1) For each medication listed below, match it to the most appropriate OCC record.
OXYCODONE-ACETAMINOPHEN 5-325 MG PO TABS(a unit dose compound)
RX
... [Show More] SIMPLE MED
For each medication listed below, match it to the most appropriate OCC record.
AMLODIPINE-HYDROCHLOROTHIAZIDE (MODURETIC 5/50) COMBO TABS (a solid form mixture)
RX BULK PRODUCT NO DOSE REQUIRED
The solid form mixture points to this one.
For each medication listed below, match it to the most appropriate OCC record.
HYDROCHLOROTHIAZIDE 12.5 MG CAPS(an IMS solid)
RX SIMPLE MED
For each medication listed below, match it to the most appropriate OCC record.
HYDROCHLOROTHIAZIDE 6.25 MG SPLIT TABLETS(a custom ERX for split tablets)
RX SIMPLE MED
You've been asked to configure the ERX records for phantasidose (Trainex) tablets. This new knowledge-enhancing medication is available in three commercial strengths: 50 mg, 100 mg, and 200 mg tablets. Your P&T committee approved the medication, and your buyer has purchased all three strengths.
When you configure these three ERX records, which of the following fields should have the SAME values in ALL THREE records?
a. Order Display Name
b. Medication Short Name
c. Medication Brand Name
d. Inpatient Order Name Suffix
e. Default charge method
f. Default Frequency
g. Suggested Doses (dose buttons)
h. Medication Unit
i. Administration Unit
j. Dispense Unit
k. Equiv Qty and Unit[JPS1]
l. Allowed Order Units
m. Allowed (& Default) Routes
n. Frequency Buttons
o. Route Buttons
Equiv Qty and Unit
This should be different, reflecting the strength of each pill.
Which of the three phantasidose (Trainex) tablet ERX records should be on your central pharmacy's medication list? What about on your formulary medication list?
All three should be on both
1) On each of the lists in question 3, which ERX records should have a green dot next to them? Why?
Only the 50 mg tab should have a dot. It's an IMS drug (multiple strengths of the same drug + form), so you only want/need one of them on the linked preference lists.
1) After you set the records up, a technician approaches you with this first dose label for 3 first doses:
He points out the dispense amount. "1.5 tablets? But we don't dispense partial tablets unless they've been split and repackaged in bulk." He's right, you don't. Which of the following do you need to do to fix this? Choose ONE answer only.
a) Change the Allowed Order Units in the ERX record to only include "tablet"
b) Change the Default Dispense Code to "Solid Form Mixture" in the ERX record
c) Change the Dispense Rnd Factor to "1" in the ERX record[JPS1]
d) On the Label Routing table for your pharmacy, change the Group? column for this dispense code
This is the problem. Each dose is 0.5 tablets, but in this scenario, you should be dispensing 3 separate tablets. The Rnd Factor is set to 0.5 (or blank).
And yes, it should be 3 tablets being dispensed. There are 3 first doses. Each one should have a dispense amount of 1 tablet. This label is grouped, so it should be 3 tablets for 3 doses.
1) Trainex has been so popular that there's now a shortage on 50 mg tablets. You run out! The 100 mg are still available, so you start splitting them in bulk and repackaging them as 50 mg "split tablets."
You configure your custom ERX for phantasidose (Trainex) 50 mg split tablets, add it to your central med list, and select it in the Orders activity. But when you change the dose from 50 mg to 100 mg, it doesn't change to the 100 mg tablets; it's dispensing 2 x 50 mg split tablets from Central Pharmacy. Name two settings that could be preventing IMS from working correctly.[JPS1]
[JPS1]See chapter 3
In the ERX, possible culprits are:
· Use IMS when this is ordered? (should be Yes)
· GPI/GMI/GPK: must match commercially available products.
· Medication Unit: must be in units like mg, not tablet or split tablet.
Also: maybe you've only got 50 mg split tabs on the central list. You might have accidentally removed the 100 mg tabs from the list!
