PHM 552 EXAM II QUESTIONS AND
ALREADY PASSED ANSWERS.
medication management
-key to medication management in a hospital is the *formulary system* - Answer Describes the process
used to assure *safe and effective* use of drugs in a cost conscious manner
drug formulary - Answer • A *continually updated list of medications* established by the Pharmacy
and Therapeutics (P&T) Committee
• Supported by *current evidence-based medicine*, judgment of physicians, pharmacists and other
experts in the diagnosis and treatment of disease and preservation of health
• The primary purpose is to encourage the use of *safe, effective, and most affordable medications*
closed formulary - Answer • List of medications which limits access of a prescriber to certain
medications
• Limited selection --> ↓ cost
• A common practice in the hospital setting
open formulary - Answer A list of medications in which prescribers have no restrictions on
ordering/prescribing medications
• Broader selection -->↑ costs
RESTRICTED formulary medications
,-usually to minimize side effects and costs - Answer Certain medications on the formulary are limited or
restricted to specific physicians, patient care areas, or disease states via formulary restrictions
• Example: Certain antibiotics can only be ordered by Infectious Disease (ID) physicians
-A non-formulary medication will go through an *approval process* if it is
needed
-Many CPOE systems give an alert to the prescriber that the medication is non-formulary
-The physician will *need to present evidence* that the medication is appropriate for the patient
----Typically, the patient has tried other medications, or the alternative is not appropriate
(Analogous to filling out a prior authorization in the out-patient setting) - Answer WHAT HAPPENS
WHEN A NON-FORMULARY MEDICATION IS ORDERED IN A CLOSED FORMULARY HOSPITAL?
"is there a therapeutic interchange?"
"are there any contraindications?
ETC. - Answer What questions would you ask the prescriber if he/she orders a non-formulary
antibiotic?
Pharmacy and Therapeutics (P&T) - Answer -Composed of representatives from *medical staff,
administration, pharmacy, and nursing*
-A committee with oversight for medication management including the drug formulary
-*Reviews the medication list* and guidelines on a regular basis to assure that it is current and meets the
needs of the medical staff and patients
P&T Committee - Answer • Establishes and *maintains the formulary*
, • Prevents and monitors *adverse drug reactions* and medication
errors
• *Educates* health professionals to the optimal use of medications
• Develops of *protocols and procedures* for medications on the formulary
-DUR (drug utilization review)
-MUE (medication use evaluation) - Answer How are formulary drugs evaluated?
Drug Utilization Review (DUR) aka DUE (evaluation) - Answer A system of ongoing, systematic, criteria-
based evaluation of drug use that will *help ensure that medicines are used APPROPRIATELY* generally
in terms of prescribing
• If therapy is deemed to be inappropriate, interventions with providers or patients will be necessary to
optimize drug therapy
• Examples include *inappropriate use or incorrect doses of a medication*
*medication use evaluation (MUE)*
-similar to DUR but broader
*did the patient's condition improve* - Answer emphasizes improving patient *outcomes and
individual quality of life*
• Dependent on a *multidisciplinary approach* involving all professionals dealing with drug therapy
• Examples include: infection cure rates, decreased lipid levels, Use of tigecycline for appropriate
infections
ALREADY PASSED ANSWERS.
medication management
-key to medication management in a hospital is the *formulary system* - Answer Describes the process
used to assure *safe and effective* use of drugs in a cost conscious manner
drug formulary - Answer • A *continually updated list of medications* established by the Pharmacy
and Therapeutics (P&T) Committee
• Supported by *current evidence-based medicine*, judgment of physicians, pharmacists and other
experts in the diagnosis and treatment of disease and preservation of health
• The primary purpose is to encourage the use of *safe, effective, and most affordable medications*
closed formulary - Answer • List of medications which limits access of a prescriber to certain
medications
• Limited selection --> ↓ cost
• A common practice in the hospital setting
open formulary - Answer A list of medications in which prescribers have no restrictions on
ordering/prescribing medications
• Broader selection -->↑ costs
RESTRICTED formulary medications
,-usually to minimize side effects and costs - Answer Certain medications on the formulary are limited or
restricted to specific physicians, patient care areas, or disease states via formulary restrictions
• Example: Certain antibiotics can only be ordered by Infectious Disease (ID) physicians
-A non-formulary medication will go through an *approval process* if it is
needed
-Many CPOE systems give an alert to the prescriber that the medication is non-formulary
-The physician will *need to present evidence* that the medication is appropriate for the patient
----Typically, the patient has tried other medications, or the alternative is not appropriate
(Analogous to filling out a prior authorization in the out-patient setting) - Answer WHAT HAPPENS
WHEN A NON-FORMULARY MEDICATION IS ORDERED IN A CLOSED FORMULARY HOSPITAL?
"is there a therapeutic interchange?"
"are there any contraindications?
ETC. - Answer What questions would you ask the prescriber if he/she orders a non-formulary
antibiotic?
Pharmacy and Therapeutics (P&T) - Answer -Composed of representatives from *medical staff,
administration, pharmacy, and nursing*
-A committee with oversight for medication management including the drug formulary
-*Reviews the medication list* and guidelines on a regular basis to assure that it is current and meets the
needs of the medical staff and patients
P&T Committee - Answer • Establishes and *maintains the formulary*
, • Prevents and monitors *adverse drug reactions* and medication
errors
• *Educates* health professionals to the optimal use of medications
• Develops of *protocols and procedures* for medications on the formulary
-DUR (drug utilization review)
-MUE (medication use evaluation) - Answer How are formulary drugs evaluated?
Drug Utilization Review (DUR) aka DUE (evaluation) - Answer A system of ongoing, systematic, criteria-
based evaluation of drug use that will *help ensure that medicines are used APPROPRIATELY* generally
in terms of prescribing
• If therapy is deemed to be inappropriate, interventions with providers or patients will be necessary to
optimize drug therapy
• Examples include *inappropriate use or incorrect doses of a medication*
*medication use evaluation (MUE)*
-similar to DUR but broader
*did the patient's condition improve* - Answer emphasizes improving patient *outcomes and
individual quality of life*
• Dependent on a *multidisciplinary approach* involving all professionals dealing with drug therapy
• Examples include: infection cure rates, decreased lipid levels, Use of tigecycline for appropriate
infections
