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How would the pharmacist determine if a cold chain package that has
experienced shipping delays is still safe for the patient to use?
The pharmacist would consult the manufacturer and/or leverage all available
drug information to determine if the product is safe to use.
How is Recalled, Discontinued, Expired, Damaged, Adulterated, Unacceptable,
or Misbranded product handled?
If we found an Expired, Damaged, Adulterated, Unacceptable, or Misbranded
product it would immediately be quarantined ("DO NOT USE" bin). Patients and
Prescribers would be notified as needed per our Expired and Other Unusable
Medications Policy.
How is inventory reviewed for expiration dates?
We complete a review of on-hand inventory and pull drugs that are expiring 3
months out. New inventory is placed behind older inventory to ensure
maximum expiration dating.
,How do you dispose of products that are expired, returned, recalled,
discontinued, and damaged?
We quarantine the product in the "Do Not Use" bin and then return to Inmar
(our designated reverse distributor) on a routine basis. Recalls are handled per
our Medication Recalls Policy.
How are patients educated on reporting of suspect medications?
Patients receive a welcome packet with a link to the specialty pharmacy
website with our 24 hour on call phone number.
What is the process of out of stock or back order products?
We notify the patient and prescriber, as needed, based on the clinical
significance. We use our Americsource Bergen rep to access the medications
from an alternate distribution center. We make all attempts to utilize inpatient
resources to obtain the product as quickly as possible. (Medication Shortages
Policy)
How is inventory managed and ordered?
Some specialty medications are ordered specific to a patient while others are
kept on hand based on order points (an arbitrary number chosen by the
pharmacy).
How do you prevent cross-contamination of drugs?
A separate labeled hazardous drug counting tray and spatula is used when
counting and repackaging individual doses that are not in unit dose packaging.
We wear nitrile gloves when dispensing a hazardous product, and when
required. The counting tray and spatula are cleaned with 70% isopropyl
alcohol wipes after each use. Pill counters and dispensing machines are NOT
used for hazardous drugs.
, How are hazardous drugs identified in the pharmacy?
Hazardous drugs are kept in a separate section of the pharmacy labeled as
Hazardous Drugs. Return to stock bottles have a red Hazardous Medication
sticker to identify the medication outside of the stock bottle.
What precautions are required when handling hazardous drugs?
It is critical to use separate labeled counting trays and spatulas for hazardous
drug handling. We wear personal protective equipment, as necessary per the
Hazardous Material Safety, Storage, Spill, and Disposal Procedures Policy.
How is the equipment used in the pharmacy cleaned, calibrated, randomly
tested, and certified? (i.e. Scales, Pill Counters, and Hoods)
Pill counters are cleaned on each day of use. Scales are calibrated annually by
internal facilities/engineering team.
How do you ensure compliance with the Drug Quality and Security Act?
Medication is ordered and purchased only through approved vendors (i.e.
licensed wholesalers, vendors or direct from the manufactures); suspicious
products are reported to the manager for further instruction
What would you do if a suspicious drug was received from the vendor? Such as
a product that appears counterfeit, has an unusual odor, or as a broken seal?
If we suspect that medication has been compromised or has become
unacceptable for patient use, we segregate the product. Quarantine the
product and report it to the manager and vendor.