Which of the following is/are frequently used Remote Medication Order Processing (RMOP) model(s)?

I. Contracted Services
II. Supplemental Workload Balancing
III. Unit of Dispensing Services

a. I only
b. I and II only
c. II and III only
d. All

Which of the following is/are frequently used Remote Medication Order Processing (RMOP) model(s)?

I. Contracted Services
II. Supplemental Workload Balancing
III. Unit of Dispensing Services

a. I only
b. I and II only
c. II and III only
d. All

Answer: I and II only. The technologies used in Remote Medication Order Processing (RMOP) are relatively new and rapidly changing, so different methods for RMOP have evolved, and further evolution should be encouraged. At least two models of RMOP are currently in use: contracted services and supplemental workload balancing, which includes network workload balancing and on-call assistance.

Each of these models has unique characteristics that must be considered in planning for its use. Contracted Services. In this model, a hospital pharmacy that is not continuously open contracts with a larger hospital or a service to provide RMOP when its pharmacy is closed. This model is typically applied when a hospital without 24-hour pharmacy services has sufficient automated dispensing cabinet capacity that RMOP allows nursing staff to keep functioning without having a pharmacist present, although some institutions have developed models for remote verification by pharmacists of dispensing performed by pharmacy technicians at the client site.

Supplemental Workload Balancing. Similar to the model described above, in this case a health system with a number of hospitals relies on the ones that have a 24-hour pharmacy department or on a service to provide RMOP for hospitals whose pharmacies are closed or that experience unanticipated peaks in order processing workload. For example, in an on-call model, a staff pharmacist from the client site or a contracted service is placed on call to help with managing workload. This pharmacist works remotely (sometimes from a home office, where allowed by state regulation) to help the client’s pharmacy department manage unanticipated peaks in order processing workload (often on the second or third shift). In this model, the remote pharmacist is responsible for medication order entry and/or review, and medication order fulfillment occurs through the client-site pharmacy.

[Citation: http://www.ashp.org/DocLibrary/BestPractices/AutoITGdlRMOP.aspx]

A patient brings a new prescription for Zoloft. The prescription reads: Zoloft 25 mg, take 1 tablet by mouth every day for 30 days x 5 refills. The patient requests to fill the whole prescription, for 180 tablets, in a single filling. Which of the following would be the most appropriate action by the pharmacist under North Carolina Pharmacy Law?

a. Fill the requested amount.
b. Obtain the authorization from the prescribing physician.
c. Fill only 30-day supply.
d. Tell the patient that law does not permit to fill the whole supply.

Answer:

A patient brings a new prescription for Zoloft. The prescription reads: Zoloft 25 mg, take 1 tablet by mouth every day for 30 days x 5 refills. The patient requests to fill the whole prescription, for 180 tablets, in a single filling. Which of the following would be the most appropriate action by the pharmacist under North Carolina Pharmacy Law?

a. Fill the requested amount.
b. Obtain the authorization from the prescribing physician.
c. Fill only 30-day supply.
d. Tell the patient that law does not permit to fill the whole supply.

Answer: Obtain the authorization from prescribing physician, [21 NCAC 46 .1802(b)].

If deemed appropriate in the pharmacist's professional judgment, a patient may receive upon request drug quantities in excess of the face amount of a prescription for a non-controlled substance, up to the total amount authorized.

The pharmacist shall NOT dispense in excess of the face amount of a prescription for a controlled substance or psychotherapeutic drug (e.g. Zoloft) without authorization from the prescriber.

Which of the following is a strong indicator of an Internet pharmacy’s compliance with state and federal laws and regulations and NABP's criteria?

a. DMEPOS
b. VAWD
c. PARE
d. VIPPS
e. PCOA

Answer:

Which of the following is a strong indicator of an Internet pharmacy’s compliance with state and federal laws and regulations and NABP's criteria?

a. DMEPOS
b. VAWD
c. PARE
d. VIPPS
e. PCOA

Answer: VIPPS. The VIPPS accreditation program (Verified Internet Pharmacy Practice Sites), is a strong indicator of an Internet pharmacy’s compliance with state and federal laws and regulations and NABP's criteria. Online retailers of prescription drugs who seek VIPPS accreditation know that they will benefit from NABP’s recognized credibility and the decade-old VIPPS program and Seal. The VIPPS Seal demonstrates public accountability – it is also a symbol of a pharmacy’s commitment to its patients’ health and safety.

