PTCB Preparation is a purchased curriculum and adheres to a specified instructional course outline provided by PassAssured’s Pharmacy Technician Training Program, Pass Assured, LLC; however, this template is being made available for your personal classroom notes/use. 21st Century Instructional Guide for Career Technical Education PTCB Preparation Health Science Education Cluster Pre-Pharmacy Technician Concentration Title: PTCB Preparation (0771) Standard Number: HSE.S.PTCB.1 Orientation Students will demonstrate an understanding in basic pharmacy terms and definitions regarding certification, licensure, and registration. How is the dispensing of medications influenced by laws regarding certification, licensure, and registration of pharmacy personnel? Students will Learning Plan & Notes to Instructor: differentiate certification, licensure, and certification registration. process by which a non-governmental association or agency grants recognition to an individual who has met certain predetermined criteria specified by that association or agency licensure process by which a government agency grants permission to an individual engaged in a given occupation (i.e. pharmacist) upon finding that the applicant has attained the minimal degree of competency necessary to ensure that the public health, safety, and welfare will be reasonably well protected usually requires written state board examination must be renewed 1 Essential Questions: Objectives: HSE.O.PTCB.1.1 HSE.O.PTCB.1.2 determine certification requirements for the Pharmacy Technician. HSE.O.PTCB.1.3 recognize the origin and goal of the Pharmacy Technician Certification Board (PTCB). HSE.O.PTCB.1.4 examine the role of the PTCB. HSE.O.PTCB.1.5 distinguish professional organizations related to the field of pharmacy. continuing education units are required for most professions registration the process of making a list or being enrolled in an existing list Certification is the process by which a nongovernmental association or agency grants recognition to an individual who has met certain predetermined qualifications specified by that association or agency. There are two parts to being a Certified Pharmacy Technician (CPhT). First, pharmacy technicians must sit for and pass the national PTCE. Once a pharmacy technician has passed the exam, he or she may use the designation of CPhT. Second, to continue to hold certification, a CPhT is required to obtain twenty hours of continuing education for recertification within two years of original certification or previous recertification. (www.ptcb.org) PTCB established in January, 1995 founding organizations – American Pharmaceutical Assoc., American Society of Health-Systems Pharmacists, Illinois Council of Health-System Pharmacists, and Michigan Pharmacists Assoc. goal – creation of one consolidated voluntary national certification program for pharmacy technicians responsible for the development and implementation of policies related to voluntary national certification for pharmacy technicians professional organizations American Association of Health-System 2 HSE.O.PTCB.1.6 characterize the functions and responsibilities of the pharmacy technician. HSE.O.PTCB.1.7 classify the three areas in which skills will be measured on the Pharmacy Technician Certification Exam. Pharmacists American Pharmacy Association American College of Clinical Pharmacy Association of Colleges of Pharmacy Board of Pharmaceutical Specializations National Association of Boards of Pharmacy Academy of Managed Care Pharmacy A pharmacy technician is defined as individuals working in a pharmacy, who under the supervision of a licensed pharmacist, assist in activities not requiring the professional judgment of a pharmacist (www.ptcb.org) Pharmacy Technician Certification Exam 1. Assisting the Pharmacist in Serving Patients – 66% of exam 2. Maintaining Medication and Inventory Control Systems – 22% 3. Participating in the Administration and Management of Pharmacy Practice – 12% (www.ptcb.org) recertification 20 contact hours must be earned in pharmacy-related subject matter earned within 2 year period cannot carry over extra hours at least one hour of credit must be in pharmacy law HSE.O.PTCB.1.8 determine the requirements and process needed to maintain certification. Standard Number: HSE.S.PTCB.2 Federal Laws Students will understand legislation that affects the pharmacy industry. 3 Essential Questions: Objectives: HSE.O.PTCB.2.1 Are the legislative rules and mandates impacting the pharmacy industry an asset to the industry? HSE.O.PTCB.2.2 recognize the importance of the Controlled Substance Act of 1970 as it relates to the manufacturing, distribution and dispensing of controlled substances based on abuse potential. HSE.O.PTCB.2.3 differentiate filing procedures, maintaining Students will examine laws and legislation affecting the pharmacy industry. Learning Plan & Notes to Instructor: 1906: The Pure Food and Drug Act (PFDA) 1914: The Harrison Narcotic Act 1938: The Federal Food, Drug, and Cosmetic Act (FFDDCA) 1951: The Durham-Humphrey Amendments to the FFDCA 1962: The Kewfauver-Harris Ammendments to the FFDCA Hazardous Substances Labeling Act 1970: Poison Prevention Packaging Act 1970: Controlled Substances Act 1990: Omnibus Budget Reconciliation Act (OBRA) 1990: The Anabolic Steroids Control Act 1997: FDA Modernization Act Have students research each piece of legislation and determine the significance of each to the industry. Controlled Substance Act of 1970 part of a larger piece of legislation – Comprehensive Drug Abuse, Prevention and Control Act enacted to improve the administration and regulation of all parties involved in the manufacturing, distribution, and dispensing of controlled substances o Schedule I o Schedule II o Schedule III o Schedule IV o Schedule V Students should identify the potential for abuse within each classification and what drugs are within each. mandated filing procedures 4 records according to State and Federal Laws, and drug substitutuion requirements. HSE.O.PTCB.2.4 evaluate the mission of the Drug Enforcement Administration. HSE.O.PTCB.2.5 determine the process by which a doctor obtains a DEA Number. HSE.O.PTCB.2.6 establish the purpose of a prescriber DEA Number. log of controlled substances dispensed to be maintained and signed daily by pharmacist DEA number required to prescribe Schedules II-5 maintain required records x 2 years readily retrievable when federal and state laws differ, adhere to the stricter of the two State Board of Pharmacy is the regulating agency for pharmacists and pharmacies The mission of the Drug Enforcement Administration (DEA) is to enforce the controlled substances laws and regulations of the United States and bring to the criminal and civil justice system of the United States, or any other competent jurisdiction, those organizations and principal members of organizations, involved in the growing, manufacture, or distribution of controlled substances appearing in or destined for illicit traffic in the United States; and to recommend and support non-enforcement programs aimed at reducing the availability of illicit controlled substances on the domestic and international markets. (www. usdoj.gov/dea/agency/mission.htm) The DEA Forms listed below are for those applying to DEA for a controlled substance registration: Tax ID number and/or Social Security Number State Controlled Substance Registration Information State Medical License Information purpose prescriber DEA number is needed for all outpatient prescriptions for controlled substances 5 HSE.O.PTCB.2.7 illustrate the process to determine the validity of a DEA Number. HSE.O.PTCB.2.8 distinguish the storage requirements for Schedule II Drugs. HSE.O.PTCB.2.9 investigate the four phases of Investigational Drugs. John Doe, MD AD0865937 Add together the first, third, and fifth digits: 0+6+9=15 Add together the second, fourth, and sixth digits and multiply this sum by two: (8+5+3)x2=32 Add the result of steps one and two together: 15+32=47 The last digit of this sum should correspond with the ninth digit of the DEA registration number – AD0865937. A: identifies type of prescriber D: first letter of last name requirements physical inventory annually, within four days of the anniversary date distribution records for in-patient locked cabinet or distributed throughout general stock Phase I initial introduction of drug for human use (physician must order) o must sign informed consent Phase II establishes effectiveness and relative safety limited trials patients are closely monitored Phase III specifies effective/indications more precise definitions of adverse effects Phase IV post-marketing trials long term 6 Standard Number: HSE.S.PTCB.3 Essential Questions: Objectives: HSE.O.PTCB.3.1 no control groups all remaining drugs should be returned to the person(s) responsible for the drug Medication Review Students will demonstrate knowledge of drug classifications, medication dosage forms, and administration of medications. Within the pharmacy industry, where should the parameters be established regarding the accountability of knowledge expected of Pharmacy personal (i.e. Pharmacist and Pharmacy Technician)? Students will Learning Plan & Notes to Instructor: demonstrate basic terms and abbreviations terms and concepts used in the pharmacy. absorption o orally o topically o rectally o by inhalation o parenteral distribution metabolism excretion bioavailability therapeutic incompatibility therapeutic duplication adverse effects anaphylactic reactions side effects toxicities cross sensitivity drug interactions possible detrimental effects possible beneficial effects risk to benefit ratio contraindicated administrative devices 7 HSE.O.PTCB.3.2 differentiate chemical, generic, and trade names of drugs. HSE.O.PTCB.3.3 compare dosage forms of drugs. semi-solid dosage forms other dosage forms liquid dosage forms solid dosage forms therapeutic classes dependence addiction tolerance physiology Have students define each of the terms and concepts from Medication Review (doses and terminology) Drugs often have several names. When a drug is first discovered, it is given a chemical name, which describes the atomic or molecular structure of the drug. The chemical name is thus usually too complex and cumbersome for general use. Next, a shorthand version of the chemical name or a code name (such as RU 486) is developed for easy reference among researchers. When a drug is approved by the Food and Drug Administration (FDA—the government agency responsible for ensuring that drugs marketed in the United States are safe and effective), it is given a generic (official) name and a trade (proprietary or brand) name. The trade name is developed by the company requesting approval for the drug and identifies it as the exclusive property of that company. For example, phenytoin is the generic name and Dilantin is a trade name for the same drug. (www.merck.com) compare semi-solid dosage forms other dosage forms 8 liquid dosage forms solid dosage forms methods of administration orally topically rectally by inhalation parenteral see