose of all items considered dangerous and sharp, such as: needles, syringes, and broken glass

Sharp's container

directions to the patient. Ex: take 1 tablet by mouth daily

Signa aka Sig

Brand Name: Januvia Drug Class: antidiabetic Indication: treatment of type 2 diabetes Controlled: no

Sitagliptin Phosphate

a CSP given usually as an IVPB over a short period of time -less than 250 mL (usually 150,100, 50, 25 mL) -examples: antibiotics, antifungals, antiviral medications

Small Volume Parenteral

Drug Class: ? Description of condition: smoking can increase risk of cancer, COPD, heart disease, and stroke Indication: - Side effects:- Examples: -bupropion-nicotine-varenicline Special consideration: -

Smoking Cessation agents

Mineral: ? Chemical Symbol: Na Use in the body: nerve and muscle function, cellular balance

Sodium

Brand Name: Vesicare Drug Class: urinary antispasmodic Indication: treatment of overactive bladder and urinary incontinence Controlled: no

Solifenancin Succinate

combining substances using a spatula

Spatulation

provides protection in the event of a spill, in such cases as chemotherapy (cytotoxic drugs), certain antibiotics, and some radiopharmaceuticals

Spill Kit

Brand Name: Aldactone Drug Class: diuretic--potassium sparing Indication: treatment of edema and hypertension Controlled: no

Spironolactone

Alternative Supplement: ? Common Use: depression

St. John's Wort

oversees the practice of pharmacy in each state; defines all roles and duties of pharmacists and pharmacy technicians; can discipline when necessary

State Boards of Pharmacy (BOP)

Drug Class: ? Mechanism of Action: stimulate the gut through irritation of the lining, which increases contractions and bowel movements Indication: used for the treatment of constipation Side effects: - Examples: -bisacodyl-senna Special consideration: be careful of overuse-can cause the bowel to become dependent on laxative use

Stimulant Laxatives

Drug Class: ? Mechanism of Action: allow fluid to mix into the bowel and stool, which creates a softer and easier-to-pass stool Indication: used for the treatment of constipation Side effects: - Examples: docusate Special consideration: -

Stool Softners

Brand Name: Carafate Drug Class: antiulcer Indication: treatment of gastroesophageal reflux disease (GERD), and prevention and treatment of ulcers Controlled: no

Sucralfate

Brand Name: Bactrim, Septra, SMZ-TMP DS Drug Class: antibacterial--sulfonamide Indication: used for the treatment of urinary tract infections and other bacterial infections Controlled: no

Sulfamethoxazole with Trimethoprim

Drug Class: ? Mechanism of Action: disrupts the pathway for producing folic acid in bacteria Indication: UTIs, otitis media Side effects: rash, photosensitivity Examples: -sulfasalazine-sulfamethoxazole with trimethoprim Special consideration: can cause Stevens-Johnson syndrome, a potentially fatal reaction marked by large red blotches of the skin; should take with plenty of water to avoid crystallization in urine

Sulfonamides

Mineral: ? Chemical Symbol: S Use in the body: energy production and cellular functions

Sulfur

Brand Name: Imitrex Drug Class: antimigraneous agent Indication: treatment of migraine headaches Controlled: no

Sumatriptan Succinate

used in the preparation of a CSP to withdraw or inject solutions

Syringe

Brand Name: Flomax Drug Class: alpha blocker for benign Prostatic Hyperplasia (BPH) treatment Indication: treatment of enlarged prostate Controlled: no

Tamsulosin Hydrochloride

Brand Name: Micardis Drug Class: antihypertensive--angiotensin II receptor blocker (ARB) Indication: Treatment of hypertension Controlled: no

Telmisartan

Brand Name: Restroril Drug Class: sedative Indication: treatment of insomnia Controlled: YES

Temazepam; C-4

Brand Name: Hytrin Drug Class: antihypertensive/Prostate--anti-inflammatory (aplha adrenergic blocker) Indication: treatment of high BP and benign prostatic hyperplasia Controlled: no

Terazosin Hydrochloride

Drug Class: ? Mechanism of Action: inhibits protein synthesis in bacteria Indication: acne, chronic bronchitis, walking pneumonia, Lyme disease Side effects: rash, photosensitivity Examples: -doxycycline hyclate-tetracycline-minocycline Special consideration: antacids interfere with absorption and will render medication ineffective when taken concurrently; should not be given to children or pregnant women; taking expired of this can cause a fatal renal disease

