pebc ethics

8/13/2019 PEBC Ethics

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Mm Code of Ethics

In May 1996, Council approved in principle a revised Code of Ethics based on a patient-centred care

approach to practice. The draft was circulated in the ul!"u# 1996 issue of $har%acy Connection for

feedbac& fro% %e%bers. Input fro% phar%acists and further discussions by the Ethics Co%%ittee were

incorporated into this' the final version of the Colle#e(s Code of Ethics.

PREAMBLE:

"ll phar%acists have the obli#ation to act in the best interest of the patient, observe the law, uphold the

di#nity ) honour of the profession, ) practice in accordance with ethical principles. The followin#

ethical principles of professional conduct are intended to #uide phar%acists in their relationships with

patients, other health care practitioners, ) the public.

Principle One: COVENANT

The phar%acist establishes ) %aintains a uni*ue relationship with each patient that is based on

an ethical covenant. The word +covenant+ %eans that phar%acists have %oral obli#ations inreturn for the trust #iven the% by society.

$har%acists encoura#e shared responsibility for adherence to %edication re#i%ens ) achievin#

desired dru# therapy outco%es.

This principle i%plies that the best phar%aceutical service, no %atter how provided, occurs

where the opportunity eists for direct patient contact between patient ) phar%acist.

Principle Two: CARING COMPA!!IONATE

The phar%acist actively pro%otes the well-bein# of every patient in a carin#, co%passionate

%anner. The patients well-bein# is at the centre of the phar%acist(s professional ) businesspractices.

This principle ensures that no patient shall be deprived of phar%aceutical services because of

the personal convictions or reli#ious beliefs of a phar%acist. here such circu%stances occur,

the phar%acist refers the patient to another phar%acist who can %eet the patient(s needs.

The phar%acist eercises his or her professional /ud#e%ent to ensure the patients( needs are %et

in situations where e%er#ency services or care %ay be re*uired.

Principle Three: CON"I#ENTIALIT$

The phar%acist preserves the confidentiality of infor%ation about individual patients ac*uiredin the course of his or her professional practice ) does not divul#e this infor%ation ecept

where authori0ed by the patient or re*uired by law. $har%acists protect their patients by servin#

the% in a private ) confidential %anner.

$har%acists do not divul#e infor%ation that identifies the patient' ecept in instances where there is

a co%pellin# need, in the phar%acist(s professional /ud#e%ent, to share infor%ation in order to

protect the patient or another person fro% har%, or where authori0ed by the patient or re*uired by

law.

Principle "o%r: A&TONOM$

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The phar%acist respects the autono%y, individuality ) di#nity of each patient. $har%acists

ac&nowled#e the ri#ht to self-deter%ination, ) reco#ni0e individual self-worth by encoura#in#

patients to participate in decisions about their health.

$har%acists respect personal ) cultural differences, ) do not discri%inate a#ainst any patient

for reasons of race, ancestry, place of ori#in, colour, ethnic ori#in, citi0enship, creed, se, seualorientation, a#e, %arital status, fa%ily status or handicap.

Principle "i'e: (ONE!T$

The phar%acist acts with honesty ) inte#rity. $har%acists never &nowin#ly condone the

dispensin#, pro%otin# or distributin# of dru#s or %edical devices which are not of #ood *uality.

$har%acists do not participate in any pro%otional %ethods or ca%pai#ns which encoura#e the

inappropriate use of %edicines or in any professional or business dealin#s which are not %ar&ed

by honesty and inte#rity.

Principle !i): COMPETENT

The phar%acist continuously i%proves his or her professional co%petence ) strives to enhance

the *uality of phar%aceutical service ) care provided by the profession. $har%acists ta&e

responsibility for assurance of their own co%petence, ) strive always to perfect ) enhance their

professional &nowled#e. $har%acists further develop the *uality of phar%aceutical service ) care

provided to the public throu#h association with or#ani0ations whose %andated include this #oal.

Principle !e'en: CO*OPERATIVE

The phar%acist collaborates with other health care professionals to achieve the best possible

outco%es for the patient. $har%acists understand the individual roles ) contributions of otherhealth care professionals ) consult or refer where appropriate. $har%acists also ac&nowled#e

that collea#ues ) other health care professionals %ay differ in the beliefs ) values they apply to

the care of the patient. $har%acists %ay not participate in any pro%otional %ethods or

ca%pai#ns which under%ine the eercise of professional /ud#e%ent by the phar%acist or any

other health care professional.

Principle Ei+ht: A#VI!ABLE

The phar%acist advocates for health pro%otion at the individual, co%%unity ) societal levels.

$har%acists have a pri%ary obli#ation to pro%ote the health of individuals. This obli#ation can

be etended beyond the individual to the co%%unity ) society as a whole. $har%acists en#a#ein dialo#ue with patients, provide public education t o co%%unity #roups ) see& opportunities

to advocate for health pro%otion to benefit society as a whole.

Principle Nine:

The phar%acist pro%otes the appropriate utili0ation of health care resources. $har%acists

pro%ote the use of cost-effective therapies and discoura#e the purchase or use of unnecessary

products or *uantities.

Principle Ten:

The phar%acist practices only under conditions which do not co%pro%ise professionalstandards ) enables other phar%acists to practice in accordance with hi#h professional

standards. $har%acists act in accordance with the hi#hest professional standards when carryin#

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out their duties ) do not accept e%ploy%ent where their ability to do so %ay be co%pro%ised.

$har%acists in control of a phar%acy practice as owner, %ana#er or in-char#e phar%acist,

ensure that there are no conditions which co%pro%ise another phar%acist(s ability to practice in

accordance with hi#h professional standards ) eercise solid professional /ud#%ent.

