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 https://www.youtube.com/watch?v=qpUEaChXz3w

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

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.

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 ‘email’ pharm of problems and enter pt status. CADM-computerized adverse drug monitoring

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

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.

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.

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.

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.

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.

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