Download Lesson 1 Introduction to Pharmacy

Instructor: Milan Topalov
Instructor Credentials
 Education:
 St. John’s University, Jamaica, N.Y. : Bachelor Degree in
Chemistry cum laude. Awarded 1997 . Curriculum included
organic synthesis, functional group analysis, and other chemical
theory study.
 St. John’s University, Jamaica, N.Y.: Pharm.D in Pharmacy, cum
laude. Awarded in 2006. Curriculum included required NYS
pharmacy study: pharmacology, pharmacokinetics, therapeutics,
pharmacy law.
 Professional Licensure: NYS licensed Pharmacist (RPH):
licensed October 2006
Employment History:
 New York Presbyterian Hospital at Columbia / Cornell
622 W. 168th Street, New York, N.Y. 10032
Title: Pharmacist
Duties as Pharmacist:
medication review and order entry,
drug information consultation for MD and RN
supervision of pharmacy personnel
IV admixture preparation
Omnicell and Pyxis experience
Held: January 2008- Present.

Flushing Hospital Medical Center, Flushing NY
Title: Pharmacy Intern. Held between December 2002-October, 2006
Title: Pharmacist. Held between October 2006-December 2007
Duties as Pharmacist:
medication review and order entry,
drug information consultation for MD and RN
supervision of pharmacy personnel
IV, TPN, and chemotherapy admixture preparation (limited experience)
Definition of Pharmacy Technician
 A pharmacy technician is an individual who is trained
to perform certain tasks related to providing pharmacy
services to patients in an institutional setting and
customers in a community setting.
 A pharmacy technician is an important part of the
pharmacy team who directly assists the pharmacist in
the provision of pharmaceutical related care.
 The expanding role of the pharmacy technician has
enabled the pharmacist to spend more time in
providing clinical services to patients.
Duties performed by a pharmacy
technician
 The duties performed by a pharmacy technician vary
according to the state that the technician is employed.
 Technicians in most states can:
 Provide purchaser services and place orders for
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medications to suppliers.
Physically fill and handle automated dispensing
cabinets (i.e pyxis and omnicell)
Assist in Inventory management.
Count, pour and label medications for patients
Prepack medications from manufacturer’s packaging to
institutional packaging.
Duties performed by a pharmacy
technician (continued)
 A pharmacy technician is allowed to accept written
prescriptions presented to the pharmacy by patients
and gather patient specific information.
 A pharmacy technician is allowed to key personal
prescription data into a computerized system; however
a licensed pharmacist must initial and approve the
entries.
 A pharmacy technician is allowed to handle issues
dealing with pharmacy third party payers.
Duties that a pharmacy technician
can’t provide.
 In all states, a pharmacy technician can not provide counseling
to patients or provide drug information to other health care
professionals (i.e MD’s and RN’s).
 A pharmacy technician can not accept oral orders for
prescriptions from health care providers authorized to prescribe
drugs (MD, NP, PA)
 In some states, a pharmacy technician is not permitted to
compound medications like creams, ointments, and parenteral
agents.
 All these duties are the responsibilities of the pharmacist or a
pharmacy intern.
 In general, any issue that involves professional judgment requires
the pharmacist. Performing these duties can leave you open to legal
liability.
Requirements to be a pharmacy
technician
 18 years of age
 High school diploma or GED
 No felony convinction
 The above requirements will allow you to be able to take
the PTCE which is the Pharmacy Technician
Certification Board’s (PTCB) exam
 The above requirements will allow you to be able to take
the ExCPT which is given by Institute for the
Certification of Pharmacy Technicians (ICPT).
 The website for the PTCB is www.ptcb.org
 The website for the ICPT is www.nationaltechexam.org
Certification versus Licensing:
difference between a pharmacy
technician and a pharmacist
 A license is granted to a pharmacist by the state in which
he/she is employed.
 A certification is granted by a nongovernmental agency
that indicates an individual has obtain a certain level of
competency in the field in which the certification is
granted.
 States and employers recognize these agencies and often
attach highest priority to these individuals possessing
certification
 Many states require these certifications to allow individuals to
be registered as pharmacy technicians.
 Some employers require these certifications for consideration
in employment.
The Pharmacist: background
information
 A pharmacist is an individual licensed to dispense, compound, and provide
drug related advise on medications.
 A pharmacists can work in a community/retail setting, hospital or institutional
setting or in the pharmaceutical setting for drug companies like Pfizer or
Sanofi Aventis. Opportunities in these areas exist for the pharmacy technician
as well.
 To be a pharmacist requires:
 Six years of study in a college of pharmacy to include organic chemistry,
physiology, pharmacology and therapeutics among other course work
 9 months of internship (part of six year program)
 Graduation from the program with a PharmD. degree
 Passage of the NAPLEX exam
 Passage of the Jurisprudence (Pharmacy Law)exam for the state in which
applicant wishes to practice.
 Registration with the state in which the applicant wishes to practice.
 45 CE credits every 3 years to be able to renew registration. License is
permanent unless its revoked for professional misconduct.
Legal Cases involving Pharmacy
Technicians (and Pharmacists)
 “Rx for errors: Drug error killed their little girl”
 Article reported in US Today in February, 2008 about 2
year old Emily Jerry in a cleveland ohio hospital.
 http://emilyjerryfoundation.org/emilys-story/
 https://www.youtube.com/watch?v=iru56ZO9tKc
Emily Jerry’s Case
 2 year old girl was diagnosed with a curable tumor in the abdominal region of
her body in 2005. The “cure” became the curse.