administration devices HSE.O.PTCB.3.4 investigate methods of administering medications. Standard Number: HSE.S.PTCB.4 Essential Questions: Drug Classification Students will demonstrate a knowledge of the mechanisms of drug actions within the body systems. Given the expansion of drug research and the development of new drugs, what should be the accountability standard regarding the depth of knowledge of the mechanisms of drug actions within the body systems for Pharmacy Technicians? Students will Learning Plan & Notes to Instructor: examine the basic structure and functions of nervous system the nervous system. structure o brain o spinal cord o nerves o sense organs function o communication o integration o control o recognition of sensory stimuli From PassAssured’s PTCB files: “the CNS is composed of the brain and spinal cord, example: burn your finger, goes to spinal cord to brain, brain says ‘move finger’.” “Involved in integrating and deciphering all incoming messages and sending responses to the organs and tissues of the body; coordinates muscle movements, visualization, temperature regulation, pain, and Objectives: HSE.O.PTCB.4.1 9 HSE.O.PTCB.4.2 report uses, mechanism of action, side effects, and examples of the following drug classifications for CNS drugs: Sedative Hypnotics Skeletal Muscle Relaxants Anticonvulsants Narcotic Analgesics Antipsychotics Antidepressants Antianxiety Agents CNS Stimulants Anti-Parkinson’s Agents Sympathomimetic Agents Sympatholytic Agents Parasympathomimetics Agents Parasympatholytic Agents Neuromuscular Blocking Agents sensation.” Sedative Hypnotics uses: short-term use (days to a few weeks) for insomnia, not for long term use long term use (months or years); can cause drug-induced abnormalities in the patient’s sleep cycle antidotes for overdoses of stimulants in combination with analgesics in painful situations preoperative anesthetics mechanism of action: not sure, but is thought to reduce the activity of the brain and spinal cord side effects: drowsiness addiction tolerance and dependence respiratory and cardiac depression (with high doses) examples benzodiazepines o Dalmane, Xanax, Ativan, Valium, Serax, Versed, Restoril, Halcion, ProSom, Klonopin barbiturates o Seconal, Amytal, Nembutal, Mysoline miscellaneous o Ambien o Noctec o alcohol o diphenhydramine (Benadryl, Compoz, Nytol, Sominex) 10 o Eszopiclone (Lunesta) Skeletal Muscle Relaxants uses relieve muscle spasm associated with muscle inflammation and injury useful in neuromuscular disorders, such as Multiple Sclerosis, and Cerebral Palsy mechanism of action not understood, but may block nerve response within the spinal column, this has an effect of reducing muscle tone and relieving muscle spasm and tension side effects drowsiness addiction tolerance and dependence respiratory and cardiac depression (with high doses) examples Valium, Flexeril, Robaxin, Lioresal Parafon Forte, Soma, Skelaxin, Zanaflex, Norflex Anticonvulsants uses epilepsy: seizures accompanied by loss or disturbance of consciousness and possible abnormal body movements (convulsions) needs to be individualized by dose and addition of other anticonvulsant agents prevent the occurrence of seizures, they do not cure the disease mechanism of action control the excessive discharge of signals from the brain (seizures) side effects 11 drowsiness slurred speech addiction tolerance and dependence respiratory and cardiac depression (with high doses) examples the anticonvulsant chosen depends on the type of seizure the patient has (e.g. partial vs. generalized onset seizures) Valium and Ativan are drugs of choice to treat a life threatening seizure disorder called Status Epilepticus other examples include: Phenobarbital, Dilantin, Tegretol, Depakene, Depakote, Neurotin, Lamictal, Klonopin, Tranxene, Zarontin, Trileptal, Felbatol, Lamicta, Keppra, Gabitril Filmtabs, Topamax, Mysoline, Tridone Narcotic Analgesics uses relief of moderate to severe pain cough suppressant (antitussive) o antitussives are often combined with expectorants to decrease viscosity of respiratory tract secretions o expectorants help the patient cough up phlegm severe diarrhea mechanism of action bind to specific receptors within the brain and depress certain parts of the CNS to cause pain relief, respiratory depression, decreased GI motility, and suppression of cough side effects 12 drowsiness constipation nausea/vomiting addiction, tolerance, physical and psychological dependence overdoses can cause respiratory distress, profound coma, and pinpoint pupils narcotic antagonists are used to treat overdoses (Narcan) examples single agents: Codeine, Morphine (MS Contin, Roxanol), Roxicodone, Nubain, Demerol, Duragesic, Dilaudid, Ultiva, Talwin, Levo-Dromoran, Darvon, Stadol combination products: Tylenol with Codeine, Tylenol with hydrocodone (Lorcet, Lortab, Vicodin), Tylenol with propoxyphene (Darvocet-N, Propacet, Wygesic), Tylenol and Oxycodone (Percocet, Roxicet), Oxycodone and ASA (Percodan) Antipsychotics uses relieve the signs and symptoms of psychoses (e.g. schizophrenia) have a much better effect on the positive symptoms of psychosis: auditory and visual hallucinations, agitation, suspiciousness, feeling of persecution, ideas of reference, and intrusion of unwanted thoughts noncompliance is the leading cause of recurrent symptoms negative symptoms include: emotional apathy, extreme inattentiveness, and social withdrawal 13 some analgesic, antinausea, and antihistamine effects mechanism of action originally it was proposed that these drugs block dopamine (a chemical in the brain) receptors in the brain chemically effects unknown side effects sedation extrapyramidal symptoms (abnormal body movements) anticholinergic symptoms orthostatic hypotension arrhythmia’s examples typical o Haldol, Thorazine, Compazine, Permitil, Mellaril, Navane, Stelazine atypical o Clozaril, Risperdal, Zyprexa, Abilify, Seqroequel Antidepressants uses treat severe depression mechanism of action exact mechanism unknown appear to increase neurotransmitters in the brain (norepinephrine and serotonin) usually takes 3-6 weeks for these drugs to relieve the depression side effects sedation anticholinergic abnormal heart rhythm 14 seizures examples tricyclic antidepressants (TCAs): Elavil, Norpramin, Tofranil, Pamelor, Surmontil, Anafranil, Remeron serotonin-reuptake inhibitors: Prozac, Effexor, Paxil, Zoloft, Luvox, Celexa, Lexapro serotonin and norepinephrine reuptake inhibitors: Cymbalta miscellaneous: Desyrel, Serzone, Wellbutrin, Lithonate, Lithobid, Eskalith monoamine oxidase inhibitors: Nardil, Parnate *Important to do a drug interaction check Manic-Depressive Disorder periods of elation, followed by periods of depression uses moderate mood swings examples Lithium Carbonate (Eskalith, Lithonate) Alzheimer Disease form of dementia, a term used to describe a group of brain disorders that cause memory loss and a decline in mental function over time uses treat Alzheimer disease mechanism of action NMDA receptor antagonists cholinesterase inhibitors side effects dizziness confusion insomnia nausea 15 agitation coughing fatigue abnormal thinking examples NMDA receptor antagonists: Namenda cholinesterase inhibitors: Cognex, Aricept, Exelon Antianxiety Agents uses to relieve nervousness and tension in normal and neurotic patients have muscle-relaxing capabilities some have anticonvulsant activity mechanism of action benzodiazepines work by binding and affecting certain receptors and neurotransmitters in the brain second generation drug, Buspirone, has an effect at the serotonin and dopamine receptors side effects drowsiness dizziness fatigue abrupt termination of high doses can cause coma, convulsions, and death examples benaodiazepines: Xanax, Ativan, Valium, Serax, Dalmane, Versed miscellaneous: BuSpar, Sinequan, Atarax CNS Stimulants uses to improve mental function, elevate mood, 16 overcome fatigue, and produce a general feeling of well being mechanism of action amphetamines stimulate activity and are mediated by the release of norepinephrine and dopamine in the brain Pemoline and Methylphenidate’s action is unknown side effects dependence increased blood pressure increased respiratory rate stomach upset examples caffeine, Ritalin, Dexadrine, Cylert, Adderall, Provigil, Focalin anorexiants: Didrex, Adipex-P Anti-Parkinson’s Agents uses to treat the shaking, rigidity, salivation, and slowing of initial movements mechanism of action disease is characterized by loss of dopamine manufacturing neurons, creates an imbalance between acetylcholine (increased) and dopamine (decreased) anticholinergics decrease the amount of CNS acetylcholine levadopa – increases dopamine levels amandadine – augments dopamine release and inhibits dopamine reuptake side effects anticholinergics: dry mouth, blurred vision, constipation, hallucinations, memory 17 HSE.O.PTCB.4.3 examine the structure and functions of the peripheral nervous system. impairment amandadine: dizziness, insomnia, nervousness, irritability, confusion, nausea and vomiting, constipation Levodopa: nausea and vomiting, confusion, depression, restlessness, postural hypotension, arrhythmias examples Sinemet, Parlodel, Symmetrel, Permax, Mirapex, Requip, Eldepryl, Cogentin *Special note: alcohol and other CNS depressants can have addictive CNS depressant effects and concomitant use should be avoided Students should know both generic and brand name. *Both may not be listed in the Instructional Guide. composed of all the nerves outside of the brain and spinal cord these nerves transmit information to and from the brain via chemical and electrical messages afferent nerves send messages back to the CNS efferent nerves transmit messages from the CNS to the rest of the body sympathetic nerves facilitate mobilization of the body for quick action o (fight or flight syndrome) o chemical messenger is norepinephrine or epinephrine o provides sympathetic stimulation of heart, lungs, blood vessels, GI tract, and GU tract parasympathetic nerves direct restorative and conservative processes 18 HSE.O.PTCB.4.4 report uses, mechanism of action, side effects and examples of the follwing drug classifications for peripheral nervous system drugs: Sympathomimetic Agents Sympatholytic (Adrenergic Blocking) Agents Parasympathomimetics (Cholinergic) Agents Parasympatholytic (Anticholinergic) Agents Neuromuscular Blocking Agents o (feed and breed syndrome) o Chemical messenger is acetylcholine o Provides parasympathetic stimulation of GI tract, GU tract, heart, blood vessels, lungs, and eyes Sympathomimetic Agents uses used to treat hypertension, shock, heart block, asthma, decongestant, depression mechanism of action direct acting o enhance actions of the sympathetic nervous system o examples – Neosynephrine, Catapress, Dobutrex, Brethine, Maxair, Xopenex, o Serevent o Proventil, Ventolin, Adrenalin, Levophed, Intropin , Isuprel indirect acting o facilitate the release of norepinephrine or block the reuptake of norepinephrine in the neuronal membrane o example – Amphetamines, increase release of norepinephrine o example – tricyclic antidepressants, block