Advanced Pharmacy Practice for Technicians

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ISBN: 9780766826618 | 0766826619
Cover: Paperback
Copyright: 5/9/2002

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Advanced Pharmacy Practice for Technicians goes beyond the basic training requirements for pharmacy technicians. It is the only book on the market that covers non-traditional areas of pharmacy practice, including long-term care, home health care, managed care, hospice settings, nuclear pharmacy, and federal pharmacy. Coverage includes elements that make up the specialized pharmacy practice, the prescription filling process, the various services offered, and the legislation and regulation that pertain to each area. It can be used as a teaching tool for students or as an information resource for practicing pharmacy technicians.

Preface

Acknowledgments

xvii

About the Author

xix

Pharmacy and the U.S. Health Care System

(28)

Introduction to Health Care Systems

(1)

Components of a Health Care System

(1)

Types of Health Care Systems

(1)

Health Care Personnel

(4)

Pharmacists

(1)

Pharmacy Technicians

(1)

Physicians

(1)

Nurses

(1)

Physician Assistants

(1)

Allied Health Care Personnel

(1)

Health Care Institutions

(5)

Outpatient Care Institutions

(2)

Inpatient Care Institutions

(3)

Health Care Services

(1)

Health Care Financing

(4)

Health Care Expenditures

(1)

Sources of Funding

(1)

Health Care Reimbursement

(1)

Problems in the U.S. Health Care System

(1)

Health Care Reform

(1)

The Role of Managed Care

(3)

Managed Care Organizations

(2)

Outcomes-Based Therapy

(1)

Pharmaceutical Care

(8)

Introduction to Long-Term Care

(19)

Overview of Long-Term Care

(3)

Characteristics of Long-Term Care

(1)

Funding for Long-Term Care

(1)

Long-Term Care Settings

(7)

Institutional Settings

(2)

Community Settings

(4)

The Home-Based Setting

(1)

The Elderly Population

(1)

Drug-Related Problems in the Elderly

(3)

The Role of Pharmacy in Long-Term Car

(5)

The Long-Term Care Pharmacy

(33)

Overview of a Long-Term Care Pharmacy

(1)

Elements of a Long-Term Care Pharmacy

(2)

Personnel

(1)

Inventory

(1)

Pharmacy Design

(1)

Equipment and Supplies

(1)

Delivery Service

(1)

Drug Distribution Systems for Long-Term Care

(10)

Unit-Dose System

(5)

Modified Unit-Dose System

(1)

Blended Unit-Dose System

(3)

Traditional Vial System

(1)

Automated Dispensing Systems

(1)

Specialized Medication Dispensers

(1)

The Prescription-Filling Process in a Long-Term Care Pharmacy

(1)

Services of a Long-Term Care Pharmacy

(18)

Auditing System for Controlled Substances

(1)

Emergency Medication Supply

(3)

Medication Storage in the Long-Term Care Facility

(3)

Forms and Reports

(12)

Legislation and Regulations for Long-Term Care Pharmacy

(24)

Overview of Legislation and Regulations for Long-Term Care Pharmacy

(1)

History and Evolution of Legislation and, Regulations for Long-Term Care Pharmacy

(2)

Omnibus Budget Reconciliation Act of 1987

(5)

Unnecessary Drugs

(1)

Antipsychotic Drugs

(1)

Antipsychotic Dose Reductions

(1)

Medication Errors

(1)

Pharmacy Services

(1)

Consultant Services

(1)

Labeling of Drugs

(1)

Storage of Drugs

(1)

OBRA Revisions

(1)

Freedom of Choice

(1)

Anti-Kickback Legislation

(2)

Safe Harbor Regulations

(2)

Drug Enforcement Agency Regulations

(2)

Transmission of Schedule II Prescriptions by Facsimile

(1)

Partial Filling of Schedule II Prescriptions

(1)

Destruction of Controlled Substances in the Long-Term Care Facility

(1)

Expiration Date Labeling of Medications

(1)

Return and Reuse of Medications from the Long-Term Care Facility

(1)

Provision of Material Safety Data Sheets to the Long-Term Care Facility

(1)