Tetracyclines

drug given to pregnant mothers for morning sickness in the late 1950s and early 1960s -babies were born with severe birth defects, and the Kefauver-Harris Amendment of 1962 was passed in response to this tragedy

Thalidomide

Brand Name: Theo-Dur, Theo-24, Elixophyllin Drug Class: bronchodilator Indication: treatment of the symptoms of asthma and chronic bronchitis Controlled: no

Theophylline Anhydrous

when two or more drugs are combined that are not compatible, it causes a change in the effectiveness of one or more of the drugs when administered

Therapeutic Incompatibilities

when two drugs can be substituted and have the same affect both clinically and in safety profiles; they must be the same dosage form, strength, route of administration, and contain the same active ingredient

Therapeutic equivalence

also know as TE codes; coding process the FDA uses to determine whether a product is therapeutically equivalent. -a drug is given a rating of A if the FDA can demonstrate through studies that it is therapeutically equivalent -a drug is given a rating of B if it is not therapeutically equivalent

Therapeutic equivalency codes

Drug Class: ? Mechanism of Action: Inhibit reabsorption of sodium and chloride ions in the distal convoluted tubule of the kidney, which promotes water excretion Indication: used for the treatment of hypertension, edema, and congestive heart failure Side effects: - Examples: hydrochlorothiazide Special consideration: may cause hypokalemia (low potassium)

Thiazide Diuretics

Brand Name: Armour Thyroid Drug Class: thyroid hormone Indication: treatment of hypothyroidism Controlled: no

Thyroid, dessicated

Brand Name: Spiriva Drug Class: Antiasthmatic (inhalation) Indication: treatment of COPD, including chronic bronchitis and emphysema Controlled: no

Tiotropium Bromide

Brand Name: Zanaflex Drug Class: muscle relaxant Indication: management of muscle spasticity Controlled: no

Tizanidine Hydrochloride

Brand Name: Detrol, Detrol LA Drug Class: urinary atispasmodic Indication: treatment of overactive bladder and urinary urgency and urge incontinence Controlled: no

Tolterodine Tartrate

how the cells in our body respond to surrounding fluid; three classifications--hyperotonic, hypotonic, and isotonic

Tonicity

Brand Name: Topamax Drug Class: antiepileptic, anticonvulsant Indication: treatment of seizure, also used for prophylaxis of migraine Controlled: no

Topiramate

an IV solution that provides nutrients for patients who are unable to eat or cannot get the nutrition they need through eating orally. Composed of: -sterile water -dextrose -amino acids -lipids -electrolytes and other additives -medications that a patient may need

Total Parenteral Nutrition (TPN)

Brand Name: Ultram, Ryzolt, Ultram ER Drug Class: analgesic Indication: management of moderate to moderately severe pain Controlled: YES

Tramadol Hydrochloride

Brand Name: Ultracet Drug Class: analgesic--combination product Indication: management of acute pain Controlled: yes

Tramadol Hydrochloride with Acetaminophen; C-4

Brand Name: Travatan, Travatan Z Drug Class: glaucoma agent Indication: reduction of intraocular pressure in glaucoma Controlled: no

Travoprost

Brand Name: Kenalog, Cinolar, Trianex, Triderm Drug Class: corticosteroid (topical) Indication: relief of inflammatory and pruritic symptoms Controlled: no

Triamcinolone Acetonide

Brand Name: Diazide, Maxzide Drug Class: diuretic; combination--potassium sparing and thiazide Indication: treatment of edema and hypertension Controlled: no

Triamterene with Hydrochlorothiazide

Drug Class: ? Mechanism of Action: blocks the reuptake of serotonin or norepinephrine Indication: used to treat depression and bedwetting in children Side effects:- Examples: -amitriptyline-doxepin-imipramine Special consideration: has even longer delay of onset--results may not show for weeks; anticholinergic side effects= urinary retention, dry mouth, constipation, cardiotoxic in higher doses and must be monitored

Tricyclic Antidepressant (TCA)

grinding tablets or other substances into a fine powder

Trituration

Drug Class: ? Description of condition: disease of the respiratory tract cause by a bacteria; patients have a long drug therapy consisting of many medications, which leads to poor compliance. Indication: used for treatment of tuberculosis Side effects: - Examples: -isoniazid-rifampin-ethambutol Special consideration: -patients should avoid alcohol with all drugs-rifampin causes discoloration of urine, tears, sweat and any body fluid--turns all fluids a reddish orange

Tuberculosis Agents

chapter of USP dedicated to non sterile compounding

USP Chapter <795>

chapter of USP dedicated to sterile compounding and requirements to help eliminate contamination of compounded sterile products (CSPs)

