IPPE 1 Community Workbook Class of 2020

MIDWESTERN UNIVERSITY
CHICAGO COLLEGE OF PHARMACY
INTRODUCTORY
PHARMACY PRACTICE EXPERIENCE
(IPPE) 1: COMMUNITY
PPRAD 1530
19TH Edition
 2017 Midwestern University Chicago College of Pharmacy

Department of Experiential Education
All Rights Reserved
1
TABLE OF CONTENTS
CONTENT PAGE
Office of Experiential Education Contacts 3
Introduction 4
General Guidelines for Students and Preceptors 5
Guidelines for Successful Rotations 7
How to Set Up Your Rotation Binder and Experience Summary 8
Site Information Form (Due March 10, 2017) 9
Change in Preceptor/Site Notification Form 10
ACTIVITIES
Section 1 - Prescription Processing and Pharmacy Patient Care Services 13
Section 2 - Managed Care, Third Party Payer Programs (Insurance) and Legal Issues 27
Section 3 - Over the Counter Medications (OTC)/Self Care Medications and Patient Counseling and
34
Communication
Section 4 - Side Effects and Adverse Drug Reactions 50
Appendix A: Role Play Cases for Recommending an OTC Medication 57
ASSIGNMENTS
Assignments and Due Dates 59
Observation Check List (Due May 12, 2017) 60
Student Rotation Log (Due May 12, 2017) 62
Experience Summary (To be completed in RMS by May 12, 2017) 64
Evaluation Instructions 65
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MIDWESTERN UNIVERSITY CHICAGO COLLEGE OF PHARMACY
OFFICE OF EXPERIENTIAL EDUCATION
**For questions regarding the course please contact Dr. Susan Cornell
**For questions regarding the RMS online evaluations please contact Ms. Kathy Price
Carrie Sincak, PharmD, BCPS, FASHP 630/515-7658

Assistant Dean for Clinical Affairs E-mail: csinca@midwestern.edu
Professor of Pharmacy Practice
Amy Lullo, BPharm 630/515-6043

Director of Experiential Education E-mail: alullo@midwestern.edu
Assistant Professor of Pharmacy Practice
Susan Cornell, PharmD, CDE, FAPhA, FAADE 630/515-6191

Course Director for IPPE I E-mail: scorne@midwestern.edu
Associate Director of Experiential Education
Associate Professor of Pharmacy Practice
Kathy A. Price 630/515-7258

Data Coordinator E-mail: kprice@midwestern.edu
Cheryl DiVittorio 630/515-7677

Senior Administrative Assistant E-mail: cdivit@midwestern.edu
Mary Mees 630/515-6477

On Boarding Coordinator E-mail: mmees@midwestern.edu
Kim Gould, BPharm, MS 630/515-6397

Experiential Education Specialist E-mail: kgould@midwestern.edu
Adjunct Assistant Professor of Pharmacy Practice
Linda Haase, B.Pharm 630/515-6100

Experiential Education Specialist E-mail: lhaase@midwestern.edu
Adjunct Assistant Professor of Pharmacy Practice
Office Fax 630/515-6103
Office Email CCPOEE@midwestern.edu
Written and Edited by:

Kim Gould, BPharm, MS
Linda Haase, BPharm
Susan Cornell, PharmD, CDE, FAPhA, FAADE
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INTRODUCTION
PPRAD 1530 Introductory Pharmacy Practice Experience (IPPE) - 1: Community
General Course Description

IPPE-1 Community is a required course offered in the PS-1 year to introduce the student to the philosophy,
socialization, and practice of the profession of pharmacy through experiences in a community pharmacy practice
environment. This course will meet for a weekly 9-hour site visit for 10 weeks (total of 90 hours on site) at an
assigned community pharmacy. Guided exercises in the community pharmacy practice environment will introduce
the student to the basics of practice and serve as a foundation for advanced practice experiential rotations.
Experiential Education Sites