State Regulation of Long-Term Care Pharmacy

(1)

JCAHO Standards for Long-Term Care Pharmacy

(8)

The Roles of the Pharmacist and the Pharmacy Technician in Long-Term Care

105

(24)

Overview of Consultant Pharmacy Practice

106

(1)

The Consultant Pharmacist

106

(1)

Consultant Pharmacist Services

107

(3)

Educational Activities

107

(1)

Medication Systems Management Activities

108

(1)

Clinical Activities

109

(1)

Drug Regimen Review

110

(4)

Pharmaceutical Care Plan

114

(1)

Medication Pass Observation

114

(2)

Consultant Pharmacist Services in Alternative Long-Term Care Settings

116

(3)

Subacute Care

116

(2)

Psychiatric Hospitals

118

(1)

Correctional Facilities

118

(1)

Assisted Living

118

(1)

Board and Care Homes

119

(1)

Other Community and Home-Based Long-Term Care Settings

119

(1)

The Role of the Pharmacy Technician in Long-Term Care

119

(10)

The Pharmacy Technician in the Long-Term Care Pharmacy

120

(1)

The Pharmacy Technician in the Long-Term Care Facility

121

(8)

Home Health Care

129

(16)

Overview of Home Health Care

130

(1)

Types of Home Health Care Services

131

(1)

Specialty Home Health Care Programs

132

(2)

The Home Health Care Patient

134

(1)

Criteria for Selection for Home Health Care

135

(1)

The Home Health Care Process

136

(2)

The Role of Pharmacy in Home Health Care

138

(7)

Home Infusion Pharmacy

145

(38)

Overview of Home Infusion Pharmacy

146

(1)

Types of Home Infusion Therapies

146

(2)

Anti-Infective Therapy

147

(1)

Pain Management Therapy

147

(1)

Chemotherapy

147

(1)

Nutrition Therapy

147

(1)

Hydration Therapy

147

(1)

Biotechnology Therapy

148

(1)

Miscellaneous Therapies

148

(1)

Ancillary Drugs

148

(1)

Elements of a Home Infusion Pharmacy

148

(2)

Personnel

148

(1)

Inventory

149

(1)

Pharmacy Design

149

(1)

Equipment and Supplies

149

(1)

Delivery Service

150

(1)

The Home Infusion Therapy Process

150

(10)

Pharmacy Patient Assessment

150

(4)

Pharmaceutical Care Plan

154

(2)

Monitoring

156

(1)

Discharge Assessment

156

(1)

Documentation

156

(4)

The Prescription-Filling Process in a Home Infusion Pharmacy

160

(3)

The Provision of Equipment and Supplies for Home Infusion

163

(4)

Vascular Access Devices

163

(1)

Infusion Devices

164

(3)

Home Infusion Supplies

167

(1)

Nutrition Therapy

167

(4)

Enteral Nutrition Therapy

168

(2)

Parenteral Nutrition Therapy

170

(1)

Legislation and Regulations for Home Infusion Pharmacy

171

(3)

Omnibus Budget Reconciliation Act of 1990

172

(1)

Drug Enforcement Agency Regulations

172

(1)

FDA Safe Medical Devices Act

172

(2)

Freedom of Choice Law

174

(1)

JCAHO Standards for Home Infusion Pharmacy

174

(1)

The Role of the Pharmacist in Home Infusion

174

(1)

Clinical Role

175

(1)

Dispensing Role

175

(1)

Administrative Role

175

(1)

The Role of the Pharmacy Technician in Home Infusion

175

(8)

Sterile Compounding

176

(1)

Equipment and Supplies

176

(1)

Computer Functions

176

(7)

Managed Care Pharmacy

183

(28)

The Prescription Drug Benefit

184

(7)

Pharmacy Provider Networks

185

(1)

Reimbursement

186

(1)

Covered and Excluded Drugs

186

(1)

The Formulary

187

(1)

Formulary Exception Processes

188

(1)

Member Co-payment

189

(1)

Plan Limitations

190

(1)

Cost of the Prescription Drug Benefit

191

(3)