USP Chapter <797>

sets official standards for all prescription and OTC drugs manufactured and sold in the United States; sets standards based on quality, purity, strength, and consistency of product

United States Pharmacopeia (USP)

Brand Name: Valtrex Drug Class: antiviral Indication: treatment of genital herpes, herpes zoster (shingles), and cold sores (herpes labialis) Controlled: no

Valacyclovir Hydrochloride

Brand Name: Diovan Drug Class: antihypertensive--Angiotensin II receptor blocker (ARB) Indication: treatment of hypertension Controlled: no

Valsartan

Brand Name: Diovan-HCT Drug Class: antihypertensive (combination of ARB and diuretic) Indication: treatment of hypertension Controlled: no

Valsartan with Hydrochloride

Drug Class: ? Mechanism of Action: inhibits cell wall synthesis Indication: life-threatening infections, such as MRSA, Clostridium difficile (C. Diff), or endocarditis Side effects: nephrotoxicity and ototoxicity Examples: - Special consideration: doses are adjusted on a patient-specific basic and measured daily to ensure no toxicity is occurring (trough and peak measuring); if infused too quickly, patient will flush--known as red man syndrome

Vancomycin

Brand Name: Chantix Drug Class: smoking cessation agent Indication: to aid in the cessation of smoking Controlled: no

Varenicline Tartrate

Brand Name: Effexor Drug Class: antidepressant Indication: treatment of depression Controlled: no

Venlafaxine Hydrochloride

Brand Name: Calan, Isoptin, Verelen Drug Class: antihypertensive--calcium channel blocker Indication: treatment of hypertension and angina Controlled: no

Verapamil Hydrochloride

a hood used to prepare the CSPs that are hazardous (e.g. chemotherapy) -air flows down through the HEPA filter and is forced upward and vented outside -technicians should wear eye protection and use double gloves for these preparations

Vertical Laminar Airflow Workbench

a container that is sealed containing medication either in liquid or powder form

Vial

essential organic compounds required y an organism in a limited amount for necessary functions

Vitamin

retinol; bone health and growth, eyes (retina function), and reproduction

Vitamin A

thiamine; important for energy production and heart and muscle function

Vitamin B1

cyanocobalamin; important for red blood cell production

Vitamin B12

Riboflavin; important for energy production and hair, skin, and nails

Vitamin B2

nicotine acid; involved in fat synthesis and protein metabolism, also called niacin

Vitamin B3

pantothenic acid; important for energy and normal growth

Vitamin B5

pyridoxine; helps in metabolism and red blood cells production

Vitamin B6

biotin; necessary for cell growth, may strengthen nails

Vitamin B7

folic acid; essential for healthy fetal development in pregnant women

Vitamin B9

ascorbic acid; helps in the immune process and promotes healing

Vitamin C

Ergocalciferol; bone health

Vitamin D

Tocopherol; antioxidant and enhances immune response

Vitamin E

Phytonadione; blood clotting

Vitamin K

Brand Name: Coumadin, Jantoven Drug Class: anticoagulant Indication: prevention of blood clots Controlled: no

Warfarin Sodium

Temperature degrees-Farehnheit: 86 to 104 Temperature degrees-Celcius: 30 to 40

Warmer

eliminated by the kidneys, so overdosing is less likely to be as dangerous as a fat-soluble overdose--Vitamin B complex and C

Water soluble

Drug Class: ? Mechanism of Action: used for the treatment of obesity Indication: - Side effects: - Examples: -orlistat-phentermine-siburtramine Special consideration: some are stimulants and controlled substances

Weight-loss medications

Drug Class: ? Mechanism of Action: relax airway smooth muscle, leading to opening of airways and increased air movement Indication: used for treatment of lung diseases unresponsive to other treatments Side effects: - Examples: -aminophylline-theophylline Special consideration: theophylline has many interactions and used only if asthma or other lung disease is unresponsive to other treatments

Xanthine Derivatives

Mineral: ? Chemical Symbol: Zn Use in the body: immunity

Zinc

Brand Name: Geodon Drug Class: antipsychotic Indication: treatment of schizophrenia Controlled: no

Ziprasidone Hydrochloride

Brand Name: Ambien, Ambien CR Drug Class: sedative, hypnotic Indication: treatment of insomnia Controlled: YES

Zolpidem Tartrate; C-4

Brand Name: Zonegran Drug Class: anticonvulsant Indication: used as an adjunct in the treatment of seizures Controlled: no