The student is guided and evaluated throughout the rotation by one or more pharmacists. A pharmacist preceptor
selected by the university will be responsible for coordinating the program at the pharmacy site and providing a final
evaluation for each student. It is intended that the preceptors serve as role models, as well as instructors, for the
students. The Office of Experiential Education (OEE) at CCP is responsible for the overall programmatic planning of
the experiential program and interacts regularly with preceptors.
Preceptor Selection
Much of the success of the learning experience is dependent on the selection of suitable preceptors. Minimal
preceptor criteria include:
1. Current pharmacist licensure in good standing;
2. A minimum six months of practice experience;
3. Adherence to a philosophy of education that is consistent with the educational mission of CCP;
4. Preceptor is respected by peers and provides a high quality pharmacy practice that is well received by
health professionals and patients;
5. Preceptor must possess professional competency: high standards of ethics, excellent character, and an
attitude appropriate to the presence of students;
6. Preceptor must possess the qualities of a teacher, particularly the ability to communicate with students;
7. Preceptor is receptive to new roles of pharmacists and the provision of patient centered care in the practice
setting; and
8. Preceptor is willing to meet (in person or via phone) with other preceptors and the Director of Experiential
Education for discussion and improvement of the course.
Preceptor Training
A preceptor orientation and training program supported by CCP is provided to all current and prospective
preceptors. All preceptors not having previous student precepting experience should complete the online training
program. OEE coordinates the training program. The intent of this program is to ensure a consistent philosophy
through professional learning experiences, as well as to augment the teaching and assessment skills required of a
preceptor.
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GENERAL GUIDELINES FOR STUDENTS AND PRECEPTORS
The student is responsible for the material covered in this manual.
1. Each student is required to complete a total of 10 nine-hour visits, which are scheduled one visit per week for
10 weeks, to an assigned community pharmacy in the PS-1 spring quarter. Students will have an on-campus
orientation prior to the first site visit. Students will have an on-campus meeting during week 10 of the spring
quarter after completion of site visits.
2. Students are expected to be at the site for 9 hours for each visit. A sign-in and sign-out log will be required of
students that are co-signed by a preceptor to verify hours for the College.
3. All rotation requirements are to be completed in approved experiential locations.
4. Dress Code for Rotations: Looking good is important! Mandatory professional dress includes wearing a
clean, white lab coat and a properly displayed MWU/CCP name badge. Appropriate dress for a man includes
dress slacks, shirt and tie, or sweater. For women, skirt or dress (professional length), dress slacks, and a
blouse or sweater. Business casual khakis are acceptable for men and women. Acceptable footwear:
appropriate closed-toed, closed-heeled shoes. Socks or hosiery must be worn. Some sites may have a
special identification badge or mandatory dress codes, which must be followed. Inappropriate dress includes:
blue jeans, spandex, shorts, tee-shirts, sweat pants, sweat shirts, halter or tank tops, midriffs, back-less tops,
short skirts or dresses and fatigues. Details on the appropriate dress code are at:
https://www.midwestern.edu/Documents/protected/student/Student%20Services/STUDENT%20HANDBOOK
%20-Policies.pdf. In addition, CCP requires students on rotation to remove any visible piercing (e.g.
tongue, nose) and to discreetly cover any visible tattoos. Pierced earrings are acceptable as long as
the site dress code is followed.
5. Transportation to the site is the student’s responsibility.
6. Parking arrangements are site-dependent. This information should be obtained from the primary preceptor
prior to the start of the rotation. Any cost for parking or transportation will be the student’s
responsibility.
7. All students are covered by professional liability insurance provided through MWU/CCP. Any other insurance
needs (i.e. health, accident, or car insurance) are the responsibility of the student.
8. No personal calls are permitted on site phones.
9. Personal cell phones must be turned off while at the site.
10. All patient data reviewed or discussed during the rotation must be kept confidential. Any breach of patient
confidentiality, however minor, will result in the failure of the rotation. There will be no exceptions.
11. All students are required to abide by all HIPAA regulations, as well as, any and all measures that the
pharmacy sites have implemented in an effort to be compliant with HIPAA.
12. Students will conduct themselves in a professional manner at all times. An unprofessional act, deemed as
such by the principal preceptor or authorities at the site, will result in failure of the rotation. There will be no
exceptions.
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13. Assignments are to be turned in on time. Late assignments and/or reports will result in the deduction of points
from that specific assignment as stated in the course syllabus.
14. The preceptor is responsible for reviewing and evaluating the workbook assignments. On the last day of
rotations, students are required to return all evaluation forms to the Office of Experiential Education
to process grades in a timely manner.
15. Students will not receive financial or other consideration from the preceptor or site for services associated
