1. institutional pharmacy
aka--hospital pharmacy. prepare IV meds, load Pyxis medstation,
enter data
larger hospitals have satellite pharmacies(ICU, burn, CCU, NICU,
cancer, ect discharge pharmacy--in hosp rx sent by staff, tube, fax, computer
terms to know----
ADS---automated dispensing system
crash cart---has O2, meds, AED, ect
EMAR--electronic medication administration record
floor stock--most common hosp drugs ready to go
prn-pro re nata-- as needed
the joint commission --nonprofit org that accredits
hosp for Medicare Medicaid
formulary--approved list of meds we carry

2. agencies for inst pharm
the joint commission---unannounced visit every 39 months
CMS---center for Medicare and Medicaid services. give payment approval and amount
HHS--health and human services
DPH--dept public health
BOP--board of pharmacy

3. hosp rx medication order---rx in a hospital written on pt file
CPOE--computerized physician order entry---sent to pharmacy
or pneumatic tube or hand delivery
person in hosp will not have name, address,ect. they have pt med record number.
Dpharm will likely enter the rx order and machine print out label for cpht to fill order.
scan the NDC to verify correct item.
dpharm verifies then off to the pt.
STAT order--do it now=priority
ASAP--priority over new orders
standing order---list of basic meds to be used for xxxx surgery so dr doesn't keep writing same rx for same surgery.

4. POE system(point of entry)
electronic access of medical info/meds for med staff to limit error.maybe handheld scan
computer will discover dangerous drug interaction, recommend dosage for dr, medication order goes right to pharmacy, pt notes can be entered.
COW=‘computer on wheels’ at pt bedside
bar code BPOE---nurse can scan in unit dose med. linked to pharm and EMAR(electronic medication administration record) to alert nurse of problems. nurse can ‘ ’ pharm of problems and enter pt status.
CADM-computerized adverse drug monitoring

5. institution job details
work holiday and overnight?
maybe IV tech, nuclear tech, investigational drug research(special storage,disposal
show job descr pg 213

6. cassette drawers
new pt gets started dose, meds needed for the day are loaded into cassette drawer. normally 2 carts per floor that are rotated for use.
ADS--automated dispensing system. pyxis medstation 4000 uses employee fingerprint. keeps track of who got meds and what med.
UD meds=unit dose meds. must be made by pharm tech. only meds used constantly.
UD liquids=TJD requires hosp make the dose patient specific, then labels, and sent to pt.

7. controlled substances
cpht restock and fill narcotics.
nurse count narcs every shift.
PAR--periodic automatic replenish.cpht will make drug order when drug gets low.
hosp will have their own method for controlled substances. in brown bag if no ADS.
you will be signing paperwork with nurse about drug inventory.

8. IV prep
Certified in IV—makes parenteral meds. Required to have ‘clean room’before entry to compounding area. This is USP 797.
Horizontal laminar flow hood
Biological safety cabinet(vertical flow hood for chemo agents)
Glove box
These need HEPA filter
ISO class I is cleanest room
Tech must initial on label, pt name, pt record #, room #, drug name, strength, name of mixed solution, infusion rate, does time, date made, exp date
Expired IV are logged out, disposed.

9. Hospital terms
Show pg 222
Cpht will know what drugs are most used in hosp sections
Crash cart—show meds pg 223-adult, pediatric, neonatal
If used cpht gives new cart and refills old cart, look for expired
Central supply—hosp room that has instruments, bandages, sterile water, kcl bags. Lactated ringer. Drugs not stored in central supply.

12. advanced pharm tech jobs
pharmacy purchasing agent---order needed drugs daily
meet c sales reps
negotiate prices
find cost-efficient practice
2yr exp, certification
medication reconciliation technician---compare pt med orders
with previous meds.
interview pt about meds and vitamins/herbs
data entry for provider
much experience, get cert if possible
managed care pharmacy technician---
work for PBM company(pharmacy benefit management)
develop drug benefits for a large group.
build formularies, negotiate contracts, tell pts their benefits
process claims, do mailorder rx.

13. advanced pharm tech jobs
pharm tech trainer---work in college or or big chain train new
techs.
need to have ASHP certificate
years exp, BA pharm
pharmaceutical sales rep---travel to sites to promote meds
know the drug well
BA in chem or similar, business,
pharm knowledge, pays well
nuclear pharm tech---compound and dispense radioactive
materials for use in medical procedures.
special training program at a few univ
rare but pays well
telepharmacy---internet comm with dpharm. rural area
pharmacy infomatics--build med info for pharmacy, computer
and pharm exp