Pharmacy Operations. Basic Facts in Pharmacy. Pharmacy Technician Training Systems Passassured, LLC

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1 Pharmacy Operations Basic Facts in Pharmacy Pharmacy Technician Training Systems Passassured, LLC

2 Pharmacy Operations, Basic Facts in Pharmacy PassAssured's Pharmacy Technician Training Program Pharmacy Operations Basic Facts in Pharmacy Click Here for Glossary Index! (Internet Access is Required for this Feature) Click Here to Print Topic Help File,.pdf (Internet Access is Required for this Feature) Drug Names Chemical name meaningful to the pharmaceutical chemist Generic name (nonproprietary) Brand name (proprietary) Multiple source products: more than one manufacturer Prinivil - (Lisinopril) Zestril - (Lisinopril) Example: Brand name: Soma Generic name: Carisoprodol Chemical name: N-ISO-PROPYL-2-METHYL-2-PROPANESIOL-DICARBAMATE Codes Used in Pharmacy: National Drug Code (NDC) - can be found in Red Book, Blue Book Assigned by Federal Drug Administration Pharmacy use: p2

3 Computers Ordering Machines Submitting claims Checking medications Identification Can be found in the Red Book, Blue Book Example: NDC st five numbers identify manufacturer or distributor 2nd four numbers identify name, strength, and dosage form Last two numbers identify package size Uniform Product Code (UPC) Bar Code Mnemonic Code - Short Entry/Abbreviation Example: Pb 30mg (Phenobarbital 30mg) Expiration Dates Based on shelf-life Medication considered effective before the expiration date Exp. 06/03 - Drug expires last day of June 2003 Exp. 06/04/03 - Drug expires on June 4, 2003 Never dispense an expired product Reference Books / Information The United States Pharmacopoeia (USP) contains official drug standards and is a required reference source in all licensed pharmacy settings. The Remington's Pharmaceutical Sciences: reference book used to look up formulas. p3

4 Handbook on Injectable Drugs: Parenteral Product Reference Materials Guide to Parenteral Admixtures: Parenteral Product Reference Materials Facts and Comparisons is updated monthly and has information concerning new drugs and contains information on drug to drug interactions. Package insert is a good resource: Not for Patient Use Manufacturer supplied information is a good resource. American Drug Index provides all the following: Brand to generic name cross referencing, available medication dosage forms, and manufacturer name, address and phone number. Dispensing Containers Hermetically sealed containers are impervious to air. Vials These are in cylindrical shaped plastic containers and are available in a variety of sizes. They are typically amber in color to protect the contents from light which may cause the contained medication to deteriorate. Ointment Jars White plastic jars used to hold ointments and creams These prevent the penetration of light which may cause the contents to deteriorate, and there are no child-resistant closures. Bottles Glass bottles used to dispense liquid medications: Theophylline Valproic Acid Plastic bottles used to dispense liquid medications: Lindane Shampoo - Requires "External Use Only" label p4

5 Cough syrups Amber in color to protect the contents from light Sizes: 1-16 fluid ounces ii = 2 fluid ounces = 60cc iii = 3 fluid ounces = 90cc xvi = 16 fluid ounces = 480cc Dropper Bottles These are glass bottles with droppers inside the cap; are used for small doses. Used for infant drops: Ear drops NOT eye drops unless sterile Oral syringes are unable to accept a Luer-lock needle. They are often used for dispensing liquid medication to children and for dispensing liquid medication in respiratory devices. Unit Dose These are used to supply medicine to patients in nursing homes, assisted living centers, or hospitals. Can be filled to provide medication for a designated period of time - 7 days, 30 days, etc. Unit dose cups (TJDC): Used for oral liquids in hospitals Dose Packs These are medications packaged to improve patient compliance. These usually provide medication which is taken every day or has complicated instructions. Examples: Month supply of birth control pills, Medrol dose pack p5

6 Parenteral Bags Used to administer infusion medications. This is covered in Aseptic Techniques. Closures Two Types Child resistant Easy-open or non-safety Child-resistant vial caps may not be reused. The Poison Prevention Packaging Act of 1970 This act requires that most over-the-counter medications and prescription medications use child-resistant containers. Exemptions Prescribing physician or patient request non-safety/easy open Obtain patient's signature in writing Prescription dispensed to care facilities if staff dispensing Manufacturers of over-the-counter products are allowed to market non-safety closures on a single size of a product for use by the elderly or handicapped individuals. Legend Drugs That are Exempt Sublingual Nitroglycerin Sublingual or chewable Isosorbide Dinitrate in strengths of 10mg or less Packages of Sodium Fluoride products containing 264mg or less Anhydrous Cholestyramine powder Packages of Methylprednisolone tablets containing 84mg or less Packages of Mebendazole tablets containing 600mg or less Packages of Betamethasone tablets containing 12.6mg or less Potassium supplements one unit dose forms containing 50 meq or less p6