re-uptake of norepinephrine side effects high blood pressure increased heart rate depends on the recepton site where drugs exert effects Sympatholytic (Adrenergic Blocking) Agents uses hypertension, heart disease, migraine headaches 19 mechanism of action oppose the action of the natural messengers – epinephrine and norepinephrine, as their receptor sites side effects dizziness fainting nasal stuffiness examples Beta Blockers – Inderal, Tenormin, Lopressor, Corgard, Blocadren Alpha Blockers – Ergotamine, Minipress, Hytrin, Dibenzyline, Cardura, Floxax, Uroxatral Alpha/Beta Blockers – Trandate, Coreg, Parasympathomimetics (Cholinergic) Agents uses glaucoma bladder problems GI problems Alzheimer’s disease mechanism of action salivation, lacrimation, urination, defefaction mimics actions of acetylcholine, enhances actions of parasympathetic nervous sytem, opposes effects of sympathetic nervous system, may be direct action on cholinergic receptors or an indirect action through inhibition of enzymes that destroy acetylcholine side effects diarrhea bradycardia miosis 20 decreased blood pressure bronchoconstriction sweating examples Pilocar, Urecholine, Tensilon, Antilirium, Miostat, Acetylcholine, Aricept, Prostigmin, Mestinon, Cognex, Exelonj Parasympatholytic (Anticholinergic) Agents uses anti-spasmodics anti-Parkinsonism bronchial disorders eye exams motion sickness mechanism of action inhibit or reverse the actions of the parasympathetic nervous system bind with the cholinergic receptors and prevent binding of acetylcholine (they are antagonists) side effects urinary retention tachycardia dry mouth constipation mydriasis examples Atropine, Cogentin, Transderm-Scop, Cyclogyl, Anaspaz, Levbid, Levsin, Atrovent, Kemadrin, Pro-Banthine, Artane Neuromuscular Blocking Agents uses properative skeletal muscle reaction mechanism of action 21 HSE.O.PTCB.4.5 chart the location of the major endocrine glands and their hormone secretion. blocks the transmission of nerve impulses to skeletal muscles resulting in paralysis of skeletal muscles has a narrow therapeutic index – must have respiratory support equipment available side effects allergy examples used mainly in hospitals o Nimbex, Anectine, Pavulon, Norcuron, Mivacron, Zemuron local anesthetic uses minor surgery mechanism of action block conduction of impulses along nerves and prevents the sensation of pain from reaching the brain side effects allergy examples Xylocaine, Anbesol, Benzodent, Lanacane, Orajel, Solarcaine, Pontocaine, Marcaine, Cocaine, Nupercainal endocrine system structure o pituitary gland o pineal gland o hypothalamus gland o thyroid gland o parathyroid gland o thymus glands o adrenal glands o pancreas 22 HSE.O.PTCB.4.6 differentiate between local and systemic hormones. HSE.O.PTCB.4.7 differentiate histamine and prostaglandins. o ovaries o testes function o secretion of hormones growth metabolism reproduction fluid/electrolyte balance o communication o integration o control Have students develop a chart listing the endocrines glands and their hormones. Label the glands and their hormones on a pictorial representation of the human body. local hormones synthesized in various tissue types are released and act locally exert profound changes in the body system hormones produced by one specific gland act throughout the body have a regulatory effect histamine local hormone found in all tissues of the body causes bronchial constriction, stomach acid secretion, blood vessel dilation, and local edema, pain, and itching prostaglandins group of local hormones that cause a variety of local reactions causes uterine and bronchial contractions and relaxation, decreased gastric secretions, pain, and inflammation 23 HSE.O.PTCB.4.8 report uses, mechanism of action, side effects, and examples of the following systemic hormones: Androgens Estrogens Progestins Corticosteroids Insulin Oral Hypoglycemics Oxytocics Thyroid hormones Anti-Thyroid Hormones Androgens male hormones, which are secreted by the testes responsible for characteristic sexual changes in men uses testosterone deficiency muscle wasting mechanism of action hormone replacement side effects masculinizing effects examples Halotestin, Durabolin, Androderm, Depotest, Methyltestosterone Estrogens female hormones, which are secreted by the ovaries responsible for development of characteristic sexual changes in women uses hormone replacement (menopause) decrease heart problems prevent osteoporosis contraception cancer chemotherapy mechanism of action hormone replacement side effects headaches, blood clots examples hormone replacement Premarin, Estinyl, Ogen oral contraceptives 24 Lo-Ovral, Demulen, Loestrin, Ovcon, Levlen, Nordette, Yasmin biphasic – Ortho-Novum 10/11, Necon 10/11 triphasic – Ortho Novum 7/7/7, Triphasil, TriNorinyl, Tri-Levlen, Ortho Tri-Cyclen Progestins female hormones secreted by the corpus luteum, which cause growth of mammary ducts and prevention of uterine bleeding during pregnancy uses hormone replacement contraception mechanism of action hormone replacement side effects breast changes, changes in weight examples hormone replacement – Cycrin, Provera, contraception – Nor-QD, Ovrette Corticosteroids hormones secreted by the adrenal gland uses inflammation, asthma, cancer, hypoadrenalism mechanism of action hormone replacemtent side effects stomach upset, water retention, increased appetite, agitation, suppression of the body’s production of Cortisol examples Deltasone, Orasone, Medrol, Prelone, Decadron, Hydrocortisone (Anucort – HC, 25 Cortain, Gynecort, Hytone, Locoid, Proctocream, Cortifoam, Westcort), Triamcinolone (Aristocort, Azmacort, Kenalog), Betamethasone (Alphatrex, Diprolene, Diprosone, Valisone), Cortone Insulin hormone produced by the pancreas uses replace insulin in patients with Type I or II diabetes mechanism of action facilitates the utilization and storage of glucose side effects hypoglycemia examples Regular, NPH, Semilente, Ultralente, Lente, Humalog, Lantus Oral Hypoglycemics uses manage Type II diabetes mechanism of action promote the release of insulin from the pancreas’ beta cells side effects hypoglycemia photosensitivity skin rash AVOID ALCOHOL examples Micronase, Diabeta, Glucaphage, Rezulin, Diabinese, Amaryl, Tolinase, Orinase, Glucatrol test for glucose 26 o Glucostix, Chemstrip BG, Clinistix, Chemstrip K Oxytocics hormones secreted by the pituitary gland stimulate the contraction of uterine smooth muscles uses relief from breast enlargement during lactation conrol of postpartum bleeding migraine headaches mechanism of action hormone replacement side effects nausea and vomiting dizziness increased blood pressure chest pain examples Pitocin, Ergotrate, Methergine Thyroid hormones regulate the rate of many of the body’s phsiological processes uses treat thyroid hormone deficiency mechanism of action hormone replacement side effects various examples Synthroid, Levothroid, Proloid, Thyroid tablets Anti-Thyroid Hormones uses treat hyperthyroidism mechanism of action 27 HSE.O.PTCB.4.9 examine the basic structure and functions of the Cardiovascular System. HSE.O.PTCB.4.10 determine the meaning of arrhythmia and angina. HSE.O.PTCB.4.11 report uses, mechanism of action, side effects, and examples of the following drug classifications for Cardiovascular drugs: Cardiac Glycosides Antiarrhythmics Antianginals Vasodilators Calcium Channel Blockers Angiotensin-Converting Enzyme (ACE) Inhibitors Angiotensin II Inhibitors Beta-Adrenergic Blockers Alpha-Adrenergic Blockers Antilipidemic Agents interferes with thyroid production side effects (none given) examples Tapazole, PTU, SSKI cardiovascular system structure o heart o blood vessels function o transportation o regulation of body temperature o immunity arrhymia absence of rhythm, irregular heart beat angina chest pain due to reduced blood flow to the heart muscle Cardiac Glycosides obtained from the digitalis plant and exert powerful action on the heart, increasing the muscle’s contraction and improving irregular heartbeats uses congestive heart failure some arrhythmias mechanism of action unknown, but increase the contraction of the heart side effects nausea and vomiting confusion arrhythmias yellow/green halos low therapeutic index 28 examples Lanoxicaps, Lanoxin, Digitex Antiarrhythmics uses helps to restore and maintain normal heart rhythms mechanism of action multiple classes have different effects on the heart to affect its rhythm side effects nausea and vomiting confusion arrhythmias examples Xylocaine, Procan, Quinidex, Cordarone, Norpace, Mexitil, Tambocor, Rythmol, Adenocard, Tikosyn Antianginals uses angina mechanism of action decrease the amount of blood that returns to the heart, decreasing the heart rate or decreasing the resistance to pump, and decreases the amount of work for the heart side effects headaches dizziness hypertension examples Nitrostat, Isordil, Imdur, Calcium channel blockers Vasodilators uses 29 peripheral vascular disease caused by arteriosclerosis and advanced diabetes mechanism of action dilate peripheral blood vessels increase blood flow to extremities by relaxing the smooth muscles of the blood vessels side effects tachycardia examples Apresoline, Nitropress, Pavabid, Vasodilan, Nitroglycerin, Isosorbide Dinitrate Calcium Channel Blockers uses hypertension angina mechanism of action dilate coronary arteries, reduce oxygen demand on the heart, and decrease heart rate side effects constipation examples Procardia, Calan, Isoptin, Cardizem, Cardene, Norvasc, Plendil, Sular, Vascor, DynaCirc Angiotensin-Converting Enzyme (ACE) Inhibitors uses hypertension congestive heart failure mechanism of action prevents the conversion of Angiotensin I and Angiotensin II, Note: Angiotensin II causes vasoconstriction and fluid retention side effects cough examples 30 Capoten, Vasotec, Zestril, Lotensin, Monopril, Accupril, Altace, Univasc, Aceon, Mavik Angiotensin II Inhibitors uses hypertension congestive heart failure mechanism of action inhibits Angiotensin II reduces vasoconstriction and blood pressure side effects cough examples Cozaar, Diovan, Avapro, Atacand, Micardis, Teveten, Benicar Beta-Adrenergic Blockers uses hypertension angina mechanism of action inhibits the action at the beta receptors on the heart side effects hypotension bronchoconstriction dizziness examples Tenormin, Lopressor, Inderal, Corgard, Visken, Betapace, Sectral, Normodyne, Trandate, Blocadren, Timoptic, Zebeta Alpha Adrenergic Blockers uses hypertension severe congestive heart failure mechanism of action 31 HSE.O.PTCB.4.12 examine the basic structure and functions of the Renal System. HSE.O.PTCB.4.13 determine the uses and mechanism of action of diuretics. inhibits the action at the alpha receptors in the blood vessels side effects orthostatic hypertension dizziness examples Minipress, Hytrin, Cardural, Aldomet Antilipidemic Agents uses heart disease high cholesterol mechanism of action reduce serum lipids and minimize the rate of new fat deposition side effects diarrhea flushing examples Mevacor, Lopid, Questran, Pravachol, Zocor, Lipitor, Lescol, Colestid, WelChol, Crestor, Tricor, Zetia, Exetimibe/Simvastatin