The Strength & Strength Unit are also important, but not in this specific scenario. If they were wrong in the commercially available 100 mg tab record, they could prevent the system from changing to them. But if it was wrong in the 50 mg split tab, you'd see the problem when the dose 50 mg, not when you changed it to 100 mg.
Also, the Proxy might come up, but it's not about IMS. See next question.
See chapter 3
In the ERX, possible culprits are:
· Use IMS when this is ordered? (should be Yes)
· GPI/GMI/GPK: must match commercially available products.
· Medication Unit: must be in units like mg, not tablet or split tablet.
Also: maybe you've only got 50 mg split tabs on the central list. You might have accidentally removed the 100 mg tabs from the list!
The Strength & Strength Unit are also important, but not in this specific scenario. If they were wrong in the commercially available 100 mg tab record, they could prevent the system from changing to them. But if it was wrong in the 50 mg split tab, you'd see the problem when the dose 50 mg, not when you changed it to 100 mg.
Also, the Proxy might come up, but it's not about IMS. See next question.
The makers of phantasidose (Trainex) tablets also manufacture Super Trainex, or METHYLPHENIDATE-PHANTASIDOSE 10-50 MG PO TABS. Your hospital has started to get patients who have PTA prescriptions for it, and your physicians are ordering it during med rec. Your P&T committee hasn't approved Super Trainex, but they have approved METHYLPHENIDATE HCL 10 MG PO TABS.
1) Which of the following should you create? (choose ALL that apply)
a) An "and" linked panel for Super Trainex
b) A custom simple ERX record for Super Trainex
c) A solid-form mixture for Super Trainex
d) An inpatient Alternative record that redirects away from the Super Trainex[JPS1] simple ERX
[JPS1]These two. Though, the second one is BTB. Try it out with Vytorin.
· On Caleb >> Admission >> Admission Orders >> Review PTA meds à add Vytorin (any dose)
· On Reconcile Meds à order it! See alternative suggesting solid form mixture.
These two. Though, the second one is BTB. Try it out with Vytorin.
· On Caleb >> Admission >> Admission Orders >> Review PTA meds à add Vytorin (any dose)
On Reconcile Meds à order it!See alternative suggesting solid form mixture.
1) Phantasidose (Trainex) is now available as an IV injection with a 25 mg/mL concentration. When ordered for adults, the most common doses are 25, 50, and 100 mg. When ordered for pediatric patients, typical dosage is 0.25 mg/kg and 0.5 mg/kg. You want your dose buttons for this ERX record to change based on the patient. What will you need to create to accommodate this?
Two (at least) override contexts for the TRAINEX injection.
1) Assume that the ERX record for PHANTASIDOSE HCL 25 MG/ML IJ SOLN is configured like so:
If you order it at 0.5 mg/kg for your Buffy patient (who weighs 29.3 kg), what will the Administer Dose be? (HINT: see page 6.13 for rounding!)
Step 1: Simplify the ordered dose
0.5 mg/kg x 29.3 kg = 14.65 mg
Step 2: Calculate & Round Admin Amount
14.65 mg x (1mL/25mg) = 0.586 mL
Per System Level Liquid Rounding Table, round to nearest 0.01 mL à 0.59 mL
Step 3: Calculate Administer Dose
0.59 mL x (25mg/1mL) = 14.75 mg
Your IPS table for ADS and robot pharmacies in your hospital record looks like this
Which of the following statements are true? (Choose all that apply.)
a) ADS cabinets and robots will dispense up to 999 packages of controlled substances.
b) ADS cabinets and robots will dispense up to 3 packages of either controlled or non-controlled substances.
c) ADS cabinets and robots will only dispense exact matches of packages.
d) If you switch the order of the two rows in the table above, it will change IPS's behavior.
A: TRUE. Per the first row, this is true.
B: FALSE. While leaving Controlled Substance blank does allow for either controlled or non-controlled substances to be included, because we have a row before it that specifies Yes, the second row can only include No.