Zonisamide

the process of a drug entering the bloodstream

absorption

Drug Class: ? Mechanism of Action: attach to acetaminophen and detoxifies the metabolite Indication: antidote for acetaminophen overdose Side effects: - Examples: - Special consideration: can also be used for some bronchial diseases

acetylcysteine

the part of the drug that alters the body to produce the desired effect

active ingredient

determining whether or not a drug will be covered under the insurance plan; once a prescription has been entered, it will undergo adjudication by the insurance company to determine coverage

adjudication

a type of medication order written by a physician if a patient should be admitted into the hospital; this order is sometimes written when a patient has visited the emergency room and, after a physician's assessment, it is decided he or she should be admitted into the facility.

admission order

hypersensitivity of the immune system that may begin immediately after taking a medication or take weeks to show symptoms

allergies

Brand Name: Xanax, Xanax XR Drug Class: antianxiety--benzodiazepine Indication: treatment of anxiety and panic disorders Controlled: YES

alprazolam; C-4

Brand Name: Norvasc Drug Class: antihypertensive--calcium channel blocker Indication: treatment of hypertension, can also be used for treatment of angina Controlled: no

amlodipine besylate

synthetic testosterone abused by athletes and regulated under the Anabolic Steroid Control Act; classified as a schedule III narcotic

anabolic steroid

drugs that relieve pain; can be non-narcotic or narcotics (derived from opioid)

analgesics

what more severe allergies can result in; leads to swelling of the airways and difficulty breathing; can lead to death if not immediately treated

anaphylaxis

when two drugs are taken together, and one drug negates the effect of the other drug

antagonism

medication that decreases inflammation

anti-inflammatory

drugs used to kill or inhibit growth of certain types of bacteria. -bacteriostatic -bactericidal

antibiotics

Drug Class: ? Mechanism of Action: depression is characterized by feelings of intense sadness, problems eating and sleeping, lack of self-worth, and pessimistic behavior, and thoughts Indication: used to treat depression Classes of antidepressants: -selective serotonin repute inhibitors (SSRIs)-serotonin and norepinephrine reuptake inhibitors (SNRIs)-monoamine oxidase inhibitors (MAOIs)-tricyclic antidepressants (TCAs) Special consideration: have a delay of onset (usually 10-21 days) as the patient's neurotransmitters are modified from the medication, so these drugs should never be taken on "as needed" basis; a medication guide must always be dispensed with all antidepressants

antidepressants

Drug Class: ? Mechanism of Action: decrease bowel motility and act as a water adsorbent Indication: used for symptomatic relief of diarrhea Side effects: - Examples: -diphenoxylate with atropine-loperamide-bismuth subsalicylate Special consideration: diarrhea can lead to dehydration and should be monitored

antidiarrheals

medication that lowers a fever

antipyretics

Brand Name: Lipitor Drug Class: antihyperlipidemic--HMG CoA Reductase Inhibitor Indication: treatment of high cholesterol Controlled: no

atorvastatic calcium

a secure storage device that contains medications used by specific patient care units; access is limited to authorized individuals who has patient order that need to be filled

automated dispensing cabinets

bright, colorful label placed o a bottle label to provide information in addiction with what is on the bottle label; alerts patients to specific information to which careful attention should be paid

auxiliary label

an antibiotic that kills bacteria

bactericidal

an antibiotic that inhibits growth of bacteria

bacteriostatic

a unique 6-digit number identifying each third party to determine where the electronic claim should be sent

biller identification number (BIN)

a warning communicated to medical personnel through product package inserts that alerts physicians to serious adverse reaction potential of specific medications

black box warning

antibiotics that are effective against a wide variety of bacteria, and effectiveness is not limited to one specific type of bacteria (gram positive or gram negative)

broad spectrum

a method of drug delivery in which a medication is placed into the cheek pouch and absorbed through the blood vessels of the cheek

buccal

a solid tablet dosage form shaped like a capsule; can assist in easier swallowing of large tablets

caplet

a container, usually made of gelatin, that contains a medication to be dissolved in the GI tract; easier to swallow than a tablet and generally has a slightly faster onset of action

capsule

health benefits program that helps pay medical expenses for the families of veterans who have been disable because of injuries related to military experience

champva

a tablet that is to be chewed and swallowed; not swallowed whole; ideal for children and patients who have difficulty swallowing tablets; has a faster onset of action than regular tablets

chewable tablet

Brand Name: Plavix Drug Class: platelet inhibitor Indication: prevention of blood clots Controlled: no

clopidogrel bisulfate

the fee a patient pays at the time of service

co-payment

a fee a patients pays for services rendered based on a percentage of the cost. Example: if the plan pays 80% and the patient pays 20% of the cost of the services, and the prescription costs $100, then the patient's responsibility will be $20, and the insurance will pay $80.