urinary system structure o kidneys o ureters o urinary bladder o urethra function o elimination of waste o electrolyte balance o acid-base balance diuretics increase urinary output uses 32 HSE.O.PTCB.4.14 report uses, mechanism of action, side effects, and examples of types of diuretics: Thiazides Loop Potassium Sparing Combination Osmotics congestive heart failure hypertension fluid retention mechanism of action alter the body’s electrolyte pattern by prohibiting or enhancing excretion of electrolytes most diuretics increase potassium excretion, eat high-potassium foods (bananas, orange juice), or taking a potassium sparing diuretic Thiazides uses reduce blood pressure mechanism of action causes kidney to secrete more, decreases water retention, decreased blood pressure side effects increased urination weakness muscle cramps stomach upset dizziness examples Hydodiuril, Diuril, Lozol, Zaroxolyn Loop uses congestive heart failure potent diuretic side effects increased urination weakness muscle cramps stomach upset dizziness 33 HSE.O.PTCB.4.15 characterize gout. HSE.O.PTCB.4.16 report uses, mechanism of action, and side effects of gout agents: Allopurinol Probenecid Colchicine examples Lasix, Bumex, Edecrin, Demadex Potassium Sparing Combination Osmotics uses congestive heart failure weak diuretics, often used in combination with other diuretics Note: no potassium supplement needed side effects increased urination weakness muscle cramps stomach upset dizziness examples Aldactone, Dyrenium, Midamor gout disease characterized by overproduction or insufficient elimination of uric acid within the body that will crystallize in the joints and cause pain and inflammation Allopurinol – Zyloprim uses prevention and treatment of gout attacks mechanism of action inhibits uric acid production side effect rash Probenecid – Benemid mechanism of action enhance the excretion of uric acid side effects kidney stones Colchicine 34 HSE.O.PTCB.4.17 compare electrolytes. HSE.O.PTCB.4.18 examine the uses, side effects, and examples of electrolytes. HSE.O.PTCB.4.19 compare bacteriostatic and bacteriocidal. HSE.O.PTCB.4.20 report uses, mechanism of action, and side effects of anti-infectives: Antibacterials Urinary Anti-infectives Antibiotics Penicillins Cephalosporins Quinolones uses drug of choice for acute attacks mechanism of action reduces the pain and swelling of gouty flares side effect GI complaints electrolytes salts which are dissolved in body fluids and are necessary in proper concentration to maintain normal body functions Have students research electrolytes and compare results. Electrolytes uses replacement of depleted salts side effects stomach upset, constipation, diarrhea examples ammonium, bicarbonate, calcium, chloride, magnesium, phosphate, potassium, sodium bacteriostatic allow the natural defense mechanisms to have time to destroy the microorganisms by inhibiting bacterial growth bactericidal kills the microorganism Antibacterials uses unlike antibiotics, antibacterials are not synthesized from microorganisms mechanism of action usually bacteriostatic side effects photosensitivity 35 Macrolides Tetracyclines Aminoglycosides Antifungals Antiparasitic Agents Antihelminthics Amebicides Antitubercular Agents Antiviral Agents allergy examples sulfa agents – Sulamyd, Gantanol other antibacterials – VoSol, Betadine, Iodine, pHisoHex Urinary Anti-infectives uses used to treat UTI mechanism of action concentrated in the urine side effects stomach acid Pyridium, may discolor urine examples Macrodantin, Macrobid, Noroxin, Pyridium Antibiotics uses used to treat bacterial infections mechanism of action synthesized by microorganisms – grown Patient Information: should be taken for the full course of therapy examples Penicillins, Cephalosporins, Quinolones, Macrolides, Tetracyclines, Aminoglycosides Penicillins side effects allergy, nausea, vomiting, diarrhea examples Pen–VK, Amoxil, Tegopen, Dynapen, Nafcil, Pipracil, Ticar Cephalosporins side effects allergy 36 nausea, vomiting, diarrhea examples Keflex, Ceclor, Duricef, Suprax, Ceftin, Cefzil, Vantin, Fortaz, Ceptaz, Rocephin, Cefotan, Claforan, Ancef, Omnicef, Zefazone, Mefoxin Quinolones side effects GI upset, headache examples Cipro, Floxin, noroxin, Levaquin, Penetrex, Cinobac, NegGram, Tequin, Avelox Macrolides side effects GI upset, diarrhea examples Erythromycin, Zithromax, Biaxin, Dynabac Tetracyclines side effects photosensitivity examples Tetracycline (Achromycin, Sumycin), VibraTabs, Minocin, Declomycin Aminoglycosides (used in hospitals) side effects kidney damage, ototoxicity examples Garamycin, Nebcin, Amikin, Mycifradin Sulfate, Streptomycin Miscellaneous Vancomycin (used in serious infections not treatable with other antibiotics) Clindamycin ( use: anaerobes – serious respiratory or GI infection) Sulfamethoxazole (Bactrim, Septra, Cotrim) 37 Imipenem and Cilasttin (Primaxin – for IV use only) Chloramphenicol Bacitracin Metronidazole (Flagyl) Antifungals uses to treat topical and systemic fungal infections side effects kidney damage with systemic antifungals examples Amphotericin B, Nizoral, Monistat, Diflucan, Mycostatin, Lotrimin, Lamisal Antiparasitic Agents uses to treat parasitic infections Antihelminthics (worms) side effects stomach upset, nausea, diarrhea examples Vermox, Antiminth, Albenza, Vermizine Amebicides (amoeba infections) side effects same as antihelminths examples Flagyl, Aralen (treatment of extraintestinal amebiasis) Antitubercular Agents uses to treat tuberculosis examples Rifadin, INH, Myambutol, Pyrazinamide Antiviral Agents uses to treat viral infections 38 HSE.O.PTCB.4.21 characterize cancer. HSE.O.PTCB.4.22 characterize Leucovorin. examples Amantadine – Summetrel o uses: to treat influenza o side effects: nausea, CNC effects Antivirals for Herpes Virus o Zovirax, Famvif, Valtrex o side effects: nausea and vomiting Antivirals for HIV and AIDS Protease inhibitors o side effects: nausea and vomiting, muscle weakness o examples: Crixivan, Viracept, Norvir, Invirase Non-nucleoside reverse transcriptase inhibitors o Viramune o Rescriptor Reverse transcriptase inhibitors o side effects: nausea, diarrhea, anemia, headache, insomnia, fatigue, peripheral neuropathy o examples: AZT, Retrovir, Videx, Epivir, Zerit cancer malignant neoplasm class of diseases in which group of cells display uncontrolled growth, invasion of other tissues, and sometimes metastasis (spread to other parts of the body) difficult to treat because drugs cannot differentiate between cancer and normal cells, therefore both normal and cancer cells are killed Leucovorin 39 HSE.O.PTCB.4.23 report uses, mechanism of action, and side effects of chemotherapy drugs: Antimetabolites Alkylating Agents Hormones Vinca Alkaloids Asparaginase Antibiotics also referred to as folinic acid used to protect healthy cells from chemotherapy or to enhance the anticancer effect of chemotherapy called rescue therapy Antimetabolites mechanism of action mimics a necessary nutrient or blocks a reaction, which synthesizes a necessary nutrients side effects bone marrow depression, hepatotoxicity, immunosuppression, anorexia, nausea, vomiting, oral and anal ulcers, fever, rash, hair loss examples 5-FU, Efudex, 6-MP, Mexate, Ara-C, Cytosar, 6TG, Fludara, Alimta, Xeloda Alkylating Agents uses to treat leukemia, testicular and ovarian cancers, and bladder cancers mechanism of action bind to DNA and prevent its relocation side effects nausea, vomiting, diarrhea, testicular atrophy, impotence, bone marrow suppression, hepatotoxicity, nephrotoxicity, rash, loss of taste and hearing, seizures, mental cloudiness, depression examples BCNU, Myleran, Leukeran, Nitrogen Mustard, Cytoxan, Ifex, Paraplatin, CeeNU, DTIC-Dome Hormones 40 uses used to treat hormone dependent cancers such as breast cancers side effects nausea, vomiting, diarrhea, hot flashes, insomnia examples Nolvadex, Lupron, Depo-Provera, Megace, DES, Teslac, Depo-Testosterone, Arimidex, Emcyt, Casodex, Eulexin, Nilandron unclassified: Vinca Alkaloids (Velban, Oncovin, Navelbine) mechanism of action arrests mitotic division at the metaphase of cell division side effects; bone marrow suppression, nausea, vomiting, hair loss Asparaginase (Elspar) mechanism of action blocks asparagines dependent protein synthesis in tumor side effects hypersensitivity, bone marrow suppression, bleeding, depression, nausea/vomiting Antibiotics mechanism of action inhibits nucleic acid synthesis examples and side effects Bleomycin (pulmonary fibrosis, fever, chills, nausea/vomiting) Doxorubicin (myelosuppression, cardiotoxicity, nausea/vomiting) Mitomycin (bone marrow toxicity, 41 hep examine the composition and functions of blood. HSE.O.PTCB.4.25 determine the treatment for Iron Deficiency Anemia. HSE.O.PTCB.4.26 determine the treatment for Megaloblastic Anemia. HSE.O.PTCB.4.27 report uses, mechanism of action, and side effects of agents used in blood disorders: Anticoagulants Hemostatics Antithrombotics Thrombolytics Hemorrheologic Agents Antianemics nausea/vomiting) Cosmegen, Idamycin, Novantrone, Hycamtin, Mithracin blood connective tissue composed of a liquid medium called plasma, in which solid components are suspended solid components include erythrocytes, leukocytes, thrombocytes (platelets) 55% total volume is in form of plasma function varies: RBC transport oxygen and carbon dioxide, WBC fight infection and aid in tissue repair, platelet provide mechanisms for blood coagulation iron deficiency anemia most common type of anemia worldwide results from inadequate dietary intake of iron megaloblastic anemia anemia due to increased circulation of immature abnormal red blood cells resulting in decreased delivery of oxygen to body tissues Anticoagulants uses deep vein thrombosis pulmonary emboli atrial fibrillation with embolism prophylaxis of systemic emboli after MI mechanism of action stop of slow the normal clotting process side effects excess bleeding examples Coumadin, Heparin, Lovenox, Orgaran, Fragmin, Miradon, Dicumarol 42 Hemostatics uses treatment of excessive bleeding mechanism of action affects the clotting process examples Gelfoam, Thrombinar, Amicar, Vitamin K, Monoclate, Trasylol, Cyklokapron Antithrombotics uses to decrease platelet aggregation (stickiness) and to decrease unwanted clot formation examples Aspirin, Persantine, Plavix, Ticlid Thrombolytics uses dissolve existing blood clots decrease the muscle damage associated with heart attacks to treat pulmonary emboli side effects excessive bleeding examples TPA (Alteplase), Streptokinase, Eminase, Activase, Retevase, Abbokinase Hemorrheologic Agents uses intermittent claudication – severe cramping in legs mechanism of action decrease blood viscosity and help to increase blood flow to areas of need side effects nausea and vomiting 43 HSE.O.PTCB.4.28 characterize vitamins. HSE.O.PTCB.4.29 determine examples and uses of fat-soluble vitamins. HSE.O.PTCB.4.30 determine examples and uses of watersoluble vitamins. dizziness examples Trental Antianemics uses to treat anemia caused by iron or vitamin deficiencies (megoblastic anemia) side effects diarrhea, constipation, nausea, vomiting examples Iron Sulfate, Ferrous Gluconate, Folic Acid, Vitamin B6, Vitamin B-12 Colony Stimulating Factor (Neupogen) given to cancer patients for bone marrow transplants Vitamins essential food factors, chemicals in nature, present in certain food, can be synthesized necessary for normal body functions, many are not produced in the body and must be obtained from a balanced diet fat soluble vitamins accumulate and are stored in fat tissue excess intake can result in toxicity examples and uses Vitamin A – skin (acne) and vision Vitamin D (Drisdol) – calcium regulation, bone formation Vitamin E – reproduction and skin Vitamin K (Mephyton) – blood clotting water – soluble vitamins soluble in water excess intake does not usually cause problems since excess amounts are readily excreted examples and uses 44 HSE.O.PTCB.4.31 distinguish minerals as related to normal body functions. Thiamine (Vitamin B1) – energy production, growth and functioning of nerve tissue, memory and emotional stability o deficiency can cause beriberi Riboflavin (Vitamin B2) – energy production, synthesis of fats and amino acids Pyridoxine (Vitamin B6) – role in multiplication of all cells, especially RBC and immune system cells o drug induced deficiency of this with: Isoniazid, Hydralazine, Oral contraceptives Cyanocobalamin (Vitamin B12) – important in carbohydrate and fat metabolism, necessary for normal growth and formation of RBC o used to treat pernicious anemia Niacin/Nicotinic acid – implant in energy producing reactions involving enzymes o large doses are used to treat elevated cholesterol Ascorbic acid (Vitamin C) – essential for tooth and bone formation, healthy gums, formation of collagen, resistance to infections, and wound healing o prevents scurvy o large doses may cause kidney stones Folic acid – used to treat megaloblastic anemia minerals necessary for normal body functions Calcium Fluoride Iodine Magnesium Phosphorus Potassium 45 HSE.O.PTCB.4.32 investigate examples and uses of common minerals. Standard Number: HSE.S.PTCB.5 Essential Questions: Objectives: HSE.O.PTCB.5.1 HSE.O.PTCB.5.2 Sodium Iron Minerals Calcium – essential for bone and tooth formation, activating and relaxing smooth muscle, and nerve impulse transmission Fluoride – prevention of dental caries Iodine Magnesium – needed for bone, protein, new cells, clotting blood, insulin function Phosphorus – blood has excess Potassium – important for water balance, regulating muscle contractions, protein and glycogen synthesis, nerve transmission o can become depleted with the use of diuretics, coffee, and alcohol Sodium Iron – important for the formation of blood and oxygen transport Aseptic Techniques Students will demonstrate knowledge of aseptic techniques. Would violations in aseptic technique impact the roles of all pharmacy personnel, including the pharmacy technician? Students will Learning Plan & Notes to Instructor: Demonstration of aseptic technique should be exhibited demonstrate aseptic technique. during the work-based clinical experience. Evaluation of this objective will occur within theclinical setting determine the importance of aseptic aseptic technique technique to prevent contamination as it procedures carried out during the preparation of a relates to personnel and the environment. sterile product in order to minimize contamination. personnel – the person compounding is the most frequent cause of contamination, followed by contaminated equipment and raw materials 46 HSE.O.PTCB.5.3 establish the role of airflow equipment to prevent contamination. HSE.O.PTCB.5.4 assess basic equipment for parenteral administration. HSE.O.PTCB.5.5 examine methods of administering parenteral medications to include: Intradermal Subcutaneous Intramuscular Intravenous o proper attitudes and strict adherence to aseptic techniques is essential to reducing the likelihood of contamination environmental contamination o aseptic technique requires control of the environment airflow equipment Laminar Flow Hood, Laminar Airflow Workbench, Vertical Flow Hood o designed to reduce the risk of airborne contamination during preparation of sterile products o provides a constant flow of filtered air to the controlled area injections goes through one or more layers of the skin bypasses alimentary canal (digestive system) intradermal drug is injected into the superficial layer of the skin only small volumes (0.2 ml) can be administered by this route generally used for diagnostic test and a limited number of vaccines: TB test and Smallpox vaccine absorption is slow, therefore onset of action is slow subcutaneous injections of small volumes are given in the loose tissue beneath the skin generally into the outer surface of arm or thigh response is more rapid with subcu than ID intramuscular injection into the muscle mass 47 HSE.O.PTCB.5.6 examine composition of common parenteral fluids. HSE.O.PTCB.5.7 examine compounding. common sites: deltoid (arm) maximum volume adult – 2 ml, gluteal medial (hip) maximum volume adult – 5 ml absorption is more rapid that subcu prolong absorption by using aqueous or oil vehicle intravenous administration into veins for rapid effects no retreat of the drug once it has been administered solutions and some emulsions (lipids), never suspensions injection sites o peripheral – for drugs that do not irritate the veins; isotonic solutions; for patients who require only short term IV therapy; dorsal forearm surface o central – for administration of irritating drugs or hypertonic solutions (due to the high amount of blood flow which allows for rapid dilution of the solution); for long term IV therapy; use large thoracic veins (subclavian) o other routes less commonly used: intraarterial, intracardiac, intra-articular, intraspinal, intrasynovial, intrathecal common parenteral fluids dextrose – D5W, D10W Sodium Chloride – NS Sterile water for injection Ringer’s Solutions – Lactated Ringer’s injection, Ringer’s injection Compounding 48 HSE.O.PTCB.5.8 characterize aseptic technique utilized by personnel prior to compounding procedures. HSE.O.PTCB.5.9 determine the most common and important equipment for compounding. assess specific techniques and procedures utilized to avoid contamination assuring successful sterile product mixing. investigate the importance and process of visual inspection of parenteral products. HSE.O.PTCB.5.10 HSE.O.PTCB.5.11 HSE.O.PTCB.5.12 examine components of a parenteral product label. prior to compounding remove rings, watches, and bracelets (ideal for bacteria) wash hands and forearms to the elbows with appropriate germicidal agent x 30 seconds See Aseptic techniques for sterile compounding. See Aseptic techniques for sterile compounding. visual inspection of parenteral products check for particulate matter, crystals, and precipitation isotonicity is important because the injectable solution needs to be isotonic with the blood acid content or the pH of the solution is an important characteristic color and clarity of an IV is important hold product in front of well illuminated light or dark background to detect particles TPN’s that contain lipid emulsion are not clear, therefore precipitation cannot be seen parenteral product label solution name, lot number, and volume (this may be part of the manufacture’s label) patient name, record number, and room number bottle/bag sequence number additive names, strengths, quantities date of preparation and initials of preparer expiration and initials of preparer expiration time and date flow rate administration: time, date, and by whom appropriate auxiliary labels 49 HSE.O.PTCB.5.13 characterize various solutions used in pharmacy to include: Irrigation IV Piggy Back Total Parenteral Nutrition (TPN) HSE.O.PTCB.5.14 distinguish preparation, safe handling, and administration of antineoplastic agents. evaluate use of Class II Biological Safety Cabinets (Vertical Airflow) and personal protective coverings. HSE.O.PTCB.5.15 irrigation used to bathe or flush open wounds or body cavities used topically, never parentally use “for Irrigation only” auxiliary IV piggyback administration of a second solution through the site of an already established primary line compatibility between the two solutions and their additives must always be considered Total Perenteral Nutrition intravenous nutritional solutions containing amino acids (protein source), high concentrations of dextrose (carbohydrate source), occasionally lipid emulsions (fat source), electrolytes, vitamins, trace elements, sometimes insulin (rgular) o usually administered over 8-24 hours o provides adequate caloric intake for those patients who are unable to receive proper nutrition orally due to their disease state o administered peripherally or centrally o many additives increase potential for incompatibilities o calcium and phosphorous precipitate is a major concern o if the pharmacy compounds more than 30 TPN orders daily, an Automix system will assist in preparation See aseptic technique parenteral antineoplastic agents. See aseptic technique parenteral antineoplastic agents 50 HSE.O.PTCB.5.16 determine precautions necessary in the disposal of all items used in the preparation and administration of antineoplastic drugs. HSE.O.PTCB.5.17 assess stability considerations in parenteral products. HSE.O.PTCB.5.18 examine filtration in admixture preparation. HSE.O.PTCB.5.19 report examples of parenteral product reference materials. HSE.O.PTCB.5.20 demonstrate the steps of a typical parenteral admixture order work flow. All disposable items that have potentially come in contact with antineoplastic drugs during preparation or administration must be disposed of in containers designated with the biohazard symbol. Hazardous waste containers should be removed and destroyed according to work site policy and procedures. stability considerations stability time appropriate vehicle solution light protection (do not agitate, shake), thoroughly rotate instead liquid product is forced through a filter device attached to the tip of a syringe with the needle attached at the other end of the filter size of filter depends on its intended use o filtration of particulate matter: 5 micron o sterilization of a liquid: 0.22 micron filter removes most microorganisms Handbook on Injectable Drugs – Trissel Guide to Parenteral Administration, King o information in references: drug solutions, compatibility, dosage, dilution information steps of typical parenteral admixture order: physician writes order order is transmitted to pharmacy order is checked for appropriate dose, drug allergies, compatibility, and stability label and parenteral admixture worksheets are prepared preparation of admixture by pharmacist or supervised technician admixture is checked by pharmacist including 51 Standard Number: HSE.S.PTCB.6 Essential Questions: Objectives: HSE.O.PTCB.6.1 HSE.O.PTCB.6.2 HSE.O.PTCB.6.3 HSE.O.PTCB.6.4 correct additive amount, particulate matter or other indications of incompatibility, and comparison of label against original order delivery to patient storage in patient