C : FALSE. Leaving Matches Allowed blank will default to Allow Partial.
D: TRUE. Switching the order will mean that all medications (controlled or non-controlled) have 3 max packages when coming from an ADS or robot.
1) When you prepare custom doses of phantasidose (Trainex) injections (with a dispense code of "Syringe"), you want a dose label and a grouped production label to print. You'll print these labels when you dispense first doses, dispense cart doses, dispense PRN first doses, and when you redispense a dose.
Assuming this hasn't already been configured, how many rows will you need to add to the Label Routing table of your central pharmacy to get such labels to print?
8 rows total
4 actions (Dispense [First Dose], Dispense [Cart Fill], PRN Par Dispense [First Dose], and Redispense)
x 1 dispense code (Syringe)
x 2 different SmartTexts (labels)
= 8 rows total.
1) Which of the following must be true for Epic to dispense a "phantasidose (Trainex) IVPB in 100 mL" mixture from a satellite pharmacy serving the patient's unit? (Choose ALL that apply.[JPS1] ) a) All of the ingredients must be on the pharmacy's Medication List b) Any of the ingredients must be on the pharmacy's Medication List c) The mixture must be on the pharmacy's Medication List d) The pharmacy must support the mixture's Prep Type
A & D
You want to configure an ERX record for phantasidose (Trainex) IVPB in 100 mL. It can be mixed in either 100 mL of D5W or NS; no other volume or bases should be allowed. NS is the most commonly used base. You want there to be dose buttons for 100 mg, 200 mg and 400 mg; 200 mg should be selected by default.
Suggested doses
Dose Units Default?
100 mg
200 mg yes
400 mg
You test your PHANTASIDOSE IVPB IN 100 ML mixture, and find that the order name at the top of the Order Composer reads: "phantasidose (Trainex) IVPB 200 mg" You want it to read: "phantasidose (Trainex) 200 mg in sodium chloride 0.9% (NS) 100 mL IVPB". What setting did you forget to make? What specific value should you enter in that setting to get the name you want?[JPS1]
[JPS1]Order Naming Extensions
Enter 34917 - IP RXNAME STANDARD (MAIN INGREDIENT WITH BASE DISPLAYED AND BASE QUANTITY)
Order Naming Extensions
Enter 34917 - IP RXNAME STANDARD (MAIN INGREDIENT WITH BASE DISPLAYED AND BASE QUANTITY)
Which of the following must be true for Epic to dispense a "phantasidose (Trainex) IVPB in 100 mL" mixture from a satellite pharmacy serving the patient's unit? (Choose ALL that apply.[JPS1] ) a) All of the ingredients must be on the pharmacy's Medication List b) The mixture must be on the pharmacy's Medication List c) The pharmacy must support the mixture's Prep Type
[JPS1]A + C; the mixture should be added to the Central Pharmacy Med List, but it not necessary on the Satellite Pharmacy Med List
A + C; the mixture should be added to the Central Pharmacy Med List, but it not necessary on the Satellite Pharmacy Med List
You configure an IMS Orderable for phantasidose (Trainex) IVPB. You configure dispensable mapping like so:
You order this medication for your Caleb patient and enter a dose of 200 mg. Assuming it's coming from the central pharmacy, which dispensable would you expect it to choose? Why?[JPS1]
[JPS1]It will choose the 2nd line (IVPB IN 100 ML) because Caleb weighs more than 40 kg and the dose falls in the "0-400 mg" row. That takes precedence over the exact match on the premix.
It will choose the 2nd line (IVPB IN 100 ML) because Caleb weighs more than 40 kg and the dose falls in the "0-400 mg" row. That takes precedence over the exact match on the premix.
Now suppose you order this medication for your Buffy patient, again with a dose of 200 mg. This time, however, IMS picks the 3rd dispensable (the premix IV) instead of the 1st dispensable (the injection). What are two different reasons it might have done so?