with the rotation. Academic credit is received from the College.
16. Site-specific rules and regulations may also be required of students. The principal preceptor at the site will
provide this information.
17. Students must have a valid Illinois student pharmacist technician license in the State of Illinois to be
allowed into the experiential program of the curriculum.
 A photocopy of the student’s current license (NOT ORIGINAL copy) must be kept in the student’s
rotation binder and must be on file with the Office of Experiential Education.
 Students MUST keep their ORIGINAL copy of their wallet size Illinois pharmacy tech license with
them at ALL times while at their pharmacy site visit.
 A student with a technician license on probation or suspension must immediately report this to the
Director of Experiential Education.
18. Immunizations: The University requires that students submit documented laboratory proof of the absence of
tuberculosis (TB) (updated yearly). If the student experiences a positive TB skin test, absence of disease via
chest x-ray is required, and must be updated every 2 years. Proof of immunization against Measles, Mumps,
German Measles, Varicella (chicken pox), Tdap (updated every 10 years), and Hepatitis B is required prior to
matriculation. All students MUST have quantitative titers drawn for Measles, German Measles, Mumps,
Hepatitis B and Varicella. The titers are drawn to verify that immunity still exists. There may be some
exceptions depending on the student’s particular health status.
19. Sick Days are not built into the site visit schedule. If absent due to personal illness or emergency, students
are required to contact their preceptor and OEE (at 630-515-7677 and Email:
CCPOEE@midwestern.edu) that same day as soon as possible, preferably prior to the rotation start,
regarding their absence. Any time missed must be made up and it is the student’s responsibility to work with
their preceptor regarding how their time absent from the site is to be made up. Dr. Cornell must be informed
and approve the date/time for the make-up hours.
20. Students are required to be at the site on the dates and times assigned by the Office of Experiential
Education. There will be NO exceptions unless initiated by the site preceptor or under extenuating
circumstances as determined by the Office of Experiential Education. Please note that given the type of
practice setting and time constraints of the preceptors, students missing a site visit may not be given an
opportunity to make it up.
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GUIDELINES FOR SUCCESSFUL ROTATIONS
1. Call your preceptor at least one week prior to the start of rotation to introduce yourself and to obtain
directions, proper dress code, start time, parking instructions and any other information the preceptor feels is
important for you to know.
2.  Be on time. Repeated tardiness will result in failure of the rotation.
3.  Present your workbook and rotation binder to your preceptor so he/she can review your assignments.
4.  Communicate to your preceptor what this rotation means to you and WHAT YOU HOPE TO ACHIEVE from
the rotation in your first week.
5.  Don’t get “behind the 8-ball.” Be prepared before you arrive each day. Make sure any assigned readings are
done.
6.  Budget your time to complete all required and assigned work. Remember you are there to learn; your
preceptor is your facilitator in the learning process. Be self-directed in completing your work.
7.  Read the evaluation forms and use this as a guide when preparing rotation materials. The preceptor will use
these evaluation forms to grade your work.
8. Parking fees are your responsibility.
9. Contact the Office of Experiential Education with rotation concerns. Phone the OEE office at 630-515-7677
or email to CCPOEE@midwestern.edu OR contact Dr. Cornell directly.
10. Taking some time to familiarize yourself with the syllabus and workbook will help ensure a great
learning experience for both you and your preceptors.
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TIP SHEET
How to Set Up Your Rotation Binder and Experience Summary
The reason you need one:
Other than it is “required”, your binder will aid in keeping you organized and on-track during your pharmacy practice
experiences. It serves as a tool to help you determine what you have accomplished so far, and what you need to
accomplish in order to successfully meet all the requirements of experiential education. Your preceptors will also be
able to get a “snapshot” of your skills and abilities as your progress through your rotations. The appearance of your
binder reflects on your ability to be organized, neat and complete.
What kind of binder? What goes in it?
o Purchase a 2 to 3 inch 3-ring binder, plastic page protectors (6-8 pages), page dividers with tabs (4-6)
o Place your name on the outside of the binder on both the cover AND the spine
o The first section of the rotation binder must have the following (in plastic page protectors, as you will be
using this for all of your rotations over the next several years):
 Resume or C.V.
 Copy of student pharmacist technician license (not the original license, as binders have been lost
by students)
 Copy of your HIPAA compliance training form (from LawRoom training)
 Copy of your up-to-date immunization record (will be given to you)
 Pledge of Professionalism (from August 20th OEE orientation)
 Universal Precautions certificate (from LawRoom training)
 OSHA Certificate (from LawRoom training)
o Insert divider tabs for each rotation:
 IPPE-1: Community
 IPPE-2: Hospital
 IPPE-3: Clinical
o Keep hard copies of all required assignments for rotations in addition to any work completed “above and
beyond” the minimum.
What does not go in it?
ANY PATIENT IDENTIFYING MATERIAL THAT WOULD CONSTITUTE A BREACH OF PATIENT