Cost Containment Strategies

192

(1)

Future Influences on the Prescription Drug Benefit

193

(1)

Pharmacy Benefit Management

194

(2)

Pharmacy Benefit Management Company

194

(2)

Overview of Managed Care Pharmacy

196

(1)

The Role of the Pharmacist in Managed Care

197

(3)

Clinical Role

197

(3)

Administrative Role

200

(1)

Legislation and Regulations for Managed Care Pharmacy

200

(4)

Any Willing Provider Law

200

(1)

Freedom of Choice Law

201

(1)

Prescription Drug Equity Act

201

(1)

Antitrust Laws and Exclusive Pharmacy Contracts

201

(1)

Issues Regarding Formularies

201

(1)

Pharmacy Benefit Management Regulations

202

(1)

Standardized Prescription Drug Card Legislation

202

(1)

Standardized Electronic Claims Format Legislation

203

(1)

Privacy Regulations

203

(1)

Accreditation Standards for Managed Care Organizations

204

(1)

The Role of the Pharmacy Technician in Managed Care

204

(7)

Customer Service Role

205

(1)

Clerical Role

205

(1)

Auditing Role

205

(6)

Mail-Order Pharmacy

211

(28)

Overview of Mail-Order Pharmacy

212

(2)

Types of Mail-Order Pharmacies

212

(1)

Advantages and Disadvantages of Mail-Order Pharmacy

213

(1)

Other High-Volume Pharmacies

214

(2)

Central Fill Pharmacy

214

(1)

Internet Pharmacy

215

(1)

Elements of a Mail-Order Pharmacy

216

(5)

Personnel

216

(1)

Inventory

217

(1)

Pharmacy Design

217

(1)

Equipment and Supplies

218

(1)

Toll-Free Telephone Lines

219

(1)

Mail Service

220

(1)

The Prescription-Filling Process in a Mail-Order Pharmacy

221

(2)

Services of a Mail-Order Pharmacy

223

(2)

Disease Management Programs

224

(1)

Drug Utilization Review

224

(1)

Formulary Management

224

(1)

Compliance Monitoring

224

(1)

Patient Education

224

(1)

Legislation and Regulations for Mail-Order Pharmacy

225

(5)

Omnibus Budget Reconciliation Act of 1990

225

(1)

Nonresident Pharmacy Legislation

225

(2)

Drug Enforcement Agency Regulations

227

(1)

Pharmacy Automation Regulations

227

(1)

Temperature Standards Governing Mailed Prescriptions

227

(1)

Central Fill Regulations

228

(1)

Internet Pharmacy Legislation

228

(1)

Verified Internet Pharmacy Practice Site

229

(1)

The Role of the Pharmacist in Mail Order

230

(1)

Clinical Role

230

(1)

Dispensing Role

230

(1)

Administrative Role

230

(1)

The Role of the Pharmacy Technician in Mail Order

230

(9)

Prescription Order Entry Role

231

(1)

Dispensing Role

231

(1)

Pharmacist Support Role

232

(7)

Nuclear Pharmacy

239

(36)

Overview of Nuclear Pharmacy

240

(5)

Radioactivity and Radionuclides

240

(2)

Radiopharmaceuticals

242

(3)

Elements of a Nuclear Pharmacy

245

(6)

Personnel

245

(1)

Inventory

245

(1)

Pharmacy Design

245

(1)

Equipment and Supplies

246

(4)

Delivery Service

250

(1)

The Prescription-Filling Process in a Nuclear Pharmacy

251

(9)

Radiopharmaceutical Compounding

251

(4)

Quality Control Testing

255

(1)

Packaging

256

(1)

Radioactive Waste Disposal

257

(1)

Radiation Safety

258

(2)

Legislation and Regulations for Nuclear Pharmacy

260

(6)

Omnibus Budget Reconciliation Act of 1990

260

(1)

Nuclear Regulatory Commission Regulations

261

(1)

Department of Transportation Regulations

261

(5)

Food and Drug Administration Regulations

266

(1)

United States Pharmacopeia Standards

266

(1)

The Role of the Pharmacist in Nuclear Pharmacy

266

(2)

