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PHM 552 EXAM II Questions and Answers 2024( A+ GRADED 100% VERIFIED).
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PHM 552 EXAM IImedication management
-key to medication management in a hospital is the *formulary system* - ANS Describes the
process used to assure *safe and effective* use of drugs in a cost conscious manner
drug formulary - ANS • A *continually updated list of medications* established by the Pharmacy
and Therapeutics (P&T) Committee
• Supported by *current evidence-based medicine*, judgment of physicians, pharmacists and
other experts in the diagnosis and treatment of disease and preservation of health
• The primary purpose is to encourage the use of *safe, effective, and most affordable
medications*
closed formulary - ANS • List of medications which limits access of a prescriber to certain
medications
• Limited selection --> ↓ cost
• A common practice in the hospital setting
open formulary - ANS A list of medications in which prescribers have no restrictions on
ordering/prescribing medications
• Broader selection -->↑ costs
RESTRICTED formulary medications
-usually to minimize side effects and costs - ANS Certain medications on the formulary are
limited or restricted to specific physicians, patient care areas, or disease states via formulary
restrictions
• Example: Certain antibiotics can only be ordered by Infectious Disease (ID) physicians
-A non-formulary medication will go through an *approval process* if it is
needed
-Many CPOE systems give an alert to the prescriber that the medication is non-formulary
-The physician will *need to present evidence* that the medication is appropriate for the patient
,----Typically, the patient has tried other medications, or the alternative is not appropriate
(Analogous to filling out a prior authorization in the out-patient setting) - ANS WHAT HAPPENS
WHEN A NON-FORMULARY MEDICATION IS ORDERED IN A CLOSED FORMULARY
HOSPITAL?
"is there a therapeutic interchange?"
"are there any contraindications?
ETC. - ANS What questions would you ask the prescriber if he/she orders a non-formulary
antibiotic?
Pharmacy and Therapeutics (P&T) - ANS -Composed of representatives from *medical staff,
administration, pharmacy, and nursing*
-A committee with oversight for medication management including the drug formulary
-*Reviews the medication list* and guidelines on a regular basis to assure that it is current and
meets the needs of the medical staff and patients
P&T Committee - ANS • Establishes and *maintains the formulary*
• Prevents and monitors *adverse drug reactions* and medication
errors
• *Educates* health professionals to the optimal use of medications
• Develops of *protocols and procedures* for medications on the formulary
-DUR (drug utilization review)
-MUE (medication use evaluation) - ANS How are formulary drugs evaluated?
Drug Utilization Review (DUR) aka DUE (evaluation) - ANS A system of ongoing, systematic,
criteria-based evaluation of drug use that will *help ensure that medicines are used
APPROPRIATELY* generally in terms of prescribing
• If therapy is deemed to be inappropriate, interventions with providers or patients will be
necessary to optimize drug therapy
• Examples include *inappropriate use or incorrect doses of a medication*
*medication use evaluation (MUE)*
-similar to DUR but broader
, *did the patient's condition improve* - ANS emphasizes improving patient *outcomes and
individual quality of life*
• Dependent on a *multidisciplinary approach* involving all professionals dealing with drug
therapy
• Examples include: infection cure rates, decreased lipid levels, Use of tigecycline for
appropriate infections
• Did the physician prescribe tigecycline appropriately?
• Did the patient's condition improve?
*develop drug monograph*
• Pharmacists have the opportunity to assume a leadership role in introducing new medications
to the formulary
• Pharmacists will present the drug monograph to the P&T Committee - ANS HOW ARE NEW
DRUGS ADDED TO THE FORMULARY?
drug monograph - ANS A written, *unbiased evaluation of specific medication* with the
following components...
-Drug name
-Pharmacology
-Indications for use
-Summary of clinical trials
-Pharmacokinetics/dynamics
-Adverse effects and drug interactions
-Comparative costs, efficacy, and safety profile with drugs in the same class
• Why is this drug better than other drugs? Is the cost worth it? - ANS COMPONENTS OF
DRUG MONOGRAPH
A. How does this drug compare in *efficacy* to other drugs in the same/similar class?
B. How does this drug compare in *cost* to other drugs in the same/similar class?
C. How does this drug compare in *toxicity* to other drugs in the same/similar class? - ANS You
are the clinical pharmacist on the P&T Committee. A clinical pharmacist is trying to get a new
antibiotic on the formulary. What are some questions you would ask the clinical pharmacist who
is trying to get the new antibiotic on the formulary?
*managed care*
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