coinsurance

the electronic entry to instructions from practitioners in a hospital for patient orders. -can include order for lab tests, pharmacy, physical therapy, and other hospital units -gives other caregivers immediate access to patient orders and records -helps improve workflow and compliance with documentation of patient issues

computer physician order entry (CPOE)

a type of extended-release formulation that delivers that drug at a certain rate for a specific period of time

controlled release (CR)

DEA electronic version of form 222 for ordering of controlled substances -pharmacies do not have to complete corresponding 222 paperwork for ordering

controlled substance ordering system (CSOS)

when a patient has multiple insurance providers, one provider must be selected as the primary insurance and billed first. If there are unpaid claims that remain, the second insurance company can be billed, but only if there are charges remaining. This prevents duplication of reimbursement and payment.

coordination of benefits

Mineral: ? Chemical Symbol: Cu Use in the body: blood formation

copper

a device used to count tablets, capsules, or other solid oral medications and transfer these dosage forms from the stock bottle to the patient's medication bottle

counting trays

Alternative Supplement: ? Common Use: urinary health

cranberry

topical dosage form that contains more water than oil; an oil-in-water preparation; hydrocortisone cream for itching

cream

the amount that must be paid each year out of pocket before benefits will kick in

deductible

tablets that are specially coated and designed to delay absorption and dissolving until after the drugs has bypassed the stomach

delayed release (DR)

a person on a member's plan who is also covered by the insurance policy--an example could be a spouse or child

dependent

a medication order that gives instructions for a patient who is being discharged from the hospital; it should include all at-home information and prescription instructions for the patient until follow-up with a primary care physician can occur.

discharge order

a part of the prescription that when checked indicates that the generic of a drug must not be dispensed; brand name is required.

dispense as written (DAW)

the process of a drug moving from the blood into the tissues and cells to elicit the action of the drug

distribution

the physical form the drug is dispensed as. Examples: -tablet, -capsule -liquid

dosage form

a substance that alters the body in a specific way and is used in the treatment, prevention, or diagnosis of a disease, Can be: -therapeutic -prophylactic

drug

when a drug interacts with another substance when taken concurrently

drug interaction

an evaluation is required by OBRA to determine whether a medication is safe for the patient based on selected criteria and cost-effective measures

drug utilization review

an effect a drug has on the disease state or pathological condition of a patient; can be either a positive or negative effect

drug-disease interaction

the interaction of two drugs when taken together that differs in the response that would occur if each were taken alone; can usually be classified as one of the following type of interaction; -synergy -antagonism

drug-drug interaction

when the effect of a drug is altered due to the consumption of a particular food or drink; this could prevent the drug from working, enhance of decrease side effects, or cause the development of a new side effect

drug-food interaction

any medical equipment used to aid patients in achieving a better lifestyle. Examples: -cane -walker- -wheelchair -hospital bed -insulin supplies -nebulizer

durable medical equipment (DME)

direct transmission of prescriptions from physicians to the pharmacy; helps minimize errors due to illegibility in handwriting, and helps reduce the potential for forged prescriptions form drug-seeking patients

e-prescribing

Alternative Supplement: ? Common Use: colds

echinacea

electronic documentation of administration of medications rather than a nurse or caregiver documenting on a paper chart; the patient's chart is electronic, and the system is paperless -helps minimize medication errors by eliminating handwriting illegibility -helps minimize dosing problems and patient error by utilizing barcoding technology

electronic medication administration record (EMAR)

a liquid dosage form that is sweetened and usually contains alcohol

elixir

a mixture of two substances that normally would not mix together; mist be shaken well prior to use

emulsion

a solution that is administered rectally for bowel cleansing and evacuation; given prior to a procedure or for a specific treatment

enema

a tablet that is specially cared to aid in swallowing and to bypass the stomach so that it will not dissolve until it reaches the small intestine; designed for medications that may be harsh on the stomach (Aspirin)

enteric coating (EC)

the ISMP has created a list of abbreviations that are frequently misinterpreted. The use of these abbreviations should be limited, and if a technician encounters one in practice, he or she should always verify the correct meaning.