Reason 1: The 1st row might not be on the central pharmacy's medication list (if it's not available, IMS won't select it). Note: that would also prevent it from picking line 2, because (as you can see in Question 14, PHANTASIDOSE 25 MG/ML IJ SOLN is the main ingredient of the mixture in row 2).
Reason 2: The Premix IV might be loaded to an ADS cabinet that serves Buffy's unit, while the injection is not. It's technically a viable match for the order, so the system would choose to dispense that rather than getting the injection from central.
· Suppose the system chooses to dispense the 2nd dispensable (PHANTASIDOSE IVPB IN 100 ML, a main ingredient mixture). You notice, however, that the Dispense Code for the order is "Unit Dose" instead of "IVPB Mixture." In which record would you need to go to fix the dispense code? (Choose ONE only.)
A) PHANTASIDOSE IV ORDERABLE (the IMS orderable record)
B) PHANTASIDOSE IVPB IN 100 ML (the main ingredient mixture being dispensed)[JPS1]
C) PHANTASIDOSE 25 MG/ML IJ SOLN (the simple ERX record that is the main ingredient for the mixture)
D) SODIUM CHLORIDE 0.9 % IV SOLN (the simple ERX record that is the base for the mixture)
The dispense code comes from the ERX record being dispensed (in this case, the mixture).
1) You're configuring a mixture for EXAMPALIN 20 OR 40 UNITS/ML IN D5W INFUSION. It has these properties:
· The dose is usually 0.5 or 1 Unit/kg/hr.
· The frequency is "Continuous" and the route is "Intravenous."
· There should be two choices for concentration in the Order Composer: "20 Units/mL" and "40 Units/mL".
· The mixture is always prepared in 250 mL of D5W. The concentration affects how much EXAMPALIN 100 UNITS/ML IJ SOLN is put in the bag.
Based on these details, answer the following:
a) What type of mixture is this? (pick 1)
a. IV Fluid Mixture
b. Main Ingredient Mixture
c. Ratio-Based Mixture
d. Concentration-Based Mixture
a.Wrong! It's not a ratio-based mixture, it's a concentration-based mixture
c.WRONG! You don't put the multiple concentrations on MIXTURE SETUP 2. You put them on the CONCENTRATION OPTIONS screen. See ch 10
If there was only one concentration, you could do it like this
D. Correct. It's always in this volume
E. Correct! There's only one base, so it should always be selected.
NOTE: You should not configure the ORDER COMPOSER SECTION SETUP screen to say "Base" >> Allow only one? "Yes" and Selection Required? "Yes" Since there's only 1 base, and it's always selected, this will throw an error.
You probably SHOULD set Allow custom dose? To "No" for the D5W on the MIXTURE ORDER COMPOSER ITEMS screen.
a) Which OCC should you use? (pick 1)
a. RX SIMPLE MED
b. RX MAINTENANCE IV
c. RX MAIN INGREDIENT MIXTURE NO COMPONENTS DISPLAYED
d. RX MAIN INGREDIENT MIXTURE DISPLAYING BASE
e. RX CONCENTRATION DOSED MIXTURE
f. RX CONCENTRATION DOSED MIXTURE DISPLAYING BASE
E, RX CONCENTRATION DOSED MIXTURE. There's only 1 base, so use this one (which doesn't display to base to end users).
When the concentration of "20 Units/mL" is selected, the Order Name for this mixture should be:exampalin (Learnix) 5,000 Units in dextrose 5% 250 mL (20 units/mL) infusionIf they choose "40 Units/mL," the name should change to match. Assume that the EXAMPALIN 100 UNITS/ML IJ SOLN and the DEXTROSE 5 % IV SOLN are already configured appropriately. What settings in the MIXTURE record would you make to get the name to appear as described?
Mixture suffix: "infusion"
Order Entry and After Ordering naming extension: 4083492101 - IP RXNAME DOSE WITH BASE,
STRENGTH, AND TOTAL VOLUME [Show Less]