setting (may require refrigeration) administration to patient Calculations Students will demonstrate knowledge of mathematics in the Pharmacy. Should there be an established guideline for “margin of error” in relationship to the use of mathematics in the Pharmacy? Students will Learning Plan & Notes to Instructor: See PTCB’s Calculations, Weights, and Measures for solve conversions using the metric, the mathematical tutorial. avirdupois, apothecary and household systems. See PTCB’s Calculations, Weights, and Measures for use charts, graphic illustrations, and the mathematical tutorial. conversion tables to perform mathematical calculations. See PTCB’s Calculations and Abbreviations for the determine the meaning of commonly used commonly used abbreviations for the mathematical abbreviations in prescriptions and tutorial. medication orders. determine abbreviations, symbols, or syntax avoid the following: that should be avoided. u for unit – when handwritten, can be read as an O with possible resulting ten-fold overdose, the word unit should always be written out mcg for microgram – can easily be misread as mg qod – abbrev for every other day, can be read as daily or 4 x per day, to avoid always write our every other day qd – for every day, can be misread for qid SC or SQ – for subcu, can be misinterpreted for SL, sublingual T.I.W. – for three times per week, has been 52 HSE.O.PTCB.6.5 HSE.O.PTCB.6.6 HSE.O.PTCB.6.7 HSE.O.PTCB.6.8 HSE.O.PTCB.6.9 HSE.O.PTCB.6.10 HSE.O.PTCB.6.11 HSE.O.PTCB.6.12 HSE.O.PTCB.6.13 HSE.O.PTCB.6.14 demonstrate the Roman Numeral system of writing numbers. apply placement rules when using Roman Numerals. apply mathematical computations related to pharmacy procedures. apply mathematical principle to conversion equations common to those used in the pharmacy. apply rules for decimals when writing drug doses. apply mathematical principles involving temperature, weights, and measures used in the pharmacy. apply mathematical principles to problems involving dosage calculations and other applied mathematical concepts. apply ratios and proportions to enlarge and reduce chemical mixtures used in the pharmacy. calculate amounts of drugs, chemical, or solvents when enlarging and reducing formulas. examine units of measurement for drugs and expressions of quantity and misread for tid or 2 times per week when the same symbols have the more than one meaning, misinterpretation may result: D/C, HS, IVP as, au, ad (regarding ear) confused with ou,os, od (meaning eye) write out the words do not leave out spaces between the words avoid /, can be mistaken for 1 avoid &, can be mistaken for the number 4 when handwritten See PTCB Calculations tutorial for objectives 6.5 through 6.25. 53 HSE.O.PTCB.6.15 HSE.O.PTCB.6.16 HSE.O.PTCB.6.17 HSE.O.PTCB.6.18 HSE.O.PTCB.6.19 HSE.O.PTCB.6.20 HSE.O.PTCB.6.21 HSE.O.PTCB.6.22 HSE.O.PTCB.6.23 HSE.O.PTCB.6.24 HSE.O.PTCB.6.25 Standard Number: concentration for drugs in drug products. differentiate methods for determining quantities of ingredients and concentration of drugs when preparing or dispensing drug products. calculate amounts of two solutions of different strengths which must be combined to get a third solution of a specified strength. calculate final strength of a diluted or mixed solution when given the original strength(s) and volume(s) and the final volume. distinguish methods of expressing doses and dosage regimens. calculate the amount of drug product to dispense or a days supply from a dosage regime. calculate doses for pediatric patients using pediatric dosage information found in reference books. apply general rules for calculating an infant’s or child’s dose of medication when given the age or weight of the patient and the normal adult dose. determine the flow rate of an IV solution when given the total volume, total time of administration, and the drops delivered per ml by the administration set. calculate powder volume and use calculation to reconstitute dry powders for suspension or solution. examine pricing methods used in retail pharmacy. recongize the meaning of terms used in pricing methods. Pharmacy Operations 54 HSE.S.PTCB.7 Essential Questions: Objectives: HSE.O.PTCB.7.1 HSE.O.PTCB.7.2 HSE.O.PTCB.7.3 Students will demonstrate knowledge and skills necessary for the daily operation of a pharmacy. Does the expected level of competence of the Pharmacy Technician, in the daily operation of a pharmacy, ever change? Students will Learning Plan & Notes to Instructor: differentiate common pharmaceutical terms drug names to include drug names, codes, expiration chemical name date formats, dispensing containers, and general name (nonproprietary) closures. brand name (proprietary) codes National Drug Code (NDC), assigned by FDA Uniform Product Code Mnemonic Code expiration date format based on shelf life medication considered effective before the expiration date See PTCB’s Pharmacy Operations (Basic Facts in Pharmacy) for Reference Books/Information dispensing containers vials, ointment jars, bottles, dropper bottles, unit dose, dose packs, dispensing containers closures child resistant, easy-open, or non-safety Poison Prevention Packaging Act – requires that most over the counter medications and prescription medications use child-resistant containers (see exemptions and legend drugs that are exempt) determine considerations regarding authority to prescribe authority to prescribe. determined at the state level, including the practitioner’s prescription authority based on scope of practice assess possible prescribers. possible prescribers physicians, podiatrists, dentists, optometrists, 55 HSE.O.PTCB.7.4 HSE.O.PTCB.7.5 HSE.O.PTCB.7.6 HSE.O.PTCB.7.7 HSE.O.PTCB.7.8 HSE.O.PTCB.7.9 HSE.O.PTCB.7.10 veterinarians, physician assistants, nurse practitioners, medical interns and residents See Pharmacy Operations (Assisting the Pharmacy) characterize general processes related to the dispensing and medication distribution in tutorial. a traditional pharmacy. See Pharmacy Operations tutorial. examine the method of transmitting prescriptions to a pharmacy. Demonstration of patient confidentiality should be apply required patient confidentiality. exhibited during the work-based clinical experience. Evaluation of this objective will occur within the clinical setting articulate the required contents of a prescription contents prescription and medication order. patient information, date, name of product, strength, dosage form, quantity, Sig. (directions), label directions, refills, prescriber information medication order patient information, date, time of day, product name, dosage form, prescriber information, Sig. (directions, route, duration) select information obtained from patients information obtained from patients when receiving refill requests. patient name and telephone number prescription number drug name, strength, and quantity prescriber information – Doctor’s name reimbursement (third party payer) distinguish the process and information calling prescribers for refill authorization needed when calling prescribers for refill pharmacy name and telephone number authorization. patient name and date of birth drug name, strength, and quantity original and last refill date prescription directions demonstrate receiving electronic receiving information in electronic form transmission of prescriptions. transmission of the exact visual image of a document by way of electronic equipment 56 HSE.O.PTCB.7.11 differentiate patient information necessary for the patient profile. HSE.O.PTCB.7.12 relate the process required when entering prescription/medication information in the patient profile. HSE.O.PTCB.7.13 validate appropriate product selection (i.e. brand vs. generic). HSE.O.PTCB.7.14 assist the Pharmacist in preparing and dispensing medications to include: Measuring and Counting Calculation and Verifiction Compounding Weighing Reconstituting Aseptic Technique/IV Admixtures Controlled Substances prepare and package prescriptions and medication orders. relate information contained on a prescription label. HSE.O.PTCB.7.15 HSE.O.PTCB.7.16 See Pharmacy Operations (General Prescription Duties) for both ambulatory and institutional/long term care patient profile. entering prescription/medication information in the patient profile – computerized database verify information compare new order to profile enter required information pharmacist initials reimbursement pharmacy policy and procedures followed brand vs. generic dispense as written (DAW) bioavailability must be the same FDA reviews to make sure equivalent See Orange Book as reference Formulary is a document or listing of committee approved pharmaceuticals or therapeutics in stock Behaviors and characteristics should be exhibited during the work-based clinical experience. Evaluation of objectives 7.14 and 7.15 will occur within the clinical setting. prescription labels may contain name and address of pharmacy date of issuance 57 HSE.O.PTCB.7.17 report the advantages of the Unit Dose System. HSE.O.PTCB.7.18 examine types of Unit Dose Systems. HSE.O.PTCB.7.19 demonstrate the five “Rights” of medication. HSE.O.PTCB.7.20 demonstrate the three check points utilized prescription number drug name, strength, and quantity directions patient’s name prescriber’s name expiration date number of refills lot number pharmacists initials auxiliary labels federal transfer label advantages of Unit Dose System (systems provide each patient with a storage bin with a twenty-four hour supply of drugs) reduce the number of medication errors increase drug use control within institutions minimize drug waste and pilferage reduce nursing preparation time more accurate and efficient billing fully utilize involved members of the health care team enhance or improve the quality of patient care types of Unit Dose Systems centralized (med. cart, one pharmacy) decentralized (satellite pharmacy, combination of both) five “Rights” of medication Right medication Right patient Right dose Right route Right time three check points 58 retrieving bottle from stock counting from bottle returning bottle to stock report the Pharmacist’s accountability during pharmacist is ultimately accountable to patient dispensing of a prescription. articulate possible sources of medication possible sources of medication errors errors. failure to rotate stock preparing three prescriptions at a time reading the drug label fast abbreviations Supplemental Information at the Direction of the predict reporting procedures for medication Pharmacist errors. illustrate the use of supplemental patient supplemental patient information information. package inserts required every time drug dispensed, new Rx and refills o oral contraceptives, estrogens, progesterones, isotretinoin, intrauterine devices, isoproterenol inhalation products See Pharmacy Operations (Key Terms and Concepts) examine key concepts and terms used in tutorial. pharmacy inventory management. report ordering and receiving techniques. ordering pharmacy may order products directly through a representative, by telephone, fax, or computer modum receiving verifying products ordered