Clinical Role

267

(1)

Dispensing Role

267

(1)

Administrative Role

267

(1)

The Role of the Pharmacy Technician in Nuclear Pharmacy

268

(7)

Radiopharmaceutical Compounding

268

(1)

Pharmacy Maintenance

268

(1)

Computer Functions

269

(6)

Hospice Pharmacy

275

(18)

Overview of Hospice

275

(3)

Characteristics of Hospice

277

(1)

Overview of Hospice Pharmacy

278

(1)

Elements of a Hospice Pharmacy

278

(2)

Personnel

278

(1)

Inventory

279

(1)

Pharmacy Design

279

(1)

Equipment and Supplies

279

(1)

Delivery Service

280

(1)

Services of a Hospice Pharmacy

280

(3)

Pain Management

280

(1)

Symptom Management

281

(1)

Specialized Compounding

282

(1)

Starter Kits

282

(1)

Legislation and Regulations for Hospice Pharmacy

283

(2)

Omnibus Budget Reconciliation Act of 1990

283

(1)

Drug Enforcement Agency Regulations

284

(1)

Food and Drug Administration Regulations

284

(1)

CMS Conditions of Participation

284

(1)

JCAHO Standards for Hospice Pharmacy

285

(1)

The Role of the Pharmacist in Hospice Pharmacy

285

(2)

Clinical Role

285

(1)

Dispensing Role

286

(1)

Administrative Role

287

(1)

The Role of the Pharmacy Technician in Hospice Pharmacy

287

(6)

Dispensing Role

288

(1)

Compounding Role

288

(1)

Computer Role

288

(5)

Federal Pharmacy

293

(18)

Overview of Federal Pharmacy

293

(1)

Overview of Pharmacy Services in the Military

294

(8)

Pharmacy Services in the U.S. Army

296

(3)

Pharmacy Services in the U.S. Navy

299

(2)

Pharmacy Services in the U.S. Air Force

301

(1)

Pharmacy Services in the Public Health Service

302

(2)

Pharmacy Services in the Indian Health Service

303

(1)

Pharmacy Services in the Department of Veterans Affairs

304

(7)

Pharmaceutical Industry

311

(18)

Overview of the Pharmaceutical Industry

312

(1)

The Drug Approval Process

312

(2)

The Drug Manufacturing Process

314

(1)

The Drug Marketing Process

315

(1)

The Generic Pharmaceutical Industry

316

(2)

Pharmaceutical Biotechnology

318

(1)

Legislation and Regulations for the Pharmaceutical Industry

319

(3)

Pure Food and Drug Act

319

(1)

Federal Food, Drug, and Cosmetic Act

319

(1)

Orphan Drug Act

320

(1)

Drug Price Competition and Patent Term Restoration Act

320

(1)

Prescription Drug Marketing Act

320

(1)

Prescription Drug User Fee Act

321

(1)

Generic Drug Enforcement Act

321

(1)

General Agreement on Tariffs and Trade

321

(1)

Food and Drug Administration Modernization Act

321

(1)

The Role of the Pharmacist in the Pharmaceutical Industry

322

(2)

Sales and Marketing

322

(1)

Research and Development

323

(1)

Manufacturing and Quality Control

323

(1)

The Role of the Pharmacy Technician in the Pharmaceutical Industry

324

(5)

Advanced Pharmacy Technician Roles

329

(14)

Overview of Advanced Pharmacy Technician Roles

329

(2)

Expanded Pharmacy Technician Roles

331

(1)

Specialized Pharmacy Technician Roles

332

(1)

Innovative Pharmacy Technician Roles

333

(2)

Pharmacy Technician Liability

335

(2)

Benefits of Advanced Pharmacy Technician Roles

337

(6)

Appendix A Apparent Irregularities

343

(2)

Appendix B Material Safety Data Sheet

345

(6)

Appendix C Professional Organizations

351

(4)

Appendix D Professional Publications

355

(4)

Glossary

359

(14)

Index

373

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Advanced Pharmacy Practice for Technicians

Summary

Table of Contents

Supplemental Materials