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E thic,l Principles

ithin this fra%ewor&, there are four i%portant ethical principles that per%it a consistent defense of a

position on specific issues "utono%y, non%aleficance, beneficence and /ustice. 2y applyin# these

principles fro% the perspective of either an idealist, or a conse*uentialist, a phar%acist can deter%ine

the patients ri#hts ) the phar%acist(s correspolldin# duties for a #iven dile%%a. The pri%ary ob/ectiveis to enable phar%acists to /uslify ethical conduct if that conduct is challen#ed.

A%tonom-: The principle of autono%y re*uires that persons %a&e their own evaluations ) choices

when their own interests are at sta&e. If individuals are viewed as a#ents with their own uni*ue

approach to life 3their values, interests, attitudes, etc.4, then it would be disrespectful of individuals to

re/ect their considered /ud#%ents or to deny the% the liberty to act on those /ud#%ents. "utono%ous

individuals are at liberty to perfor% whatever actions they wish, as lon# as another autono%ous

individuals actions are not infrin#ed, even if the actions appear to be foolish or unwise based upon

conventional ) #enerally accepted wisdo%.

5nder the principle of autono%y a person who is a co%petent decision %a&er is free to use a %edicinaldru# in a way that is 1ess than opti%ally safe ) effective, if he #enerally reco#ni0ed ri#ht way7 to use

the dru# interferes with the persons life-style.

Non*m,leficence:The principle of non-%aleficence 3doin# no har%4 re*uests that we refrain fro%

actin# in ways that will har% or in/ure others. 8tudents sittin# in a classroo% can continue indefinitely

to stare out the window ) daydrea% without violatin# the principle of non%aleficence because it is

throu#h acts of co%%ission that this principle is viotated. on-%aleficence prohibits both deliberate

har%ful action 3substitutin# one dru# product for another without authori0ation ) without evidence of

e*uivalence4 ) unintentional har% 3carelessly typin# ta&e one tablet : ti%es daily, on the label of a

di#oin ;4.

Beneficence:The principle of beneficence 3doin# #ood4 re*uires positive action to 14 prevent what is

bad, 8 has

violated the principle of /ustice.

$har%acists are the health care professionals %ost closely lin&ed to the dru# distribution syste%, so it is

i%portant for phar%acy students to understand that dru# distribution is inherently paternalistic. Even

that #reat cha%pion of liberty, ohn 8tuart Mill, reco#ni0ed the need to prohibit the use of dru#s by

people who, under the influence of dru#s, %i#ht har% other %e%bers of the society ) the need to

reduce undue pressure on potential buyers of dru#s who %i#ht un&nowin#ly act a#ainst their own best

interests.

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Ethic,l Terminolo+-

A%tonom-: "utono%y refers to one(s %oral ri#ht to %a&e choices ) decisions about one(s own course

of action. P,tern,lism:occurs when one fails to respect another(s autono%y, ) acts with disre#ard to

that individual(s ri#hts. 8ubstitute their own beliefs, opinions, ) /ud#e%ents for the patient(s /ud#e%ent,

clai% they acted in the person(s best interest.

Non*m,leficence:?>o no @ar%+. This principle, one of the oldest ethical principles, re%inds us that if

we cannot help patients, at the very least, we owe a duty not to har% the%. 32enefit vs. ris&4

Beneficence:8tands for the duty to prevent har% to others, re%ove har% fro% others ) to pro%ote

#ood. Ane(s obli#ation to this %oral duty ends where action can brin# har% to oneself. Aften one %ust

the duty to act with the har% actin# %ay cause to oneself, in which case the obli#ation to this %oral

ends.

.%stice:fairly distributin# burdens ) benefits in society, ) #ivin# individuals their due. Ane can

balance the needs of the individual with the needs of others in society co%petin# for the sa%e

resources, called co%parative /ustice.

Ver,cit-:@onesty. Ane(s obli#ation to spea& ) act truthfully affects all co%%unication with patients.

3e.#. if a cancer patient is told he is alri#ht, veracity is bro&en4

Confidenti,lit-:"ll health care providers have a duty, or obli#ation to li%it access to infor%ation

#athered in the course of treat%ent, ) to &eep the infor%ation strictly between the health care provider

) the patient.

Informed consent:obli#ates health care providers to present patients with details, benefits, ris&s, )

potential ris&s of all proposed intervention strate#ies 3so patients can %a&e willin#, infor%ed choices in

their care4."idelit-:%eans the %oral duty to &eep pro%ises ) co%%it%ents. 3Braber, 199' 2eaucha%p )

Childress, 199:4.

#%t-:obli#ation individuals have to others in society. 8o%eti%es those duties eist because of the

nature of the relationship between the parties.

Ri+hts:ability to ta&e advanta#e of a %oral entitle%ent to do so%ethin#, or not to do so%ethin#.

Competenc-:" phar%acist does his duties.

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Code of Ethics: In /rief

1. $har%acists hold health ) safety of each patient to be of 1ryconsideration.

o no har%. If we cant help patients, at the very least, we have an obli#ation not to

har% the%. ?;is& vs. benefit7.

Beneficence:>o #ood. The duty to prevent har% to others, re%ove har% fro% others, ) to pro%ote

#ood. If action can brin# har% to oneself, the obli#ation to this %oral duty ends.

B,l,nce:>uty to act vs. har% actin# %ay cause.

.%stice: fairness

Ver,cit-:act with honesty, without deception.

Confidenti,lit-

Compli,nce:

a. The act of co%plyin# with a wish, re*uest or de%and, ac*uiescence

b. Medicine F willin#ness to follow a ; course of treat%ent

c. " disposition or tendency to yield to the will of others

Adherence:

a. The process or condition of adherin#

b. Gaithful attach%ent ) devotion 3adherence to the rule of law4.