vs. products received o original purchase order or “want book” o invoice received with order o products received in order o check for damaged products, complete shipment, and expired contents documentation of receipt of goods o completed records should be filed or sent to accounting department during the dispensing of a prescription. HSE.O.PTCB.7.21 HSE.O.PTCB.7.22 HSE.O.PTCB.7.23 HSE.O.PTCB.7.24 HSE.O.PTCB.7.25 HSE.O.PTCB.7.26 59 HSE.O.PTCB.7.27 compare methods in managing inventory. HSE.O.PTCB.7.28 assess ways prescriptions are numbered, dated, and labeled. predict the role of the FDA in medication recall and adverse drug reaction. HSE.O.PTCB.7.29 HSE.O.PTCB.7.30 assess theft and drug diversion. HSE.O.PTCB.7.31 examine methods of reimbursement and available payment plans. HSE.O.PTCB.7.32 determine claims processing procedures using Universal Claim Forms (UCFs), paper o date and initial o indicate discrepancies on invoice o call vendor with discrepancies materials management includes the drug procurement process, inventory control, and drug storage See Pharmacy Operations (Medication Distribution and Inventory Control) See Pharmacy Operations (General Prescription Duties) FDA or pharmaceutical manufacturer may recall a product or specific manufactured batch or lot number of a product is it is deemed unsafe or has reported problems (Class I-IV) See Pharmacy Operations (Medication Distribution and Inventory Control) theft drug taken from the pharmacy without compensation drug diversion medication taken from the pharmacy without valid prescription or medication order reimbursement plans or third party programs private health insurance government programs contribute to a patient’s prescription medication costs reimbursement system patient pharmacy payer See Pharmacy Operations (Third Party Reimbursement) tutorial. claims filing vary according to whether the submission is by mail or electronic filing (i.e. via modem, on-line) 60 HSE.O.PTCB.7.33 claims, on-line claims, and electronic adjudication. relate the components of drug utilization review. HSE.O.PTCB.7.34 examine Reimbursement Formulary. HSE.O.PTCB.7.35 determine quantity restriction as it applies to preventing dispensing of unnecessary quantities. establish steps for obtaining prior authorization. HSE.O.PTCB.7.36 HSE.O.PTCB.7.37 relate the purpose of the signature log. Standard Number: Clinical Internship See Pharmacy Operations (Third Party Reimbursement) tutorial drug utilization review retrospective – based on past claims history concurrent – done during processing of prescriptions for dispensing and compares new prescriptions with what the patient has been previously taking prospective – intended to be done by the pharmacist before filling a prescription o to avoid potential harmful interactions o ensures the most appropriate medication is given to the patient o screens for fraud or misuse o targets selected higher cost therapies o changes prescribing practices and patterns of prescribers o screens for under-use of drug therapy list of medications that are covered by the payment plan (See Pharmacy Operations – Third Party Reimbursements) third party plans will typically limit the quantity of medication that can be dispensed to prevent patients from receiving unnecessary quantities prior authorization some plans require that the pharmacy call to receive approval to dispense medication in designated drug classes if approved, a third party will give a numerical code to be entered into the computer or submitted with the paper claim signature log – patient’s signature is kept on file to indicate a medication was picked up 61 HSE.S.PTCB.8 Essential Questions: Objectives: HSE.O.PTCB.8.1 HSE.O.PTCB.8.2 HSE.O.PTCB.8.3 HSE.O.PTCB.8.4 HSE.O.PTCB.8.5 HSE.O.PTCB.8.6 HSE.O.PTCB.8.7 HSE.O.PTCB.8.8 HSE.O.PTCB.8.9 HSE.O.PTCB.8.10 HSE.O.PTCB.8.11 HSE.O.PTCB.8.12 HSE.O.PTCB.8.13 HSE.O.PTCB.8.14 Standard Number: HSE.S.PTCB.9 Students will demonstrate knowledge and skills during particpation in a clinical internship. Should participation in a clinical internship be seen as a right or a privilege? Students will Learning Plan & Notes to Instructor: See industry credentialing requirements. demonstrate a working knowledge of internship eligibility requirements. See student data files. comply with required health regulations such as proof of physical examination and immunization status. See student data files. provide proof of personal health insurance. Objectives within this standard represent behaviors and wear proper clinical attire. characteristics that are a result of cognitive maintain mastery or above in attainment of skills/knowledge gained from successful completion of standards in classroom theory and lab. PTCB Preparation 0771. Behaviors and characteristics report to clinical site on time and ready to should be exhibited during the work-based clinical work. experience. Evaluation of these objectives will occur notify clinical site and instructor when within the clinical setting. absent. conform to policies regarding performance of skills and scope of responsibility. correctly and safely perform entry-level procedures under supervision of a pharmacist. request assistance or clarification as needed. maintain professional standards including client confidentiality. organize and effectively manage time. complete documentation required of clinical internship accurately. participate in clinical internship evaluation process. Technology Students will: use information technology to access, generate, and distribute information. 62 Essential Questions: Objectives: HSE.O.PTCB.9.1 demonstrate an understanding of the Internet as a resource tool. Has the application of technology impacted healthcare careers positively or negatively? Students will implement the use of software and hardware. Learning Plan & Notes to Instructor: Use software, hardware, and Internet throughout delivery of CSOs. Use Internet for resource/research for projects and assignments. Use Internet for resource/research for projects and assignments. HSE.O.PTCB.9.2 utilize the Internet as a resource/research tool. Standard Number: HSE.S.PTCB.10 Career and Technical Student Organization Students will participate in the local chapter of the Career and Technical Student Organization (CTSO). How does participation in a Career and Technical Student Organization (CTSO) impact professional development and lifelong learning? Students will Learning Plan & Notes to Instructor: See www.HOSA.org. participate in the local chapter of the appropriate Career and Technical Student Organization (CTSO). See Robert’s Rules of Order. use parliamentary procedures in chapter meetings. demonstrate team membership/leadership and See HOSA Handbook. problem solving skills. See HOSA Handbook. participate in local, state, and national projects impacting healthcare and healthcare education. Learning Skills & Technology Tools Teaching Strategies Evidence of Success Culminating Activity 21C.O.9Student recognizes Students use search Students identify job 12.1.LS1 information needed for engines to complete a job availability for their problem solving, can search for their health health care career, and efficiently browse, search, care career choice. recognize applicable and navigate online to access networking possibilities relevant information, Students will use search and pertinent evaluates information based engines to research professional Essential Questions: Objectives: HSE.O.PTCB.10.1 HSE.O.PTCB.10.2 HSE.O.PTCB.10.3 HSE.O.PTCB.10.4 21st Century Skills Information and Communication Skills: 63 21C.O.912.1.LS3 21C.O.912.1.TT1 Thinking and Reasoning Skills: 21C.O.912.2.LS1 on credibility, social, economic, political and/or ethical issues, and presents findings clearly and persuasively using a range of technology tools and media. Student creates information using advanced skills of analysis, synthesis and evaluation and shares this information through a variety of oral, written and multimedia communications that target academic, professional and technical audiences and purposes. Student makes informed choices among available advanced technology systems, resources and services (e.g., global positioning software, graphing calculators, personal digital assistants, web casting, online collaboration tools) for completing curriculum assignments and projects and for managing and communicating personal/professional information. Student engages in a critical thinking process that supports synthesis and conducts evaluation using complex networking and professional organization opportunities. organizations. Students complete multimedia presentations utilizing HOSA Competitive Event(s) as teaching/learning strategies. Students participate in HOSA projects in classroom and competition. Projects are judged based on rubrics in HOSA Handbook B. Students make informed choices regarding the use of technology systems within the clinical setting in order to manage and communicate professional information. Use of technology systems will be dictated by the systems found within the clinical setting utilized for the clinical internship. Weekly clinical evaluations will reflect appropriate use of technology systems within the clinical internship setting. Students engage in a variety of critical thinking scenarios during internship in a pharmacy Students apply the acquired knowledge by selecting the appropriate course of 64 21C.O.912.2.LS2 21C.O.912.2.LS3 21C.O.912.2.LS4 21C.O.912.2.TT1 criteria. Student draws conclusions from a variety of data sources to analyze and interpret systems. Student engages in a problem solving process by formulating questions and applying complex strategies in order to independently solve problems. Student visualizes the connection between seemingly unrelated ideas and independently produces solutions that are fresh, unique, original and well developed. Student shows capacity for originality, concentration, commitment to completion, and persistence to develop unique and cogent products. Student knows how to find information necessary to solve advanced problems related to hardware, software, networks, and connections (e.g., by accessing online help, Internet searches, technical documentation, system utilities, and setting. action and seeking assistance as needed as they complete their clinical internship requirements. Students will use problem solving skills to decide on appropriate application of course knowledge and skills. Throughout the clinical internship, the student will be presented with a variety of situations, within complex environments. Within these environments, the student must demonstrate the ability to collect and assess data from all sources and produce unique solutions that represent the best action for each situation. The student will use hardware, software, the Internet, technical documentation, system utilities and communication with technical experts, specific to the clinical setting, as an integral component of Students apply the acquired knowledge and processing skills to meet the internship standards and objectives. The student’s clinical evaluations will demonstrate evidence of appropriate adherence to the pharmacy technician’s legal scope of practice. Clinical evaluation will demonstrate the student’s ability to proficiently use hardware, software, and communication with technical experts to meet internship expectations. 