Pharmacy Operations, Drug Storage, and Inventory Management
Operations questions test storage, security, inventory, and product integrity. The goal is to prevent degradation, diversion, and dispensing of unusable stock.
Core rules
- Store drugs per labeled conditions; monitor refrigerator and freezer temperatures and humidity, with documented logs and excursion response. Do not assume room temperature is acceptable for all products.
- Separate expired, recalled, damaged, and quarantined stock from active inventory. Recalls require identification, removal, documentation, and patient notification when necessary.
- Secure controlled substances and high-risk drugs; restrict access; investigate discrepancies. Inventory records should support receipts, dispensing, returns, and destruction.
- Compounding areas follow USP standards where applicable, including cleanroom, PPE, and beyond-use dating. Hazardous drugs require separate handling.
- Returns and reverse distribution must comply with DSCSA and state law; not all returned drugs can be redispensed.
Worked example
A refrigerator log shows 8.5°C for four hours; the labeled range is 2–8°C. The pharmacist quarantines the vaccines, checks manufacturer stability data, and documents the excursion. If stability is not supported, the doses are not dispensed. The reasoning: a single excursion does not automatically destroy product, but dispensing without assessment is unsafe and undocumented.
Traps
Ignoring temperature excursions; returning expired drugs to active stock; storing look-alike products together; and documenting inventory only annually.