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Ethic,l Principles: E),mples

A%tonom-:we respect the ri#hts of others to %a&e choices ) bare the responsibility of conse*uences.

Ea%ples

If a phar%acist refuses to dispense AC$ to a #irl due to reli#ious concepts, then he bro&eautono%y.

If an end sta#e cancer patient, his fa%ily wants the physician to do a last therapeutic trial

without infor%in# the patient which principle prevents the physicianHautono%y

Beneficence:we do #ood to patients placin# the benefit of the patient over other factors such as cost.

Ea%ples

$t needs a refill ; of phenytoin on 8aturday evenin#, there is no refill authori0ation re%ainin#

) the patients >r is out of town. If the phar%acist refuses to refill the ; he is brea&in# which

principleH2eneficence

Ver,cit- 0"edilit-1: To be honest ) responsible. e act with honesty without deception.

Ea%ples

" cancer patient has only 1 %onth to live. If we do not tell hi% 3or tell hi% he is alri#ht4 you

bro&e the principle ofveracity

Ather Ea%ples

If a phar%acist refuses to councel an "I>8 patient he bro&e which principle ustice

" #irl too& AC$' her father wants to &now which dru# his dau#hter is ta&in#. If you tell hi%

you bro&e the principle ofConfidentiality.

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C,n,d, (e,lth Act O'er'iew

The Canada @ealth "ct received ;oyal "ssent on "pril 1, 19:. The "ct which ca%e into force in "pril1, 19:, repealed the @ospital Insurance ) >ia#nostic 8ervices "ct ) the Medical Care "ct. The purposeof the Canada @ealth "ct is to ?establish criteria ) conditions in respect of insured health services )etend health care services provided under provincial law that %ust be %et before a full cash contribution%ay be %ade. The criteria, provisions ) conditions relatin# to etra-billin# ) user char#es are set out insections throu#h 1< ) sections 1=, 1 ) 19 of the act. The criteria ) etra billin# ) user char#e

provisions apply to insured health services only, ) do not pertain to etended health care services3E@C84. Anly the conditions, as set out in section 1=, relate to both insured health services ) E@C8. Theinsured health services defined by the Canada @ealth "ct include all %edically necessary hospitalservices ) %edically re*uired physician services, as well as %edically or dentally re*uired sur#ical-dentalservices re*uirin# a hospital for their proper perfor%ance. Etended @ealth Care 8ervices 3E@C84

pay%ents are %ade in respect of nursin# ho%e inter%ediate care, adult residential care, ho%e care )a%bulatory health care. The services are part of a broad ran#e of health ) social services offered by avariety of co%%unity ) institutional pro#ra%s ) facilities to residents of a province. The %a/ority of

residents usin# these services are a#ed 6D ) over.The criteria ) conditions that each provincial health insurance plan %ust %eet in order to receive fullfedral cash contributions under the Canada @ealth ) 8ocial Transfer 3C@8T4 in each fisical year are

23 P%/lic Administr,tion:$ursuant to section , the health care insurance plan %ust be ad%inistered) operated on a non-profit basis by a public authority , responsible to the provincial #overn%ent )sub/ect to audit of its accounts ) financial transactions.

43 Comprehensi'eness:$ursuant to section 9, the plan %ust insure all insured health services providedby hospitals, %edical-practitioners or dentists ), where per%itted, services rendered by other healthcare practitioners.

53 &ni'ers,lit-:section 1 re*uires that 1 J of the insured persons of a province be entitled to theensured health services provided for by the plan on unifor% ter%s ) conditions.

63 Port,/ilit-:in accordance with section 11, residents %ovin# to another province %ust continue to becovered for insured health services forby the ho%e province durin# any %ini%u% waitin# periodi%posed by the new province of residence not to eceed = %onths. Gor insured persons, insured healthservices %ust be %ade available while they are te%porarily abscent fro% their own provinces on the

basis that insured services recieved out of a province, but still in Canada, are to be paid for by theho%e province at host province rates, unless another arran#%ent for the pay%ent of costs eists

between the provinces. $rior approval %ay be re*uired for elective services' out-of-the country servicesare to be paid as a %ini%u%, on the basis of the a%ount that would have been paid by by the ho%e

province for for si%ilar services rendered in the province. $rior approval %ay also be re*uired for

elective services.

73 Access,/ilit-:by virtue of section 1


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Ather The Canada @ealth "ct also prescribes a consultation process in the case of co%pliance *uestions.

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1. on%aleficence %eans do no har%


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b. Confidenciality

c. 2eneficience

d. "utono%y

Answer: A9. " patient on phenytoin ) his physician is abroad' if the phar%acist refused to #iven

hi% the dru# due to restriction of law, which of the followin# ethical principles %ay have been

