Pharmacists in Indiana are allowed denying the sale of ephedrine or pseudoephedrine products.

True or False

Pharmacists in Indiana are allowed denying the sale of ephedrine or pseudoephedrine products.

True or False

Answer: True. Pharmacists in Indiana may refuse to sell ephedrine or pseudoephedrine to a purchaser if the pharmacist determines that the drugs are not medically necessary, according to a recently passed law that goes into effect July 1, 2016. The pharmacist is provided with civil immunity for denying the sale, under Senate Bill 80 (SB 80).
 
The law states an individual who has a relationship on record with a pharmacy may purchase pseudoephedrine or ephedrine. However, if the purchaser does not have a relationship on record with the pharmacy, the pharmacist is required to determine whether there is a legitimate medical or pharmaceutical need for the ephedrine or pseudoephedrine.
 
A person who is denied the sale of a pseudoephedrine or ephedrine product may obtain pseudoephedrine or ephedrine pursuant to a prescription. SB 80 also adds ephedrine and pseudoephedrine to the definition of “controlled substance” for purposes of the Indiana Scheduled Prescription Electronic Collection and Tracking program. The Indiana Board of Pharmacy is required to adopt emergency rules that are effective July 1, 2016, under the bill.

Which of the following best describes the Capitation System?
 
a. Risk free income for healthcare service providers.
b. Healthcare provider may get more incentive to provide an extended treatment to a patient.
c. A fixed amount of money per patient per unit of time paid in advance to the physician for the delivery of health care services.
d. A patient gets more benefit if he/she gets services from Healthcare provider receiving reimbursement through capitation.
e. Free prescription benefits to patients.

Which of the following best describes the Capitation System?
 
a. Risk free income for healthcare service providers.
b. Healthcare provider may get more incentive to provide an extended treatment to a patient.
c. A fixed amount of money per patient per unit of time paid in advance to the physician for the delivery of health care services.
d. A patient gets more benefit if he/she gets services from Healthcare provider receiving reimbursement through capitation.
e. Free prescription benefits to patients.

Answer: Capitation payments are used by managed care organizations to control health care costs. Capitation payments control use of health care resources by putting the physician at financial risk for services provided to patients. At the same time, in order to ensure that patients do not receive suboptimal care through under-utilization of health care services, managed care organizations measure rates of resource utilization in physician practices. These reports are made available to the public as a measure of health care quality, and can be linked to financial rewards, such as bonuses.
 
Capitation is a fixed amount of money per patient per unit of time paid in advance to the physician for the delivery of health care services. The actual amount of money paid is determined by the ranges of services that are provided, the number of patients involved, and the period of time during which the services are provided. Capitation rates are developed using local costs and average utilization of services and therefore can vary from one region of the country to another. In many plans, a risk pool is established as a percentage of the capitation payment. Money in this risk pool is withheld from the physician until the end of the fiscal year. If the health plan does well financially, the money is paid to the physician; if the health plan does poorly, the money is kept to pay the deficit expenses.
 
When the primary care provider signs a capitation agreement, a list of specific services that must be provided to patients is included in the contract. The amount of the capitation will be determined in part by the number of services provided and will vary from health plan to health plan, but most capitation payment plans for primary care services include the following:
 
·         Preventive, diagnostic, and treatment services
·         Injections, immunizations, and medications administered in the office
·         Outpatient laboratory tests done either in the office or at a designated laboratory
·         Health education and counseling services performed in the office
·         Routine vision and hearing screening

Slow channel blocking drugs will reduce the movement of which substance into smooth muscle cells? (Select All that apply)

a. Renin
b. Kinin
c. Calcium
d. Sodium
e. Bradykinin

Slow channel blocking drugs will reduce the movement of which substance into smooth muscle cells? (Select All that apply)

a. Renin
b. Kinin
c. Calcium
d. Sodium
e. Bradykinin
 
Answer: (c). Slow channel blockers inhibit the slow inward calcium current, which may prolong conduction and refractoriness in the AV node.

Which of the following information is TRUE ABOUT anaerobic respiration? (Select All that apply)
 
a. Waste products are carbon dioxide and water.
b. It may produce between 36 and 38 ATP molecules.
c. In animals, including humans, the anaerobic cycle produces lactic acid, which causes muscle cramps.
d. The fermentation process in anaerobic respiration is roughly 5 percent as effective as what cells can do when they have access to oxygen.
e. In bacteria, it may produce nitrite, nitrogen gas, hydrogen sulfide, methane and acetic acid.