error-prone abbreviations

Alternative Supplement: ? Common Use: premenstrual symptoms

evening primrose

the process of removing a drug from the body, usually through urine (kidneys)

excretion/elimination

Drug Class: ? Mechanism of Action: decrease thickness of mucous in lungs Indication: used to decrease thickness and break up fluid in the lungs so that a cough will become productive and allow the patient so expel mucous Side effects: - Examples: -guaifenesin Special consideration: drinking water helps rid the lungs and mucous naturally

expectorants

a type of medication that allows a reduced frequently in dosing

extended release (XR, XL)

Alternative Supplement: ? Common Use: blood pressure and cholesterol

fish oil

drugs that are store on each unit of the hospital that are frequently prescribed for that unit; most floor stocks are stored in automated dispensing cabinets

floor stock

a list of drugs approved by the insurance company to be covered under an individual's plan; also a list medications approved by the P&T committee for administration to patients in a hospital or long-term care facility

formulary

Alternative Supplement: ? Common Use: cholesterol and cardiovascular health

garlic

Alternative Supplement: ? Common Use: nausea, GI upset

ginger

Alternative Supplement: ? Common Use: improve memory and prevent dementia

ginkgo biloba

Alternative Supplement: ? Common Use: fatigue

ginseng

Alternative Supplement: ? Common Use: allergies

grape seed

Alternative Supplement: ? Common Use: metabolic syndromes

green tea

a type of insurance plan that requires the designation of a primary care physician (PCP). Patients must first get referral from their PCP for any type of specialty services

health maintenance organization (HMO)

medications that if used in error carry a greater risk of causing patient harm.

high-alert medications

has no effect on the therapeutic action of a drug; also known as excipient or inert ingredients. Examples: -colorings -flavorings -preservatives -fillers

inactive ingredient

administration of a drug through inhalation into the lungs, used mostly for a asthma and COPD treatment methods

inhalation

parts of the prescription that includes the name and strength of the medication prescribed and the amount to be dispensed. Ex: Lipitor 10 mg #30

inscription

an organization whose mission is to investigate medication errors and help provide error-reduction strategies to the medical community.

institute for safe medication practices (ISMP)

adminsiteration of medication given just below the epidermis (top layer of the skin); must only inject small amount of medication--will raised the skin to form a wheal. Example; tuberculosis skin tests are administered intradermally.

intradermal

administration of a medication injected into the muscle; typically no more than 2 mL of liquid can be injected, but can go up to 5 mL; common injection sites are gluteus Maximus (butt) and deltoid (shoulder); inject at 90-degree angle

intramuscular

small device inserted into the uterus to prevent pregnancy; effective means of birth control for several years

intrauterine device (IUD)

also known as IV, administration of a drug directly into the bloodstream through a vein.

intravenous

purchasing of inventory in quantities that just meet the demands until the next time ordering is completed -reduces amount of inventory -can only be used if the pharmacy can predict the needs of patients, and if supplies are readily available -current drug shortages make just-in-time purchasing difficult

just-in-time purchasing

the zero placed before the decimal point; required and should always be included in dosing

leading zero

Brand Name: Prinivil, Zestril Drug Class: antihypertensive: ACE inhibitor Indication: treatment of high blood pressure (hypertension) Controlled: no

lisinopril

an effect of a drug that involves a specific part of the body only; for example, using a numbing agent on an injured area

localized effect

a list of medications developed by the ISMP that have the potential to be confused with other drugs

look-alike/sound-alike (LASE)

number assigned by a manufacturer based on the batch when it was produced; allows tracking of a product so that it can be located in the event of a recall

lot number

topical dosage form composed of an oil-in-water base and thinner in a consistency lighter than cream, which helps them to absorb faster and be lighter on the skin; OTC moisturizers

lotion

a solid oral dosage form that usually has localized effects; proper use is to suck or chew this (nicotine gum)

lozenge/troche

government -funded program run individual by each stare for the low-income population

medicaid

government insurance provided to patients who are 65 or older, or younger patients with certain disabilities

medicare

portion of Medicare that provided coverage for inpatient hospital stays, nursing facilities, home healthcare services, and hospice care

medicare part A

portion of Medicare that provides coverage for durable medical equipment (DME), outpatient services from hospitals, and physician services.

medicare part B

portion of Medicare that is also known as the Medicare Advantage Plan; patients can receive benefits through a separate provider, but must be enrolled in Medicare Parts A and B to be eligible

medicare part C

portion of Medicare that is the voluntary prescription drug coverage; patients must enroll during an eligibility period

medicare part D

any preventable that may cause or lead to inappropriate medication use or patient harm

medication error

supplemental information required by the FDA to be included in additions to the patient package insert for specific drugs

medication guide (MedGuide)

an order written by a prescriber for a patient in a hospital or other inpatient setting

medication order

Alternative Supplement: ? Common Use: insomnia, jet lag

melatonin

the process of a drug being converted to a form that is easily eliminated from the body

metabolism

propellant inhaler used by asthma patients that delivers a specific amount of medication through compressed gas

metered-dose inhaler (MDI)

