CPJE Video 3: Regulation of Pharmacy Practice, part II Correct 100%(SCORED A+)

A doctor's office wants to obtain an office supply of a compounded ointment from the local pharmacy to use for his patients with neuropathic pain. Which of the following is the MOST appropriate action for the pharmacist to take? Answer A. Inform the prescriber that the pharmacy can furnish compounded preparations to prescribers for office use only. B. Inform the prescriber that he can give each patient no more than a 7-day supply from his office supply. C. Inform the prescriber that he can only give each patient a 24-hour supply from his office supply. D. Inform the prescriber that the pharmacy can furnish compounded preparations to prescribers for distribution only. - ANSWER A. Inform the prescriber that the pharmacy can furnish compounded preparations to prescribers for office use only. Pharmacies cannot furnish compounded preparations to prescribers for distribution to human patients but can furnish compounded preparations to prescribers for office use. Who is responsible for consultations and maintenance of a medication profile for prescriptions that are refilled by a refill pharmacy? A. If a prescription is refilled at a refill pharmacy there is no legal requirement to keep a patient profile. B. If a prescription is refilled at a refill pharmacy there is no legal requirement to provide patient consultation. C. The originating pharmacy. D. The refill pharmacy. - ANSWER C. The originating pharmacy. The originating pharmacy is responsible for counseling patients, maintaining the medication profiles and performing a drug utilization review before delivery of each prescription. There is an automated drug delivery system in the intensive care unit of a hospital. The nursing staff, under doctor's orders, have entered several overrides during the past week to obtain drugs that had not been approved by a pharmacist for various patients. Which of the following is the MOST appropriate action for the pharmacy staff to take: A. Require all overrides to be investigated within 24 hours by nursing and pharmacy leadership. B. Limit the override function so that it can only be used for select drugs that may be needed in true emergencies. C. Continue to allow the use of overrides on all drugs in acute care units due to the possibility of rapidly changing conditions. D. Report this to the Nursing and Pharmacy Boards because overrides are illegal. - ANSWER B. Limit the override function so that it can only be used for select drugs that may be needed in true emergencies. Refer to the Medication Safety & Quality Improvement chapter of the RxPrep Course Book. Use of an override to retrieve medication before the pharmacist can review the order should be done in emergency situations only. When a pharmacy compounds medications, it must use reliable suppliers in order to ensure the integrity of the ingredients. Which of the following strategies can be used to ensure quality ingredients are used? A. If receiving material from an out-of-state pharmacy or wholesaler, they should be licensed in California. B. Use FDA licensed manufacturers, CA Department of Public Health-FDA licensed drug repackagers, or CA licensed pharmacies and wholesalers. C. All of the answers are correct. D. When purchasing chemicals from another country, obtain a certificate issued by the FDA authorizing shipment of the product into the US and a certificate of analysis. - ANSWER C. All of the answers are correct. Which of the following statements concerning generic substitution is correct? Answer A. The pharmacist can substitute a BB rated generic drug for the brand name if the patient allows it. B. The pharmacist can substitute an AB rated generic drug for the brand name even if the provider writes "Do not substitute" on the prescription. C. The pharmacist can substitute any FDA-approved biosimilar for the brand name biologic product. D. The pharmacist can substitute amoxicillin suspension for the capsule at the same dose without contacting the prescriber - ANSWER D. The pharmacist can substitute amoxicillin suspension for the capsule at the same dose without contacting the prescriber A BB rated generic is NOT considered therapeutically equivalent to the brand name, but an AB rated generic is therapeutically equivalent and can be substituted unless the prescriber indicates not to. Biosimilars can only be substituted for the brand name if they are FDA-approved as interchangeable, which no biosimilars have been approved for at this time. Switching formulations can occur if the dose is equivalent and the change will improve patient compliance. Which class of medication is unlikely to be included in a therapeutic interchange protocol? A. Antacids B. Antiretrovirals indicated for HIV C. 1st, 2nd and 3rd generation cephalosporins D. Quinolone antibiotics - ANSWER B. Antiretrovirals indicated for HIV The selection of an ART regimen is highly individualized. Patients that are stable on a particular