7 Erythromycin Ethylsuccinate granules in packages of 8gm or less Erythromycin Ethylsuccinate tablets containing 16gm or less Packets of Colestipol powder of 5g or less Containers of aerosol inhalation therapy Pancrelipase preparations Packages of Prednisone containing 105mg or less Oral contraceptives in manufacturers calendar packs Roles of the Pharmacy Technician Hospital Setting: Obtain patient information Updating databases Prepare, dispense, distribute medication under the direct supervision of a pharmacist Compounding Mixing IVs Fill med carts for the floors Process bulk orders Deliver medication to the correct floors for the patients Pharmacy setting: Obtain patient information Update databases Prepare, dispense, distribute medication under the direct supervision of a pharmacist Refilling medication Compounding Assisting customers with purchases Working a register Answering phones Contacting insurance companies Non-traditional settings are also becoming more popular and technicians are finding employment with large medical insurance companies, drug manufacturing companies, drug wholesale companies, and as instructors in pharmacy technician training programs. Automated Packaging Equipment / Automated Distribution Pharmacies use a variety of automated packaging equipment. Automated packing equipment systems are created to streamline pharmacy workflow, improve accuracy and efficiency, and reduce labor costs. While working in a pharmacy, you will need to become familiar with all the automated packing systems that pharmacies use and participate in the p7

8 automated distribution of medication. Automated distribution is when a device dispenses medications and fills prescriptions. Automated dispensing cabinets can possibly handle hundreds of different medications. An automated dispensing cabinet (ADC) is a drug storage cabinet that is computerized to help control the tracking of the distribution of medication. Other names for automated dispensing cabinets are automated distribution devices (ADD), automated dispensing machines (ADM) and unit-based cabinets (UBC). Infection Control Policies and procedures used to minimize the risk of spreading infection in a pharmacy. Purpose The purpose of infection control is to reduce the occurrence of infectious diseases. These diseases are usually caused by bacteria or viruses and can be spread by human to human contact, airborne transmission through tiny droplets of infectious agents suspended in the air, and, finally, by such common vehicles as food or water. Pharmacy technicians are expected to comply with generally accepted standards of personal hygiene and with specific guidelines for their position or area relative to hand washing, orderliness and cleanliness. It is important to read OSHA regulations to determine the appropriate way to handle safety topics in the pharmacy. Review your state regulations on handling hazardous waste in a pharmacy. Durable Medical Equipment Durable Medical Equipment (DME) means technologically sophisticated medical devices that may be used in a residence. Below is a list of some items that a pharmacy might carry which can be covered by insurance companies if a doctor writes a prescription for these items. All items will be added into the inventory as Durable Medical Equipment (DME). Check the pharmacy s policy and procedure manual for adding DME into inventory. Bathtub Lifts/seats Bed lifters Bed pans Bed side rails Bed side commodes Blood glucose monitors Canes Catheters Continuous Positive Airway Pressure (CPAP) Devices Dehumidifiers p8

9 Elastic Stockings Emesis Basins Fabric supports Face masks( surgical and oxygen) Flow meters Heating pads Hot pads Incontinent pads Infusion Pumps Nebulizers Portable Oxygen Systems Support hose Vaporizers Ventilators Walkers Wheelchairs Removing expired, discontinued or recalled items from inventory One of the duties for a pharmacy technician is to remove all expired, discontinued and recalled items from inventory. Depending on what kind Expired: medication that is past the date of what the manufacturer has given for the drug to be at its highest potential. Discontinued: item or medication that is no longer offered, to cease making or manufacturing. Recalled: to request return of a product to the manufacturer Basic Life Support Healthcare Provider While working in a healthcare setting, it is always encouraged to become a certified Basic Life Support (BLS) Healthcare Provider. Basic Life Support is a form of CPR that is taught to individuals that are already trained in the healthcare field. They are able to understand basic medical terminology and will come into contact with patients or customers that might need emergency assistance. You will learn how to react in an emergency situation such as drowning, choking and cardiac arrest. By becoming BLS certified, you can assist in a crisis that could save a life while emergency medical providers are on their way. You can become BLS certified by taking an online course or contacting American Heart Association and finding a class near you. p9

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