Alternative Supplement: ? Common Use: liver disease

milk thistle

Brand Name: Nasonex Drug Class: antiallergy agent--nasal spray--steroid Indication: treatment and prophylaxis of nasal allergy symptoms Controlled: no

mometasone furoate monohydrate

application of a drug into the nose; most often given in spray form

nasal

topical dosage form that contains more oil than water and tends to have a greasy or oily feel; a water-in-oil preparation (neosporin)

ointment

Brand Name: Prilosec Drug Class: antinuclear agent--Proton pump inhibitor (PPI) Indication: treatment of gastroesophageal reflux disease (GERD), ulcers, acid reflux, and other hypersecretory conditions Controlled: no

omeprazole

a prescribed dose is due to be given by not administered.

omissions error

application of a drug into the eye; must be a sterile solution

ophthalmic

most common route of administration--giving a medication by mouth -least expensive and most convenient route -not the quickest method because medication must be absorbed into the bloodstream from the GI tract -achieves best rates of patient's compliance to drug therapy

oral (PO)

a syring used to measure liquid to be given orally to pediatric patients. Comes with a cap so that doses can be dispensed for individual patients

oral syringe

application of a drug into the ear; medications used for the ear can be used in the eye; however, if necessary eye drops can be used in the ear

otic

the total amount a patient will pay from their own money. This amount is generally regulated by the insurance company and set at a certain limit

out of pocket expenses

a measure of how acidic or basic solution is; close to 1 is more acidic, and close to 14 is more basic.

pH

administration of a drug that involves any type of injection that bypasses the stomach; because it enters the bloodstream directly, it must be a sterile dosage form

parenteral

if a pharmacy does not have a sufficient supply of a medication to fill an entire order for a patient, a partial fill may be given: -usually a three-to-five-day supply (enough to last the patient until the pharmacy receives stock from the wholesaler)

partial fill

topical dosage form similar to an ointment, but it creates a heavier consistency, and thus the application is thicker than an ointment or cream (sunscreen)

paste

anything that can identify the patient when administering his or her medication.

patient identifier

required by the FDA for all medications dispensed; provides information about the drug for the patient

patient package insert

a database of information stored in a pharmacy system for each patient; should be continually updated by the pharmacy technician

patient profile

the amount of stock that should be on the shelves to meet demands; when inventory falls below par levels, stock should be reordered to replenish inventory

periodic automatic replenishment (Par level)

the code given to distinguish which person the service is being provided. Example: -member person code=00 -spouse person code=01 -first child=02 -second child=03

person code

some issues require the decision making and clinical knowledge of a pharmacist

pharmacist intervention

committee comprised a nurses, physicians, pharmacists, and sometimes technicians within a hospital that meets on a regular basis to review issues related to medications, including: -hospital formulary: -reviewing, maintaining, and updating when necessary -medication use evaluations (MUEs) -discussing and investigating medication errors

pharmacy and therapeutics committee (P & T committee)

a third party administrator of prescription drug programs who processes and pays for all drug claims and manages the formally for each plan

pharmacy benefit manager (PBM)

a substance that has no medicinal treatment value, often used in medical research for studies

placebo

an attempt by a member to fill a prescription for too large a quantity--for example, attempting to obtain a 90-day supply of medication when only a 30 day supply is covered

plan limitations exceeded

a type of insurance plan that does not require that designation of a primary care physician (PCP), but has a network of preferred providers to select from when services are needed

preferred provider organization (PPO)

the cost of the insurance coverage paid for by the member

premium

an order written for a patient by a licensed practitioner for be filled by a pharmacist.

prescription

label should be affixed to the medication container and match the prescription exactly.

