PTCB MTM cheat sheet

Bioavailability is the fraction of an administered dose reaching systemic circulation; intravenous administration is considered 100% bioavailable, while oral drugs undergo first-pass hepatic metabolism.

Pharmacokinetics covers absorption, distribution, metabolism, and excretion; pharmacodynamics describes the relationship between drug concentration at the receptor and pharmacologic effect.

CYP3A4 inhibitors such as clarithromycin, ketoconazole, and grapefruit increase concentrations of CYP3A4 substrates; inducers such as rifampin and carbamazepine lower them.

Narrow therapeutic index drugs such as warfarin, digoxin, lithium, phenytoin, and aminoglycosides require therapeutic drug monitoring because small concentration changes can cause toxicity or treatment failure.

Type A adverse drug reactions are dose-dependent and predictable from the drug's pharmacology; Type B reactions are idiosyncratic, often immune-mediated, and generally not dose-related.

The Beers Criteria identify potentially inappropriate medications for older adults, including benzodiazepines, anticholinergics, and certain sulfonylureas, because of fall, cognitive, or hypoglycemia risk.

A boxed warning highlights serious or life-threatening risks; drugs with boxed warnings may require risk evaluation and mitigation strategies, restricted distribution, or mandatory monitoring.

Medication reconciliation is the formal process of obtaining and comparing a patient's best possible medication history at care transitions to identify omissions, duplications, and discrepancies.

High-alert medications carry a heightened risk of harmful error; ISMP examples include anticoagulants, insulin, opioids, and concentrated electrolytes, often requiring independent double-checks.

Tall man lettering distinguishes look-alike/sound-alike drug names, such as hydrOXYzine versus hydrALAZINE, to reduce selection errors.

The NCC MERP index classifies medication errors from category A, circumstances that could cause an error, to category I, an error that contributed to or caused death.

A root cause analysis is a retrospective, team-based investigation of a sentinel event; failure mode and effects analysis is a prospective risk assessment performed before harm occurs.

FDA MedWatch receives reports of serious adverse events, product quality problems, and medication errors involving human medical products.

USP <797> sets standards for sterile compounding, including facilities, environmental monitoring, personnel training, and beyond-use dating; USP <800> sets standards for hazardous drug handling.

Medication adherence quality measures often use proportion of days covered; a PDC of at least 80% generally meets common Part D Star Ratings thresholds.

Just culture distinguishes human error from at-risk behavior and reckless behavior, encouraging nonpunitive reporting while maintaining accountability.

An independent double-check means a second qualified person separately verifies a high-alert medication's calculation, preparation, and identity before administration.

Trigger tools screen administrative data for signals such as naloxone administration or abnormal laboratory values to identify possible adverse drug events.

CMS Part D MTM eligibility generally requires multiple chronic diseases, multiple Part D-covered medications, and annual drug costs above the CMS threshold.

The annual comprehensive medication review is an interactive consultation that may be delivered face-to-face or by telehealth and must include a written summary.

A personal medication list is a patient-centered record of current medications, strengths, directions, and purpose, updated during the comprehensive medication review.

A medication action plan documents patient-defined goals, medication-related problems, recommended actions, and follow-up responsibilities.

Targeted medication reviews address specific medication concerns between comprehensive reviews and are required at least quarterly under CMS Part D MTM standards.

Patients may opt out of MTM; the sponsor must document the opt-out and provide information on how to re-enroll.

Pharmacist MTM billing often uses CPT 99605 for an initial 15-minute consultation, CPT 99606 for a follow-up 15-minute consultation, and CPT 99607 for each additional 15 minutes.

Medication therapy problems include unnecessary therapy, need for additional therapy, ineffective drug, dose too high or too low, adverse drug reaction, and nonadherence.

Part D Star Ratings include medication adherence measures for diabetes, hypertension, and cholesterol; statin use in diabetes is another common measure.