APC Intern Written Exam flashcards

31 cards. Read the term and the definition here. The deck at the top of this page is optional.

Five rights of medication administration

Right patient, right drug, right dose, right route, right time. These are core safety checks performed before administering any medication to prevent errors.

Medication reconciliation

The process of comparing a patient's medication orders to all of the medications that the patient has been taking to avoid errors such as omissions, duplications, or dosing errors.

High-alert medications

Drugs that carry a heightened risk of significant patient harm when used in error. Examples include insulin, heparin, opioids, and chemotherapy agents; they require independent double-checks.

Schedule II refills

Schedule II controlled substances cannot be refilled; a new prescription is required for each dispensing. This is a federal DEA rule.

Patient counseling

Pharmacists must offer counseling on new prescriptions, including purpose, administration, side effects, interactions, and storage, to ensure safe and effective medication use.

FIFO stock rotation

First In, First Out: a method of inventory management where older stock is used before newer stock to minimize expiration and waste.

Beta-blocker adverse effects

Common adverse effects include bradycardia, hypotension, fatigue, and bronchospasm (especially with nonselective agents). They may mask hypoglycemia symptoms in diabetics.

ACE inhibitor cough

A dry, persistent cough occurs in about 10-20% of patients taking ACE inhibitors due to accumulation of bradykinin. It is often managed by switching to an ARB.

Warfarin monitoring

Warfarin therapy is monitored using the INR (International Normalized Ratio). The typical target range is 2.0-3.0 for most indications, such as atrial fibrillation.

Heparin antidote

Protamine sulfate is the antidote for heparin overdose. It binds to heparin and neutralizes its anticoagulant effect.

Metformin and contrast dye

Metformin should be temporarily discontinued before and after iodinated contrast procedures in patients with renal impairment to reduce the risk of lactic acidosis.

Statin mechanism

Statins inhibit HMG-CoA reductase, the rate-limiting enzyme in cholesterol synthesis, leading to increased LDL receptor expression and reduced LDL cholesterol levels.

Opioid overdose antidote

Naloxone is a competitive opioid receptor antagonist used to reverse opioid-induced respiratory depression and overdose.

Aminoglycoside monitoring

Aminoglycosides require monitoring of renal function and serum drug levels because of their potential for nephrotoxicity and ototoxicity.

Dilution formula

C1 × V1 = C2 × V2, where C1 and V1 are the initial concentration and volume, and C2 and V2 are the final concentration and volume after dilution.

Dose calculation formula

Volume to administer = (Desired dose / Stock strength) × Stock volume. This formula is used to calculate the amount of liquid medication to give.

Body surface area (Mosteller)

BSA (m²) = √[(height in cm × weight in kg) / 3600]. BSA is used for dosing certain medications, especially chemotherapy.

Ideal body weight

For males: 50 kg + 2.3 kg per inch over 5 feet. For females: 45.5 kg + 2.3 kg per inch over 5 feet. Used for drug dosing when actual weight is not appropriate.

Creatinine clearance (Cockcroft-Gault)

CrCl (mL/min) = [(140 − age) × weight (kg)] / [72 × serum creatinine (mg/dL)]. Multiply by 0.85 for females. Used to estimate renal function for drug dosing.

Half-life

The time required for the plasma concentration of a drug to decrease by 50%. After approximately 5 half-lives, about 97% of the drug is eliminated.

IV flow rate

mL/hr = total volume (mL) / time (hr). Drops per minute = (volume in mL × drop factor in gtt/mL) / time in minutes.

Percentage strength

For solutions, % w/v means grams of solute per 100 mL of solution; % w/w means grams of solute per 100 g of solution.

Alligation method

A method to calculate the ratio in which two solutions of different strengths must be mixed to obtain a desired intermediate strength: ratio = (higher % − desired %) : (desired % − lower %).

HIPAA confidentiality

The Health Insurance Portability and Accountability Act protects patient health information. Pharmacists may not disclose protected health information without authorization, except for treatment, payment, or operations.

DEA controlled substance schedules

Schedule I: no accepted medical use, high abuse potential. Schedule II: accepted medical use, high abuse potential, no refills. Schedules III-V: decreasing abuse potential.

MedWatch reporting

The FDA MedWatch program collects reports of adverse drug reactions, medication errors, and product quality problems from healthcare professionals and the public.

Informed consent

A process where a competent patient voluntarily agrees to a medical intervention after receiving full disclosure of risks, benefits, and alternatives.

Ethical principle: beneficence

The ethical obligation to act in the best interest of the patient and to promote good. It is a core principle in healthcare ethics.

Ethical principle: nonmaleficence

The obligation to avoid causing harm to patients. It is often expressed as 'first, do no harm' and underpins safe medication practices.

Medication error reporting

Medication errors must be documented and reported according to institutional policy and state law, and may be reported to patient safety organizations to improve care.

Professional boundaries

Pharmacists must avoid conflicts of interest, maintain competence through continuing education, and adhere to the profession's code of ethics.