%ost violated

a. on-%aleficience

b. 2eneficience

c. Confidentiality

d. Co%%on sense

Answer: B

1. Mr. ones is wor&in# 8aturday evenin# at his co%%unity phar%acy in a s%all villa#e.

@e is approached by a patient who needs a refill prescription for his phenytoin, ) no refill

authori0ation re%ains. The patient(s doctor is out of town. Mr. ones chooses to not refill the ;

since he feels that he %ay be at ris& of bein# disciplined by his licensin# body if he does not

follow the law. hich of the followin# ethical principles %ay have been %ost violated if he

does not provide any %edicationH

a. on%aleficence

b. "utono%y

c. 2eneficence

d. ustice

e. Keracity

Answer: C Competency: 2.1

11. " 16 year old #irl is #ettin# A.C. @er parent ca%e to the phar%acy as&in# you. hat are the

two contradictin# ethicsH

a. veracity - non-%aleficence

b. veracity - autono%y

c. veracity - confidentiality

d. non-%aleficence - beneficence

Answer: C

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Answer: A

1=. hich of the followin# ethical principles is beenin# %ost violated by the wron# fillin# of a ;

a. on%aleficence

b. "utono%y

c. 2eneficence

Answer: A

1:. " physician who has reco%%ended uro#raphy for her co%ptent 6 year old %ale patient is

tryin# to decide whether or not to disclose the re%ote ris& 31 in 1,4 of a fatal reaction. If

the physician favors non-disclosure, reasonin# that it would not be in the patients best interest

to worry hi% with such re%ote ris&s she is #uided by

a. beneficience but not non-%aleficence

b. /ustice

c. non-%aleficence but not beneficence

d. #ratitude

e. both beneficence and non-%aleficence

A E: E. !f the "octor#s concern is not to harm the patient with unnecessary worry, the

$ui"in$ principle is non-maleficence% if her concern is to be able to benefit the patient with

uro$raphy &which is impossible since the patient refuses to ris'( the $ui"in$ principles is

beneficence.

1=. If she believes that her decision should be deter%ined by what other physicians would do in

si%ilar circu%stances, she is #uided by

a. both beneficence ) non %aleficence

b. respect for autono%y

c. stron# paternalis%

d. professional practice std.

e. wea& paternalis%

A E: D. Depen"in$ on what the professional practice stan"ar" "ictates, the "ecision woul"

still be $ui"e" by professional practice if she "eci"es whether or not the patient woul" want

to learn about such ris's, she is $ui"e" by respect for autonomy.

1:. hen a phar%acist does not counsel a patient for warfarin 8!E, he violates

a. on %aleficence

b. 2eneficence

c. ustice

d. Keracity

Answer: A

1D. " phar%acist refuses to counsel a patient who ta&es half the prescribed dose althou#h headvised hi% several ti%es before, he is violatin#

a. 2eneficence

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b. ustice

c. "utono%y

Answer: A

16. " patient ca%e to you ) badly needs a repeat for Kentolin, has no repeat, if you dont

#ive you violate

a. on%aleficence

b. 2eneficence

c. ustice

d. Keracity

Answer: B

1. $hysicians %ay #o for the beneficence of their patients ) brea& a law e.#. a >r does not

tell his patient about his illness to %a&e hi% ta&e the %edication, he brea&s which lawa. "utono%y

b. Keracity

c. Confidentiality

Answer: A

1. " physician phoned a phar%acist to as& hi% not to tell the patient about the side effects

of a dru# because if he does, the patient will not ta&e it. 2oth the physician ) phar%acist see&

for which ethics

a. 2eneficence.

b. on%aleficence

c. "utono%y

d. Keracity

Answer: A

19. " physician as&ed a phar%acist to tell the patient that the dru# prescribed is a

%ultivita%in ) not a hypnotic so that he %i#ht not co%%it suicide. hat ethics is the

physician loo&in# forH

a. 2eneficience

b. on%aleficence.

c. "utono%y

Answer: B


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d. "utono%y

Answer: A


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a. $aternalis%

b. Keracity

c. on%aleficence

d. 2eneficenceAnswer: A


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=1. " patient on 2< a#onist, he has recurrent attac&s, if you donot refer hi% to the doctor you

violate

a. non%aleficence

b. /ustice

c. autono%y

d. paternalis%

e. beneficence

Answer: E

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b. beneficence

c. autono%y

d. veracity

Answer: A:. In the above case what should the phar%acist owner doH

a. @e should accept the %ista&e ) as& the patient(s doctor what to do

:1. hat ethics is bro&en if you insist on #ivin# a %edication to a cancer pt who refuses ta&in# it

a. non%aleficence

b. beneficence

c. autono%y

d. veracityAnswer: C

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:6. Canadian @ealth "ct bans etra billin#:. The phar%acy le#islation is controlled by

a. Canadian dru# law 1961

b. Canadian dru# law 1999

c. Canadian dru# law 19:

Answer: C

:. The standards ) le#islation of phar%acy practice are controlled by

a. Canadian Gederal "ct of 19:

b. $rovincial ) federal authorities

c. Metropolitan authorities

Answer: A. )he Canadian Gederal "ct of 19: controls le#islation and practice

:9. The Canadian parlia%ent approved a law to protect

a. The patient

b. The phar%acist

c. Answer: A.

D. The Canadian health act 319:4 e%bodies all of the followin# principles ecept

a. "ffordability

b. "ccessibility

c. Co%prehensiveness

d. $ortability

e. 5niversality

f. $ublic ad%inistration

Answer: A

D1. The %ost i%portant chan#es in phar%acy practice in the last


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a. increase in dispen%sin# fee

b. increase the nu%ber of new phar%acies

c. increase the avera#e si0e of phar%acies in Canada

d. Increased involve%ent of the #overn%ent ) other =

rd

party a#encies as payors i.e. healthinsurance ) dru# benefits

e. decreased dru# sa%plin# to physicians

Answer: D

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b. 8upervisin# the prices to be the sa%e

D.Answer: Bhat is the duty of the %inistry for desi#nin# dru# pricesH

D9. hat do provinces and territories have to do to #et their supplyH

a. Each province has its own re#ulations, %inister of health and dru# benefit plan

6. Apen for%ulary

a. Contains uses of the dru#

b. Co%prehensive

c. Ma&es restriction for non-for%ulary dru# ; even if they are under clinical supervision