Which of the following information is TRUE ABOUT anaerobic respiration? (Select All that apply)
 
a. Waste products are carbon dioxide and water.
b. It may produce between 36 and 38 ATP molecules.
c. In animals, including humans, the anaerobic cycle produces lactic acid, which causes muscle cramps.
d. The fermentation process in anaerobic respiration is roughly 5 percent as effective as what cells can do when they have access to oxygen.
e. In bacteria, it may produce nitrite, nitrogen gas, hydrogen sulfide, methane and acetic acid.
 
Answer (c, d and e). "Anaerobic" means without oxygen, and respiration refers to the processes in a cell that convert biochemical energy, such as that found in glucose, into usable energy in the form of ATP. Waste products like carbon dioxide are also produced during this process.

The fermentation process in anaerobic respiration is roughly 5 percent as effective as what cells can do when they have access to oxygen. An aerobic cycle may produce between 36 and 38 ATP molecules, while anaerobic respiration only creates 2 ATP molecules.

Since muscles often run out of oxygen during extreme exertion, anaerobic respiration keeps them running. In animals, including humans, the anaerobic cycle produces lactic acid, which causes muscle cramps. In order for these cramps to stop, oxygen must find its way back into the muscle again so these cells can switch back to aerobic respiration and stop building up lactic acid.

Anaerobic respiration is also common in bacteria that live in environments without oxygen; depending on the bacteria, the products of their respiration include nitrite, nitrogen gas, hydrogen sulfide, methane and acetic acid.

New York Law Mandate Electronic Prescribing Law.

Prescribers in the state of New York must issue electronic prescriptions directly to a pharmacy according to a new law. All prescriptions must be transmitted in electronic format, except for certain limited circumstances, effective March 27, 2016, under the Internet System for Tracking Over-Prescribing (I-STOP) Act. The regulations require prescribers and pharmacists to have a secure system for electronic transmission of the prescription from computer to computer in order to protect the confidentiality of patient information, notes the Office of the Professions (OP) advisory notice. For additional information on the electronic transmittal of prescriptions in New York, visit the OP section of the New York State Education Department website.
 
The New York Times states that New York is the first state to mandate electronic prescribing and enforce penalties, such as fines and imprisonment, for physicians who do not comply. The New York Times also notes that Minnesota has an electronic prescribing law but does not enforce or fine physicians for not complying with the mandate.

Reprinted from the April 2009 Nevada State Board of Pharmacy Newsletter.

Although buprenorphine is not approved for use in pain, pharmacists are seeing an increasing number of prescriptions for this use...

Reprinted from the April 2009 Nevada State Board of Pharmacy Newsletter.

Although buprenorphine is not approved for use in pain, pharmacists are seeing an increasing number of prescriptions for this use. Rather than prescribed as a daily dose for addiction, it is usually given three to four times daily for pain. As you are all aware, buprenorphine prescribed for addiction requires the practitioner to have an “X” Drug Enforcement Administration (DEA) number, indicating special training in its use. It is legal for you to fill a buprenorphine prescription for pain with the prescriber’s regular DEA number just like all other Schedule III drugs. Your duty is to ensure that the prescription is indeed for the treatment of pain, which should hopefully be noted in the directions. Since buprenorphine can displace opioid agonists, watch for interactions that may precipitate withdrawal.

 Please note that under Georgia Controlled Substances Act, following drugs are classified as controlled substances...

 Please note that under Georgia Controlled Substances Act, following drugs are classified as controlled substances:

1. Carisoprodol (Schedule IV)

2. Sodium oxybate (Schedule III)

3. Synthetic Cannabinoids (Schedule I)

4. Ketamine (Schedule III)

 The Food and Drug Administration has approved Plan B One Step, a brand of emergency contraceptive, to be available for women 15 and older without a prescription...

The Food and Drug Administration has approved Plan B One Step, a brand of emergency contraceptive, to be available for women 15 and older without a prescription.

This comes almost a month after a federal judge ordered the FDA to make Plan B available to everyone over-the-counter, which will go into effect on May 5, unless the FDA appeals the ruling.

"The Department of Justice is considering next steps in the litigation," the FDA said in a statement. "In the meantime, the FDA took independent action to approve the pending application on Plan B One-Step for use without a prescription by women 15 years of age or older."

Judge Edward Korman ordered emergency contraceptive to be made available over the counter on April 5, citing "bad faith" that resulted in restricted access to the drug in the past. Prior to that, it was available to everyone 17 and older without a prescription.

The morning after pill is intended to be used when other contraception fails, such as when a condom breaks. Containing the synthetic hormone levonorgestrel, the pill works by preventing a fertilized egg from attaching itself to the uterine wall. But it must be taken within 72 hours of unprotected sex. It cannot terminate an existing pregnancy.

Although today's FDA approval means women seeking Plan B will need to have identification to prove they are of age to purchase it, the drug will no longer be available only when the pharmacy is open, according to an FDA statement. Instead, it will be available in the family planning and female health aisles.