prescription container label

special approval needed before an insurance company will cover a specific medication for a patient, generally an expensive bran name drug that is not present on the formulary

prior authorization

a medication order given on an "as needed" basis for specific signs and symptoms exhibited by a patient

prn order

information sent from the wholesaler on a medication for the pharmacy to utilize for any material needed regarding a specific drug; written for the pharmacist and technician--not for the patient

product package insert (PPI)

prevent or decreases severity of a disease

prophylactic

administration of a drug into the rectum; usually given via suppositories, but also may be given through an enema

rectal

an attempt by a member to get a prescription refilled before the insurance company permits a schedule fill

refill too soon

process of sending back medications when expired, damaged, or destroyed for credit from manufacturers

reverse distribution

when new inventory arrives and is being placed onto the shelf for storage, it should be placed in order of shortest expiration date so as to used the products that expire first before those that expire last

rotate stock

the way by which a drug enters into the body; selected based on several factors, including: -speed of onset required -patient status (ability to swallow a tablet) -drugs' absorption characteristics

route of administration

Alternative Supplement: ? Common Use: prostate disorders

saw palmetto

tablets that have a line or crevice to make splitting easier

scored tablets

Brand Name: Zocor Drug Class: antihyperlipidemic-HMG CoA reductase inhibitor Indication: treatment of high cholesterol Controlled: no

simvastatin

the part of the solution that is dissolved in the liquid, that is, the active ingredient

solute

a liquid in which the active ingredient completely dissolved

solution

the part of the solution that is composed of the liquid portion; the liquid that doses that dissolving (water when mixed with Kool-Aid)

solvent

Alternative Supplement: ? Common Use: menopausal symptoms

soy

a tubelike attachment to an MDI inhaler that helps patients, typically children, inhale the medication more easily and effectively

spacer

a type of medication order sent to the pharmacy that must be filled immediately.

stat order

administration of medication directly below the skin into the subcutaneous tissue; example of a medication administered via this route is insulin; inject at a 45-degree angle

subcutaneous

a method of drug delivery that involves placing a tablet under the tongue to be dissolved; the tablet can be absorbed quickly into the bloodstream through the blood vessels under the tongue -nitroglycerin, used for angina attacks. (nitrostat)

sublingual

another name for the member, or person who pays for the insurance, under his or he healthcare plan

subscriber

part of the prescription that includes directions to the pharmacist for dispensing the medication. Ex: number of refills permitted.

subscription

part of the prescription that includes the information at the top: the patient's name and address, date of birth, date the prescription was written, and Rx symbol.

superscription

a dosage form in a semi-solid state that is solid at room temperature but designed to melt at blood temperature; usually inserted rectally, can also be inserted vaginally or into the urethra

suppository

a liquid dosage form that is composed of undissolved particles of active ingredient suspended in a liquid; patients must be told to shake well when given this

suspension

a type of extended-release formulation that release the medication slowly over a specific period of time

sustained release (SR)

when two drugs taken together have a more intense effect than when each would be taken separately

synergy

a thick solution made with water and a large amount of sugar

syrup

an effect of a drug that involves the entire body; for examples, a blood pressure lowering agent

systematic effect

a solid dosage form made by compression

tablet

a device used to split tablets in half

tablet splitter

lettering used to help distinguish drug names that may be otherwise be confused

tall man lettering

formerly known as the Joint Commission on Accreditation of Healthcare Organization (JCAHO); accredits hospitals and evaluate facilities based on patient care standards and patient safety

the Joint Commission (TJC)

relieves symptoms of a disease

therapeutic

another name for an insurance provider

third party

any medication that is applied directly to the surface of the skin for localized effects

topical

the zero placed after or to the right of the decimal point; unnecessary and, if misinterpreted, could cause a tenfold increase in a medication to be incorrectly dispensed.

trailing zero

topical dosage form designed to deliver a drug enclosed with a patch to the body through skin absorption

transdermal patch

Brand Name: Desyrel Drug Class: antidepressant Indication: treatment of depression Controlled: no

trazodone hydrochloride

government health benefits program for military personnel and retire-less; also includes dependents of active-duty service members

tricare

a drug used in a hospital or other inpatient setting that prepackaged from bulk for a single administration for one patient

unit dose

to be repackaged from bulk.

unit dose labels

administration of a drug through the urethra, the tube that carries the urine from the bladder to the outside of the body; usually used for cancer or incontinence treatment

urethral

application of a drug into the vagina; used mostly for local effects such as a the treatment of yeast infections

vaginal

Alternative Supplement: ? Common Use: anxiety

valerian

purchasing from one wholesaler as a single source of multiples manufacturers of drugs and other medical products -quick turnaround time for drugs when available -when drugs aren't available, known as "back orders"

wholesaler purchasing

medical coverage for an employee who is injured on the job; patient will pay no portion of prescription drug costs

workers' compensation

a dose is given above or below the prescribed dose

wrong dose error

a prescribed dose is given out of the designated range of the hospital time guidelines

wrong time error