65 21C.O.912.2.TT4 Personal, and Workplace, Skills: communication with technical experts). Student uses technology tools and multiple media sources to analyze a real-world problem, design and implement a process to assess the information, and chart and evaluate progress toward the solution. the clinical internship. 21C.O.912.3.LS1 Student remains composed and focused, even under stress, willingly aligns his/her personal goals to the goals of others when appropriate, approaches conflict from winwin perspective, and derives personal satisfaction from achieving group goals. Within the specific clinical setting, the student will analyze client/ clinical problems and use available technology tools to document progress. Technology tools will be used for intradepartmental communication as guided by policy and procedures of the facility or pharmacy. Students will engage in leadership and problem solving scenarios during internship by planning the most appropriate course of action when given their assignment and analyze possible consequences of the task. 21C.O.9- Student independently The student’s course of The student’s clinical evaluations will document the proficient use of technology within the real-world of the clinical internship. Given the legislated scope of practice for pharmacy technician students, they will consistently apply the correct course of action within the appropriate scope of practice; display ethical behaviors related to privacy and confidentiality; and seek assistance if unsure. The student’s course of action, behavior and characteristics during the clinical internship will be documented on the clinical internship weekly evaluation. Students will adapt 66 12.3.LS2 considers multiple perspectives and can represent a problem in more than one way, quickly and calmly changes focus and goals as the situation requires, and actively seeks innovations (e.g. technology) that will enhance his/her work. 21C.O.912.3.LS3 Student demonstrates ownership of his/her learning by setting goals, monitoring and adjusting performance, extending learning, using what he/she has learned to adapt to new situations, and displaying perseverance and commitment to continued learning. Student demonstrates ethical behavior and works responsibly and collaboratively with others in the context of the school and the larger community, and he/she demonstrates civic responsibility through engagement in public discourse and participation in service learning. Student exhibits positive leadership through interpersonal and problem- 21C.O.912.3.LS4 21C.O.912.3.LS5 action during participation in the clinical internship will focus on the role of the pharmacy technician. Students will develop short and long term goals along with their instructor and clinical preceptor and utilize technology tools to meet internship requirements. Through student/teacher post-conferences, review of learning goals, and clinical accomplishments, the student will monitor and adjust clinical internship performance as deemed necessary. focus and goals to internship requirements. Clinical evaluations will document the student’s approach to the meeting of long and short term goals, and the requirements of the clinical internship. Ethical behaviors will be developed as a result of privileged communications shared with students during the work-based experience; as they are faced with situations where they must maintain client privacy and confidentiality. Clinical evaluations will document the student’s ethical practice in all aspects of the clinical internship. The student will participate in service learning thorough the local HOSA chapter. Through working in the pharmacy setting (retail or hospital) with other The student’s clinical evaluations will reflect positive leadership 67 Through the use of goal profiles and skills check off list, the students will monitor his/her learning and address skill deficits with the teacher and/or clinical preceptor. 21C.O.912.3.LS6 21C.O.912.3.TT4 solving skills that contribute to achieving the goal. He/she helps others stay focused, distributes tasks and responsibilities effectively, and monitors group progress toward the goal without undermining the efforts of others. Student maintains a strong focus on the larger project goal and frames appropriate questions and planning processes around goal. Prior to beginning work, student reflects upon possible courses of action and their likely consequences; sets objectives related to the larger goal; and establishes benchmarks for monitoring progress. While working on the project, student adjusts time and resources to allow for completion of a quality product. Student adheres to acceptable use policy and displays ethical behaviors related to acceptable use of information and communication technology (e.g., privacy, security, copyright, file-sharing, employees, the student will function effectively as a team member, contributing toward the development of positive working relationships. behaviors and effective problem solving skills as he/she works independently or with other employees in the pharmacy. The student’s clinical internship experience is documented within the clinical journal. The student is actively engaged in all preconferences. The student articulates the planned course of action and expected results for his/her clinical assignments. Post-conference reflects the student’s ability to adjust time and resources to accomplish clinical internship goals. Students engage in policy- Student can articulate based, ethical use of the methodologies information and necessary to protect communication the integrity of the technology. system in relationship to patient privacy. Students apply HIPPA regulations to all The student will participate in pre- and postconferences during the clinical internship for the purpose of planning the appropriate course of action and establishing goals for completion of daily tasks. During conference, the student will reflect on patient progress, or lack thereof. The student will adjust the course of action as necessary to meet internship requirements. 68 21C.O.912.3.TT5 21C.O.912.3.TT7 plagiarism); student predicts the possible cost and effects of unethical use of technology (e.g., consumer fraud, intrusion, spamming, virus setting, hacking) on culture and society; student identifies the methodologies that individuals and businesses can employ to protect the integrity of technology systems. Student models ethical behavior relating to security, privacy, computer etiquette, passwords and personal information and demonstrates an understanding of copyright by citing sources of copyrighted materials in papers, projects and multimedia presentations. Student advocates for legal and ethical behaviors among peers, family, and community regarding the use of technology and information. Student protects his/her identity online and in email and/or websites, limits the distribution of personal information/pictures, and evaluates the authenticity of emails that solicit personal information. Student clinical functions. The student practices ethical behavior as a result of cognitive learning within the classroom. The student applies this knowledge during interaction with the healthcare team, patient, patient’s family, and peers. Ethical behavior is documented by the clinical instructor or preceptor on the weekly clinical evaluation. Throughout the clinical internship, the student adheres to policies and procedures in regard to the use of email, websites, personal information, and system integrity. Appropriate use of the clinical facilities’ information system, demonstrates the student’s ability to follow all safeguards and system regulations. 69 21C.O.912.3.TT8 identifies the methodologies that individuals and businesses can employ to protect the integrity of technology systems. Student uses technology to seek strategies and information to address limits in their own knowledge. Learning Skills & Technology Tools Entrepreneurship Skills: GRASP B.01-B.11, .17.28 Understands the personal traits/behaviors associated with successful entrepreneurial performance. As the student participates in a wide variety of clinical encounters, the student recognizes knowledge deficits and utilizes the clinical journal to share identified deficits and technological strategies to address the deficits with the classroom teacher. Teaching Strategies Culminating Activity Students will develop leadership, personal management, communication, and job seeking skills as they engage in work assignments during internship/clinical experiences. Students will utilize various multimedia resources in developing job keeping skills and identify entrepreneurial opportunities. Culminating Assessment Tutored Exam (See PassAssured Pharmacy Technician Training Program) Utilization of the clinical journal demonstrates self assessment and correction of knowledge deficits. Evidence of Success Students display appropriate leadership, personal management, and communication skills during clinical/ internship assignments. Students successfully utilize job seeking skills as they build a professional portfolio. 70 Culminating Assessment: Industry Accreditation/ Certification: Final Exam (See PassAssured Pharmacy Technician Training Program) PTCB Practice Exam, Study tools online @ http://www.ptcb.org Technical Skills Performance Assessment Industry Accreditation/Certification PTCB Exam (Pharmacy Technician Certification Board Exam) Links and Other Resources Links and Other Resources: Related Websites: PassAssured http://www.passassured.com PTCB http://www.ptcb.org HOSA http://www.hosa.org Center for Disease Control http://www.cdc.gov Pathways to Success http://careertech.k12.wv.us/pathwaystosuccess/ U.S. Department of Labor in the 21st Century http://www.dol.gov/ Advanced Distributed Learning www.adlnet.org America's Career InfoNet www.acinet.org 71 America's Job Bank www.ajb.org America's Service Locator www.servicelocator.org CareerOneStop www.careeronestop.org Employment & Training Administration www.doleta.gov The Job Accommodation Network (JAN) http://www.jan.wvu.edu Monthly Labor Review Online: Labor Force Archives http://www.bls.gov/opub/mlr/indexL.htm#Labor force Occupational Information Network www.doleta.gov/programs/onet Office of Disability Employment Policy www.dol.gov/odep Career Voyages http://www.careervoyages.gov/index.cfm Workforce West Virginia https://www.workforcewv.org/ West Virginia Earn A Degree Graduate Early (EDGE) http://www.wvtechprep.wvnet.edu/edge.htm West Virginia Career and Technical Education http://careertech.k12.wv.us/ 72 Contacts Contacts: HSE Teachers: See HSE Directory HSE Coordinators: Rebecca Davis rdavis@accesslk12.wv.us Cynthia Sundstrom csundstr@access.k12.wv.us OCTI Assistant Executive Director and EOCTST Coordinator: Donna Burge-Tetrick OCTI Executive Director: Gene Coulson 73