Answer: B

61. The co-pay%ent pro#ra% is concerned with all of the followin# ELCE$T

a. help people who are not able to afford dru# prices

b. %a&e the patient pay a portion to decrease the cost of %edication

Answer: A

6isease cure

b. >isease prevention

c. $revent pro#ression of the sy%pto%s of disease

d. Identify >.>.I

e. >ecrease severity of the sy%pto%

Answer: A

6=. The Canadian health act 19: includes

a. o etra-billin# or user fees 3"ccessibility4

b. Medically re*uired services provided %ust be covered 3Co%prehensiveness4

c. 2enefits %ust be portable fro% province to another 3$ortability4

Answer: A, B C6:. Canadian health act includes

a. "ccessibility, co%prehensiveness, affordability

b. $ortability, universality, affordability, accessibility

c. 5niversality, public ad%inistration, accessibility

Answer: C

6D. The ai% of Canadian health care syste% is

a. Anly the Canadian citi0ens #et %edical services

b. "ll Canadian citi0ens ) i%%i#rants #et easy accessibility to %edical services

c. Kisitors to Canada are covered with %edical services

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Answer: B

66. Canada health care syste% is %ostly concerned about

a. "ll patients #et access to all services 3accessibility4

6. Canada health act pays for all ecept

a. Keterans

b. Aver %ountain

c. $olice

d. ative Canadians 3Indian affairs4

e. Inde#nity for people

Answer: C

6. 8o%ebody co%es with ">; to a new dru#. "s a phar%acist you should ta&e the %edication

history of the patient and report ">; to the reportin# unit in Attawa.

69. $E2C defines the rules and ta&es the ea%

. @ealth Care plan %a&es sure on

a. $rices of %edications in phar%acies are the sa%e

b. >ispensin# fees are the sa%e

Answer: A B

1. @ospitals wor& accordin# to federal rules to be ele#ible for

a. Ta freeb. $art of %oney

Answer:

8"C 3ational >ru# 8chedulin# "dvisory Co%%ittee4 is responsible for

a. >ru#s that are dispensed by prescription.

b. >ru#s that are not dispensed by ; but %ust be dispensed by a phar%acist

c. ATC dru#s

Answer: A, B C

=. $atent Medical $ricin# ;eview Co%%ittee reviews

a. cost of patent %edication

b. benefits of patent %edication

c. co%parin# prices of patent ) #eneric %edications

d. Controllin# pricin# of sales of %anufacturer

Answer: A

:. @ealth Canada %a&es sure that

a. all Canadians are covered

b. seniors #et %edications free

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Answer: A B

D. Canada health care syste% offers services to

a. "ll per%anent residents of Canada

6. hat re#ulates the phar%acy practice in Canada

a. Colla#e

b. AC$

c. $rovincial Institutes

d. "$;"

Answer: C

. " %edical rep brin#s you a new dru# to pro%ote. hat should you consider

a. it is approved by %edical health

b. it is approved by provincial health

c. it is peered by %edical %a#a0ines

Answer: A, B C

. The %ost i%portant chan#e in health care is based upon covera#e by

a. federal #overn%ent

b. private or#ani0ation

c. provincial #overn%ent

d. Indian affairs

Answer: C

9. hat is the duty of the %inistry in desi#nin# dru#s pricesH

a. $rotectin# clients

b. 8upervisin# the prices to be the sa%e

Answer: A B

. Canada health act #ives %ore . ) free %edicine to

a. Girst nationsb. financially poor

c. 6D yrs old

d. pets

Answer: A, B C

1. Gro% co-pay%ent increase results

a. $atient cannot afford to buy the dru#

b. >ecrease overall production

Amswer: B **


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=. "ccreditation co%%itteeH

:. $t %edication price review board who handles it Gedral #overn%ent 3not provincial,

%anufacturer nor whole saler4

D. hat does this %ean in fedral law ;CM$H

6. " ; fro% 58" is dispensed only in 58". ;e#ulation prohibits any ; fro% 58" to be

dispensed in Canada.

87.$rescription co%in# fro% 58" $atient should #o to e%er#ency clinic with his ; to

authenticate

88.; co%in# fro% 58">o not send ; to wal& in clinic alone. $atient %ust acco%pany his ;.

9. " very busy patient co%in# fro% 58" for a conference in Canada has @T ) he for#ot to brin#

his %edicine with hi%, what do you do as a phar%acist

a. Nou use your professional /ud#e%ent ) #ive hi% his %edicine /ust for his stay in

Canada

b. Nou are loo&in# for the best interest of the patient

c. Nou send hi% to a wal&-in clinic.

Answer: C

9. ; by e-%ail fro% 58" for a patient visitin# Canada for < days, what to doH

a. Must #et a new script si#ned by a Canadian doctor

91. $atient fro% 58" has ; fro% 58" ) can(t #o bac& to #et the %edication, what to do

a. Co si#n with Canadian doctor

b. >o not fill it

c. I%port dru#

d. 8ee Canadian >r.

