Question

1. A patient dies, and his relatives indicate that they have several asthma inhalers that have neither been opened nor used. You know of a patient who could use those inhalers. Which of the following is the BEST approach?
A. Ask the patient's relative to return the inhalers to the pharmacy. Then, relabel them for the other patient and provide them without charge.
B. Ask the patient's relative to return the inhalers to the pharmacy. Then, relabel them for the other patient and provide them with a small re-dispensing charge.
C. Tell the patients relative to simply throw them in the garbage because under federal law, read dispensing a previously dispensed medication is prohibited.
D. Tell the patient that you cannot accept and read dispense the medication, but that there are a number of national and global programs that accept donations.

2. A survey conducted in your community finds that most people continue to flush unwanted over the counter and prescription medications down the toilet. One of the most commonly cited reasons for doing so is that small quantities of drugs couldn't possibly pollute large bodies of water. What have researchers found?
A. Researchers have found that for the most part, flushing medication down the toilet is not a problem; the popular sentiment that large bodies of water dilute the medication is correct.
B. Researchers have found trace amounts of many medications in large bodies of water, and those medications frequently affect aquatic animals significantly differently than they affect humans.
C. Current sewage treatment plants and wastewater treatment plants are perfectly capable of filtering out medication residue, so this should not be a concern.
D. Since the FDA recommends flushing certain medications down the toilet, it's best to recommend flushing all medications down the toilet so patients don't get confused.

3. Which of the following describes a disposal method that involves chemical decomposition of carbon-based materials using heat, and is linked to one of its limitations?
A. Autoclave; it is environmentally unfriendly
B. Landfill; it is very costly
C. Pyrolysis; it is very costly
D. Recycling; it is environmentally unfriendly

4. Which step can manufacturers can take to decrease medication waste?
A. Examine supply and demand of their products and plan production accordingly
B. Shorten expiration dates for their products and encourage smaller prescriptions
C. Make sure that all stock returned to the company is sent to a quality landfill
D. Discontinue the practice of taking back expired stock so pharmacies will order less

5. Which of the following is TRUE about take-back medication collection programs?
A. These programs sort medications so in-date and unopened meds can be reused.
B. These programs use expiration date extension programs to save money.
C. These programs work with patients and ask why they have unused medication.
D. These programs usually send the medication they collect to an incinerator.

6. Which of these patients is MOST LIKELY to have leftover medication that will be wasted?
A. A 31-year-old female who fills a prescription for one month of oral contraceptives
B. A 73-year-old man with a prescription for 30 PRN opioid doses from a dentist
C. A 50-year-old woman who has been on a statin for 12 years and ask for a 90-day refill
D. A 5-year-old child whose parents refill her 90-suply of carbamazepine for the 10th time

7. Which of the following is a governmental organization that works to decrease medication waste?
A. Charitable Pharmacies
B. goodpiil.org
C. SLEP
D. World Medical Relief

8. A customer reports that one of your patients passed away. He had an unopen blisterpack of an expensive cancer drug, a partial bottle of oxycodone, a few doses of tetracycline, and some liquid magic mouthwash left in the medicine cabinet. Which of these would a donation program be most likely to accept?
A. Blisterpacked, expensive cancer drug
B. A partial bottle of oxycodone
C. A few doses of tetracycline
D. The liquid magic mouthwash

9. What should inventory management training include to reduce waste?
A. The impact of waste on aquatic life
B. The history of penicillin shortages
C. The principles of supply and demand
D. The science of medication extraction

10. Select a step that pharmacy staff can take to reduce waste and increase the likelihood that medication can be recycled or reused.
A. Tell patients they must never refuse a prescription
B. Encourage patients to use the autorefill system
C. Prompt them to fill PRN meds even if they don't need them
D. Educate patients thoroughly about proper storage

Answer 1

1. D — You cannot accept and re-dispense previously dispensed meds; refer relatives to donation programs that accept unopened/unopened-in-package meds.

2. B — Researchers have detected trace amounts of many drugs in waterways, and aquatic species can be affected differently than humans.

3. C — Pyrolysis: chemical decomposition of carbon-based materials using heat; a limitation is high cost.

4. A — Manufacturers can reduce waste by matching production to supply and demand.

5. D — Take-back programs typically send collected meds for incineration (they generally do not sort for reuse).

6. B — A 73-year-old with 30 PRN opioid doses from a dentist is most likely to have leftover (unused) medication.

7. C — SLEP (Shelf-Life Extension Program) is a governmental program that helps reduce medication waste.

8. A — A sealed blister-packed expensive cancer drug (if unopened and unexpired) is most likely to be accepted by donation programs; controlled/partial bottles and open liquids usually are not.

9. C — Inventory training should cover the principles of supply and demand.

10. D — Thorough patient education about proper storage helps reduce waste and increases the chance meds remain reusable.