DMEPOS: NABP's DMEPOS accreditation program is the reliable and cost-effective choice for those pharmacies seeking durable medical equipment, prosthetics, orthotics, and supplies accreditation. With more than 100 years of experience in pharmacy, NABP understands the complexities of modern pharmacy practice and is committed to ensuring that Medicare beneficiaries receive the appropriate products, services, and patient care associated with DMEPOS products.

VAWD, or Verified-Accredited Wholesale Distributors, is an accreditation for pharmaceutical wholesale distribution facilities. Those wholesale distributors that achieve accreditation are in compliance with state and federal laws and NABP's VAWD criteria and proudly display the VAWD Seal.

PCOA: Responding to the need expressed by the United States Department of Education, the Accreditation Council for Pharmacy Education (ACPE), and some US colleges and schools of pharmacy for an assessment tool to assist with curriculum development and review, NABP has worked closely with key stakeholders to develop the Pharmacy Curriculum Outcomes Assessment (PCOA).

PARE: The Pharmacist Assessment for Remediation Evaluation (PARE) is a multi-dimensional assessment that the boards of pharmacy may use as an auxiliary tool when making decisions regarding pharmacist practice deficiencies that are due to noncompliance with pharmacy practice standards, laws or regulations, and result in compromises to patient safety.

“Class 100 environment” means an ISO class 5 atmospheric environment, which contains less than one hundred (100) particles:

a. 0.005 microns in diameter per cubic foot of air.
b. 0.05 microns in diameter per cubic foot of air.
c. 0.5 microns in diameter per cubic foot of air.
d. 5 microns in diameter per cubic foot of air.

Answer:

“Class 100 environment” means an ISO class 5 atmospheric environment, which contains less than one hundred (100) particles:

a. 0.005 microns in diameter per cubic foot of air.
b. 0.05 microns in diameter per cubic foot of air.
c. 0.5 microns in diameter per cubic foot of air.
d. 5 microns in diameter per cubic foot of air.

Answer:(c). Class 100 environment” means an ISO class 5 atmospheric environment, which contains less than one hundred (100) particles five-tenths (0.5) microns in diameter per cubic foot of air, according to the ISO for clean rooms and associated controlled environments.

A pharmacist may administer immunizations for which of the following to a group of individuals under a drug order or prescription?

I. Influenza
II. HPV infection
III. Meningitis

a. I only
b. I and II only
c. II and III only
d. All

Answer:

A pharmacist may administer immunizations for which of the following to a group of individuals under a drug order or prescription?

I. Influenza
II. HPV infection
III. Meningitis

a. I only
b. I and II only
c. II and III only
d. All

Answer:(d). All, [Indiana Code Title 25 Article(26) Chapter(13) Sec. 31.2(a)].

A pharmacist may administer immunizations for the following to a group of individuals under a drug order, under a prescription, or according to protocol approved by a physician:

(1). Influenza.
(2). Shingles (herpes zoster).
(3). Pneumonia.
(4). Tetanus, diphtheria, and acellular pertussis (whooping cough).
(5). Human papillomavirus (HPV) infection.
(6). Meningitis.

A pharmacist in a hospital pharmacy may relabel and dispense an injection of Morphine sulfate to another registered inpatient if:

I. The medication is in an unopened tamper-evident package.
II. The original medication order for the drug is discontinued.
III. The original patient is not charged for the medication.

A pharmacist in a hospital pharmacy may relabel and dispense an injection of Morphine sulfate to another registered inpatient if:

I. The medication is in an unopened tamper-evident package.
II. The original medication order for the drug is discontinued.
III. The original patient is not charged for the medication.

a. All of the above
b. I only
c. I and II only
d. None of the above

Answer (d): None of the above, [Connecticut Pharmacy Practice Act Title 20 Chapter 400j Section 20-621].

A pharmacist practicing in a hospital pharmacy or nursing home pharmacy may relabel and dispense to a registered inpatient, parenteral medication, EXCEPT CONTROLLED SUBSTANCES, dispensed for another registered patient by a licensed pharmacy if the following requirements are met:

(1). The original medication order for the drug is discontinued;

(2). the medication is in an unopened tamper-evident package;

(3). the medication is not expired;

(4). the original patient is not charged for the medication; and

(5). upon receipt of the medication by the facility from the licensed pharmacy, it is processed through the hospital's pharmacy or nursing home pharmacy.