 A pharmacy technician had prepared Emily’s chemotherapy medication using
23.4% solution of sodium chloride instead of the normal 0.9% sodium chloride
solution.
 The pharmacist who was supervising the technician had also missed the error.
The baby received the chemotherapy agent and within a few hours was on life
support.
 She died on March 1, 2006.
 In August 2006, an Ohio grand jury indicted the pharmacist on charges of
involuntary manslaughter "in the death of Emily Jerry.“
 Unlike the pharmacist, the pharmacy technician did not face disciplinary
charges; however she no longer works at the hospital and now holds a non
pharmacy related job at CVS.
 Congressman, Rep. Steven LaTourette, R-Ohio. introduced Emily’s Act into
Ohio Legislature which would mandate certain educational requirements for
all pharmacy technicians and provide for restrict legal penalties for
misconduct.
Legal Cases
 “Inside a pharmacy where a fatal error occurred” USA
Today article published in 2008.
 Case concerned a 46 year old man with a prescription for
methadone in 2001. He had the prescription filled at a
walgreens in Florida. He received his prescription and
began taking his medication which is a pain killer. Within
a day he was found dead in the shower by his wife. An
autopsy performed determined the cause of death as a
methadone overdose.
 A legal case was brought against the Jacksonville, Florida
walgreens. The plaintiff team determined the cause as a
pharmacy technician who keyed the directions for use
incorrectly and the pharmacist who was too busy to catch
the error. The case was settled out of court.
Other cases of Pharmacy errors
 https://www.youtube.com/watch?v=tPt6ANGnK7s
 Https://www.youtube.com/watch?v=6JWstD9ov6o
 https://www.youtube.com/watch?v=G52rBOQwNc8
 https://www.youtube.com/watch?v=vxrkQOQLSU8
 https://www.youtube.com/watch?v=XEbf9bliOus
 https://www.youtube.com/watch?v=Gmy2ZR0anLc
Pharmacy Technician Certification
Board
 PTCB’s examination, called PTCE (Pharmacy
Technician Certification Exam)
 PTCB is the pharmacy technician certification board,
which began in 1995
 Provides a nationally recognized standard for
pharmacy technicians
Pharmacy Technician Certification
Exam
 The PTCB’s exam that test and certifies a candidate’s competency as a
pharmacy technician
 To qualify to take the exam you must be:
 18 years of age or older
 Possess a high school diploma or GED ( a foreign diploma equivalent may
apply)at a minimum
 No felony convictions dealing with drugs (misdemeanors also) or misconduct as
defined by the NABP
 Once you pass the exam you may use the acronym CPhT after your name
 Certification is valid for 2 years at which time renewal is required
 To renew a certification you must pay a fee and take 20 hours of CE Credit to
include the following:
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1 CE hour of pharmacy Law
As of 2014, 1 CE hour in medication & patient safety (preventing medication errors)
All CE credit must be technician specific
ACPE (Accreditation council of Pharmacy Education) accredits certain CE providers
 The Structure of the Exam
 90 questions
 10 questions are polling questions that do not count
towards your score and are meant to gauge questions
difficulty in reference to future exams
 Time to complete: 1 hr. 50 min (with some extra time to
complete a tutorial and exit survey)
 The Results
 Pass/fail score is reported to you immediately on the test
terminal
 Numerical score and certificate is mailed to your home
 Application process
 Apply online: PTCB application here
 The PTCB will ask you to set up an account
 Once your application is approved you must pay the
application fee of $129
 You will receive an authorization to test notification to
schedule an exam date and time. You must schedule a
date and time within 90 days
 What is bring with you to the test?
 You
 Government issued photo ID (driver’s license)
 Candidates who don’t bring ID forfeit all fees and will
not be permitted to test
 A erasable scratch board will be provided
 Handheld and on computer calculators are provided
 All personal property (include cell phone) will be
secured at lockers at the test site
 Exam offered year round
 How is the exam graded?
 Uses the modified Angoff method
 Panel Experts estimate the difficulty in each question
and estimate the percentage of pharmacy technician
that can answer the question correctly. More difficult
questions are weighted more heavily to the overall score.
 Each exam is the compared to other exams so that
several exams of slightly fluctuating difficulties can be
scaled relative to each other. This is called Statistical
Equating (SE)
 Grading is from 1,000 to 1,600 passing is 1,400
 For more information please view the PCTB website
for their guidebook
Retake policy
 Candidates are allowed four attempts to pass the PTCE
 Candidates must apply and pay for each attempt
 Candidates who are unsuccessful at passing the PTCE must
wait 60 days from the most recent attempt to apply for the
second and third attempts, and 6 months for the final
attempt.
 After four attempts, candidates will need to petition PTCB
in writing for additional attempts.
 Petitions will only be considered and approved by PTCB
based on a showing of reasonable cause or compelling
circumstances supporting another examination attempt.
What is coming for the PTCB
 Beginning 2020, PTCB will require that all new
applicants for PTCB certification to complete an
educational program that is approved by either the
ACPE (Accreditation Council for Pharmacy Education)
or ASHP (American Society of Health System’s
Pharmacists)
 Education requirement will include
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Didactic course work (lectures)
Practical Lab hours
Conclusions
 You as a pharmacy technician have a wonderful career
opportunity. You also have a great deal of
responsibility.
 It is your right to receive adequate supervision by your
pharmacist. Be proactive and protect yourself.
 Education is an important part of everyone’s career
path. Make it a part of yours.
 Good Luck