Answer: D

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96. " patient has a ; fro% 58", he wants < tab. only for < days till he returns ho%e. hat will you

do

a. #ive < tab

b. #et new prescript fro% e%er#ency

c. Co-si#n

d. send e-%ail to doctor in 58"

Answer: C

9. " patient fro% 58", his plane was delayed for < days ) he ran out of his %edication

3Metfor%ine, enalapril, atorvastatin4. @e brou#ht the e%pty vials ) as&ed for < days supply,

the phar%acist a#reed to #ive hi% the < days supply' this is considered

a. le#al accordin# to health canada act

b. Ethical accordin# to pt. beneficencec. Ethical accordin# to professional /ud#%ent

Answer: B C

9. " patient wants to ta&e cou#h syrup 3lar#e a%ounts4 to 58", the phar%acist refuses to #ive

her because of all of the followin# ecept

a. it is not allowed to ta&e dru#s to 58" ecept for personal use

b. this dru# %ay cause addiction

c. it will be ta&en by 58" authority

d. no phar%acy-patient intervention about the dru#

Answer: A B

99. " phar%acy is #ettin# %edication fro% "sia, brand na%e, licensed to be sold in Canada only

%anufactured in "sia, all are ri#ht ecept

a. %anufacturin# conditions %ay not be approved in Canada

b. shippin# conditions %ay not be suitable

c. it is AO if this is done by @ealth Canada

Answer:

1. " 58" >r. sends an e-%ail to dispense a few days supply for a >M patient. hat should you

do

a. >ispense as it is an e%er#ency

b. Bet a new ; fro% a Canadian >r

Answer: B

11. " physician near your phar%acy as&ed you to chan#e sa%ples for other dru#s fro% your

phar%acy

a. you chan#e the sa%ples if they can be ta&en

b. you chan#e the sa%ples if the physician is your friend

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c. This is a#ainst the Canadian $har%acy Paw ) code of ethics

d. This is not ethical

Answer: C

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Answer: B

19. Interference factor that affect the inventoryH

a. not chec&in# the epiration dates re#ularly

b. let %edical reps. %a&e order to the phar%acy

c. you cover the need of your area only

Answer: A, B C

11. To prevent the internal dru# diversion 38tealin#4 in your phar%acy, what to do H

a. 5npredictable inventory chec& up 3unepected audit4

b. "s& references upon hirin#

c. >o not leave pre%ises ) watch e%ployees durin# lunch brea&

Answer: A B

111. Nou are a phar%acy owner, you increase the duties of a phar%acist by =J to DJ' youshould do all ecept

a. discuss the suitable way to Q the efficacy of these activities

b. #ive so%e of his duties to another person

c. cancel so%e activities that have shown no benefits to the phar%acy.

d. Increase his salary

e. review his perfor%ance lately

Answer: D

11ru# #eneric L, and the %anufacturer is tryin# to convince the phar%acist to have a stoc& of itwhich are the least i%portant thin# for the phar%acist to &nowH

a. what is the %ini%u% order ) bonus, what is the shelf capacity

b. the patient needs for this %edication

c. how fre*uent will it be written by the physician

d. effectiveness of dru#

e. the costAnswer: A

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11D. The phar%acy staff are co%plainin# about one phar%acist who has /ust co%e bac& fro%%aternity leave, also patient co%plains because of the fre*uent errors in ; fillin# and due todelay in their ; fillin# due to len#thy phone calls, what is the best response fro% the %ana#erespecially when he as&ed the phar%acist and &new that a proble% with the nanny of the babyis found and she is loo&in# for a better one

a. he %i#ht tell the phar%acy staff and patient that this is a te%porary situation and it willbe solve soon

b. he %i#ht tell the phar%acists that the eistin# behavior is unacceptable and so adiscipline %i#ht be applied if it is continued ) it is better to chan#e his behaviour.

c. hire %ore staff te%porarily to help the phar%acist, fre*uency of errors

d. arran#e a trusted co-wor&er to follow the phar%acist behavior to ensure that the futuredecision is the ri#ht one.

e. apply a discipline for her

Answer: B

116. If a phar%acy assistant had a co%%on cold' while dispensin# a dosa#e for% he snee0ed in it.hat is the role of the phar%acy %ana#erH

a. >ispense the dosa#e for%, then apply discipline with the assistant.

b. >iscard the dosa#e for% and then send the assistant ho%e for rest

c. >iscard the dosa#e for% and apply discipline to the assistant

d. Oeep hi% away fro% the dispensin# area and apply discipline to hi%

e. >iscard the dosa#e for%, &eep hi% away fro% the dispensin# area and review the

pri%ary aseptic techni*ues in dispensin# with hi%Answer: E

11. hat can reduce the phar%acy inco%e

a. Par#e epenses

b. The bills

Answer: A

11. "ll %ust be audited ecept %edications bou#ht fro% wholesalers

119. " %ana#er fi nds that a phar%acist is drun& and does not behave well enou#h , what to do

a. report to the colle#e 3 after warnin# hi% verbally several ti%es4

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Answer: B

1ru# benefit$lan

Answer: B

1ecrease his salary

Answer: C

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c. re%ove overlap

Answer: B C

1==. Gor control of phar%acy products you should do all of followin# ecept

a. control cli%ate of phar%acyb. re#ular cleanin# of counter

c. chec& on te%p of refri#erator

d. clean of the shelf ) #round

Answer: A

1=:. Nou are a phar%acy %ana#er and you found there is a re#ular error in ; dispensin# so you do

all of followin# ecept

a. #et a < dispensry staff 3etra4

b. %a&e a %eetin# for phar%acist staff

c. tell the% that a displine will occur if it repeated a#ain

d. an action by deductn fro% salary will occur

Answer: A D

1=D. $h. Mana#er wants to watch inventory

a. record date of purchases

b. record a%ount of sales

c. watch technician durin# lunch ti%e

Answer: A B

1=6. "n active phar%acist de%and an increase in salary you have fleibility in bud#et so %ana#ershould consider all ecept

a. other ph. that can do this /ob are available

b. bud#et

c. other ph. as&in# for raise

d. life allowance

e. consider his eperience

Answer: A

1=. " %edical representative is ne#otiatin# with a hospital ph. %ana#er for a dru# contract ) #avehi% tic&ets for a hoc&ey #a%e ) a #ift, what is the correct action