Starch consists of:

I. Linear amylose
II. Helical amylose
III. Branched amylopectin

Starch consists of:

I. Linear amylose
II. Helical amylose
III. Branched amylopectin

a. I only
b. I and II only
c. II and III only
d. All

Answer: (d), All. Starch or amylum is a carbohydrate consisting of a large number of glucose units joined by glycosidic bonds. This polysaccharide is produced by most green plants as an energy store. However, in the Asteraceae, starch is replaced by the fructan inulin. It is the most common carbohydrate in the human diet and is contained in large amounts in such staple foods as potatoes, wheat, maize (corn), rice, and cassava.

Pure starch is a white, tasteless and odorless powder that is insoluble in cold water or alcohol. It consists of two types of molecules: the linear and helical amylose and the branched amylopectin. Depending on the plant, starch generally contains 20 to 25% amylose and 75 to 80% amylopectin by weight. Glycogen, the glucose store of animals, is a more branched version of amylopectin.

All prescription drug orders communicated by way of electronic transmission shall:

I. Be transmitted only by an authorized practitioner or practitioner's designated agent.
II. Be transmitted directly to a pharmacist in a pharmacy of the patient’s choice.
III. Specify the prescribing practitioner’s telephone number for verbal confirmation.

All prescription drug orders communicated by way of electronic transmission shall:

I. Be transmitted only by an authorized practitioner or practitioner's designated agent.
II. Be transmitted directly to a pharmacist in a pharmacy of the patient’s choice.
III. Specify the prescribing practitioner’s telephone number for verbal confirmation.

a. I only
b. III only
c. I and II only
d. II and III only
e. All

Answer:

Oregonians who may suffer agitation due to Alzheimer's disease can use small amounts of marijuana without fear of civil or criminal penalties if their doctors advise that such use may provide a medical benefit to them.

Tue or False

Oregonians who may suffer agitation due to Alzheimer's disease can use small amounts of marijuana without fear of civil or criminal penalties if their doctors advise that such use may provide a medical benefit to them.

Tue or False

A pharmacist licensed in Illinois may fill or refill a valid prescription for Ambien which is on file in a pharmacy licensed in North Carolina.

True or False

A pharmacist licensed in Illinois may fill or refill a valid prescription for Ambien which is on file in a pharmacy licensed in North Carolina.

True, [Illinois Pharmacy Practice Act 225 ILCS 85/19(5)].

Nothing contained in this Act shall be construed to prohibit a pharmacist licensed in this State from filling or refilling a valid prescription for prescription drugs which is on file in a pharmacy licensed in any state and has been transferred from one pharmacy to another by any means, including by way of electronic data processing equipment upon the following conditions and exceptions:

(1). Prior to dispensing pursuant to any such prescription, the dispensing pharmacist shall:

(a). Advise the patient that the prescription on file at such other pharmacy must be canceled before he or she will be able to fill or refill it.

(b). Determine that the prescription is valid and on file at such other pharmacy and that such prescription may be filled or refilled, as requested, in accordance with the prescriber's intent expressed on such prescription.

(c). Notify the pharmacy where the prescription is on file that the prescription must be canceled.

(d). Record in writing the prescription order, the name of the pharmacy at which the prescription was on file, the prescription number, the name of the drug and the original amount dispensed, the date of original dispensing, and the number of remaining authorized refills.

(e). Obtain the consent of the prescriber to the refilling of the prescription when the prescription, in the professional judgment of the dispensing pharmacist, so requires.

When filling or refilling a valid prescription on file in another state, the dispensing pharmacist shall be required to follow all the requirements of Illinois law which apply to the dispensing of prescription drugs. If anything in Illinois law prevents the filling or refilling of the original prescription it shall be unlawful to dispense pursuant to this Section.

Prescriptions for drugs in Schedules III, IV, and V of the Illinois Controlled Substances Act may be transferred only once and may not be further transferred. However, pharmacies electronically sharing a real-time, online database may transfer up to the maximum refills permitted by the law and the prescriber's authorization.