a. %ana#er accept it as hospital already a#reed to #et dru#

b. %ana#er accept tic&et ) refuse #ift as it is his personal life

c. %ana#er refuse both as its not ethical

d. %ana#er refuse tic&et ) accept #ift

e. %ana#er accept tic&et ) #ift

Answer: C

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1=. " phar%acy owner is #ettin# another %ana#er to do all ecept financial %atters, so he can do allecept

a. order %edication

b. chan#e shifts

c. contract of co%puters

d. narcotic si#ner

Answer: C

1=9. hat should an owner do to increase the profitability of his phar%acyH

a. R overlappin#

b. R ti%e for %iin# etre%poranous preparation

Answer: A

1:. "n owner should do certain thin#s by hi%self onlya. chan#e shifts

b. chan#e hours

c. personal awardin# or appra0in#

d. puttin# business #oals

e. order %edication

Answer: D

1:1. The hi#hest a%ount of epenses in phar%acy

a. payrolls

b. utilities

c. inventory

d. taes

Answer: A

1:


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a. "ccept the cash as lon# as it is unconditional

b. ;efuse to &eep the phar%acy inte#rity

c. "ccept the cash in your na%e rather than the hospital

Answer: A1:D. MT, a phar%acy technician, has wor&ed in a co%%unity phar%acy for D years. @e is well-

trained and welco%es new learnin# opportunities. @is %ana#er, now wantin# to dele#ate a

new technical pro/ect to hi%, should

I discuss su##ested steps to acco%plish the pro/ect.

II ne#otiate a ti%e schedule for co%pletion of the pro/ect.

III provide support and follow-up as re*uired.

a. I only d. II and III only

b. III only e. I, II and III

c. I and II only

Answer: E Competency: +.1

146. @ire a ew $har%acist o need to discuss with the collea#ues

1:. 8electin# dru# for a patient with cancer in a hospital settin# should involve all of the followin#

ecept refer to hospital for%ulary

1:. Gor%ulary is used for all of the followin# ecept insurance deductibles

1:9. hat are the for%ulary dru#s ) where can you find the%H

a. These are dru#s covered by the dru# benefit plan. They are found in the co%puter

syste% of a phar%acy or in the for%ulary dru# boo& 3A>2 boo&4.

1D. " hospital phar%acy %ana#er notices that there is a lot he should do as he noticed that there is

a lar#e nu%ber of %ista&es

a. Invite the phar%acists to a %eetin#

b. Chec& if phar%acists are over wor&ed

c. rite a letter to the phar%acists

Answer: A B **1D1. " technician is fre*uently sic&, what can the %ana#er do

a. "s& for doctor declaration

b. "s& for @; assess%ent

c. "s& for ; 3to chec&4

Answer: B **

152. 8tudents want to train in a phar%acy , the phar%acist %ust worry about what before

acceptin#Hefficiency

1D=. $har%acy technician which is wron#

a. can ta&e prescription fro% patient

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b. can #ive dru# to the patient

c. %ust as& patient about his health proble%

Answer: C

1D:. " technician starts to counsel the patient after dispensin# the ;

a. The phar%acist should politely ta&e his place in counselin# the patient, he reviews all

the sales process and tells the assistant not to counsel patients a#ain.

1DD. ;ole of technician to assist the phar%acist

a. Ta&e verbal ; fro% >r

b. councel the patient

c. ta&e ; fro% re#ular custo%er

Answer: C

1D6. hile the phar%acist is busy, a technician #ave Tylenol S 1 to one of his friends' thephar%acy %an#er saw hi%' what should the $har%acy %an#er do H

a. Interfere ) ta&e place and after the patient has #one you have to discuss and warn the

technician not to do it a#ain. 3tal& to hi% about ri#ht re#ulation4

b. #ive displenary action

Answer: A

1D. Technician can do all of the followin# ecept

a. $repare ad%iture of che%otherapy ) label it

b. Arder %edication

c. Ta&e ; fro% patient 3not a new one4

d. $repare pt files

e. Ta&e verbal ;efill ;.

Answer: E

1D. Technician can do all of the followin# ecept

a. prepare ;

b. Councellin# pt for a new ;

c. sell behind counter ) ATC

d. Ma&e filin# of ;

e. put data

Answer: B C

1D9. Technician can do under supervision

a. ; co%pletion

b. Enterin# datac. preparin# ;

d. Councellin# pt

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Answer: C

16. hich duties are ideal for a phar%acy tech.

a. prepare the label

161. @ospital phar%acy tech epansion duties include all ecept

a. tech can chec& the dru# profile and reco%%end a product

16on(t hu%iliate the technician in front of the custo%er

e. 8end her to additional trainin# courses

Answer: B

166. $har%acist saw technician #ive valiu% to his friend what to doH

a. tell phar%acy %ana#er

b. tal& to technician

c. call the police

Answer: A B

16. $t. ca%e to the phar%acy with ; for @C 1J in 2etader% crea%, she was in a hurry ) a lot of

pt. waitin# for their ; ) ph. is on phone with >r., technician do all of the followin# ecept

a. ta&e her phone no. ) arran#e a delivery for her %edication

b. >r. has to chec& conc. of %iture before %iin# it

c. dispense %edication ) #ive it to her ri#ht away as she is in a hurry

Answer: C16. Technician wor& insert co%puter data, writin# wor& 3des&4, ; prepn.

169. roles of technician include a. fi label b. prepare label c. order %edications.

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1. " pha%1acist #ive a patient Posec instead of Pasi, this is a#ainst which lawH

a. "#ainst interchan#ebility act.

11. In the above ea%ple what should the phar%acist owner doH

a. ta&e the wron# %edicine and #ive patient the ri#ht one and tell nothin# wron#b. "polo#i0e for the patient, call the doctor and return the ri#ht %ed. to patient

Answer: B

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b. Technician

Answer: A

1. " student of 5 of T is trainin# in a phar%acy, so he can do all of the followin# ecept

a. $repare ;

b. $atient counselin#

c. Gillin# on-line ;

Answer: B C. e can ta'e erbal / un"er pharmacist superision.

19. >octor %a&es a %ista&e, and phar%acist in hospital was not present and the technician

dispensed the ;, pt too& the dru#, when discovered, tell

a. nurse

b. fa%ily doctor

c. phar%acist

d. patient

e. hospital doctor

Answer: A) E

1. 8ound-li&e dru#s, for the %ana#er to decrease errors he should do all ecept

a. put the% away fro% each other

b. put label on vial 3call for error4

c. put in co%puter syste% alar% to wor& on dispensin#

d. %a&e < persons double chec& before dispensin#

e. technician as& pt. for disease bein# treated fro%

Answer: E

11. " ph. did a dispensin# error, what do you do as a phar%acy %ana#er

a. discuss with hi%

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> 1 1ru# " only

b. >ru# 2

c. >ru# C ) >d. >ru# 2 ) >

Answer: C D

1D. In decidin# what dru#s are appropriate for its for%ulary, the hospital %ust consider a dru#(s

efficacy, associated wor&load, and ac*uisition cost. 8everal new antifun#al IK dru#s 3dru# ",

dru# 2, dru# C, and dru# >4, all with e*ual efficacy, have recently beco%e available.

Currently the hospital stoc&s dru# E, which has been available for several years. >ata for the

%edications is as follows

>ru# Cost!day >osin# Gre*uency Treat%ent >uration 3days4

" 1:

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Answer: A C

19. hen orderin# di#oin brand what do you &eep in %indH

a. The brand used by the nearby hospital

b. %anufacturer reputation

c. product datin# 3stability, bio-availability4

Answer: A

19. " patient %aintained on arfarin for < wee&s in a hospital if he wants warfarin fro% yourphar%acy

a. Bive hi% the sa%e brand arfarin as the hospital used to #ive

b. #ive hi% the %ore bio-available brand

c. loo& for the %ore stable and Vshelf life

Answer: A191. Epiry date of phar%aceutical products

,3 &s%,ll- determined /- ,cceler,ted st,/ilit- st%dies3

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c. counsel the patient not to ta&e overdose

d. tell her it is a safe dru#

Answer: A C

196. " diabetic patient ca%e to you co%plainin# about his hyper#lyce%ia' you reali0ed theincreased dose, so%eti%es you reali0e that he is buyin# a rich chocolate, su#ar

a. should you advice hi% and eplain the ris&s.

b. Pet hi% decide what he wants

c. 2ut not 3do not4 obli#ate hi% and forbid hi%

Answer: A, B C

19. hich barriers are considered between phar%acist and custo%ersH

a. lan#ua#e s&ills

b. fear and aniety re#ardin# the confidencec. ineperience, lac& of confidence

d. difficulty in epressin#

e. inability to interpret verbal *uestions

f. inability to co%%unicate at the level of custo%er

#. li%ited ti%e and opportunity

Answer: A, B, C, D, E

19. " ventolin repeat ; ca%e to you. There is no refil, the ti%e is late, doctor is closed but you

reali0ed that patient is co%plainin# and he used Kentolin for : wee&s and no i%prove%ent

a. dont #ive hi% the ; ) advice hi% to #o bac& to his doctor to prescribe so%ethin# else.

b. If you #ive you bro&e non-%aleficience

Answer: A B

199. " continued education pro#ra% about hypertension will be arran#ed in your place the %ost

i%portant thin#s for the patient to &now ) to %a&e the% interested to co%e are all ecept

a. cost per participant

b. The history of each one of the lecturersAnswer: A


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b. "lways counsel with the phar%acist if you want to as& about anythin#.

Answer: A B


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r. wrote ; for his wife, what should you do

a. fill ; as it is

b. do not fill if its naccoticc. it is ille#al for hi% to write it

d. it is not ethical to write it

Answer: D. le#al only in e%er#ency


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b. refuse to #o to not to loose ; that he writes

c. #o ) testify to #et rid of this type of physicians

d. refusin# to #o is not ethical

Answer: Dr. wants to #ive his pt. a %edication for certain disease so what is the 1st

thin# to do

a. verify with dr. eactly the type of infor%ation he needs

b. select suitable database in co%puter to answer his *uestion

Answer: A B

r %isconduct case

a. @e should testify about the truth to prove his professionality in front of his co%%unity


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a. The prescriber(s >E" re#isteration nu%ber

b. $atients na%e

c. $atients aller#ies

d. $atient(s birth datee. Instructions for %edication use

Answer: A


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Gener,l R) R%les of Econom-

1. 2y law you have to #ive the patient the #eneric 3low cost4 not the brand dru# 3hi#h

cost4 unless specified.


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d. To follow the law

Answer: D

9. To i%prove the turnover liability by decreasin# the cost and increasin# the turnover

1. Cost of thin#s added afterwards is calledH

a. Incre%ental cost

b. "c*uisition cost

Answer: A

11. hich financial state%ent could be used to deter%ine the total value of prescription

dru# sales for a phar%acy for a period of a yearH

a. 2alance 8heet

b. 8tate%ent of invest%ents

c. 8tate%ent of chan#es in financial position

d. Inco%e state%ent

e. 8tate%ent of e*uity

Answer: D Competency: +.

1

pebc ethics

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