CONFIDENTIALITY ACCORDING TO THE HEALTH INSURANCE PORTABILITY AND ACCOUNTABILITY ACT
OF 1996 (HIPAA)
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DUE: Friday, March 10, 2017
Complete this form and turn in a photocopy of it to the OEE office on Friday, March 10, 2017.
The OEE office is located in Alumni Hall South, Room 350. Office hours are Monday-Friday 8am to 4:30pm.
Keep your copy of this form in your binder.
Introductory Pharmacy Practice Experience (IPPE-1): Community

PPRAD 1530- Site Information
Student Name:
Site / Store Name:
Site Address:
Preceptor’s Name:
Preceptor Contact Phone Number and Email:

( )
Store Manager’s Name:
Names of Pharmacists Other Than Your Preceptor:
Lead Technician’s Name:
Other Technicians’ Names:
Store Hours:
Store Phone Number and Contact Person To Call If You Are Late or Absent to Site:
If you are absent from your site call Midwestern University CCP Office of Experiential Education (OEE) at 630-515-
7677 and Email: CCPOEE@midwestern.edu to let us know why you are absent.
Is the preceptor and site on this form the preceptor/site you were originally assigned to? If not you will need to fill out an
APPE/IPPE Notification of Change in Preceptor or Site form. (On next page)
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IPPE Notification of a Change in Preceptor or Site
While we continue to encourage preceptors to notify OEE of any change in plans, sometimes the student is the first to learn of
a change. If anything has changed from your original site/preceptor assignment as listed in RMS, we ask that you use this
form to notify OEE. Doing so will allow a smooth transition for the preceptor and you, updates to be made in RMS, and OEE to
provide the new preceptor with all course materials. This form should be used for any changes prior to or during your rotation.
Please submit this form to OEE within 48 hours of any of the following changes:
(Below check the one that most closely matches your situation)
 My preceptor has left the site and I am unsure who will be my new preceptor. Complete Sections I & II below.
 My preceptor has left the site & I will be working with a preceptor who is not the preceptor that I am assigned to in
RMS. Complete Sections I, II, & III.
 I will be with the preceptor that I am assigned to in RMS, but will be at a site that is different from what is listed in
RMS. Complete Sections I, II and IV.
Section I: Student name: ____________________________________________________________

Today’s Date: ____________________________________________________________
Section II: My preceptor and site as assigned in RMS

Preceptor Name: __________________________________________________________
Site name: _______________________________________________________________
Section III: The new preceptor is: (I will remain at the site I was assigned to in RMS)
Date preceptor started at site: ________________________________________________
Preceptor’s Name: ________________________________________________________
Preceptor’s Title: _________________________________________________________
Preceptor’s email address: __________________________________________________
Has the pharmacist been a preceptor for Midwestern University CCP previously?
Yes No
If so when and where?
_______________________________________________________________________
Best way to communicate with preceptor? Email Phone
Section IV: I will stay with the preceptor that I was assigned to in RMS, but have moved to a new site with him/her.
Site Name: _____________________________________________________________
Site Address: ___________________________________________________________
______________________________________________________________________
Site Phone Number: _____________________________________________________
Site Fax Number: _______________________________________________________
Preceptor’s Email: ______________________________________________________
For IPPE rotations this form may be turned in to Alumni Hall South Room 350: Attention Dr. Cornell.
For questions about IPPE rotations: Email Dr. Cornell at scorne@midwestern.edu
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Activities To Be Completed With Your Preceptor
(or other designated pharmacists and/or technicians)
The following self-guided activities are to be completed on your own or with guidance from
your preceptor, designated pharmacist, or technician over the course of your rotation at
your community pharmacy site. Completion of workbook sections will be documented by
your preceptor on the Student Rotation Log (page 62).
Sections should be completed in order. A suggested timeline is provided below:
No later than week 3: Sections 1 and 2 should be completed
(Sections 1 and 2 will be turned in by Friday March 27,

2017 to be graded)
No later than week 7: Appendix A – role play should be completed
No later than week 8: Sections 3 and 4 should be completed
Workbook will be graded Monday, May 8, 2017
In addition to completing these activities, you are encouraged to participate in the

pharmacy workflow as well as other opportunities provided by your preceptor.
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Introductory Pharmacy Practice Experience – 1: Community
PPRAD 1530
Work Book Sections One and Two will be turned in by Friday March 27, 2017
Use this page as your cover sheet when turning in documents
Student Name ____________________________________________________________________
Mail Box Number__________________________________________________________________
OEE Date Stamp:
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Section 1: Prescription Processing and Pharmacy Patient Care Services
Processing a Prescription
Answer these questions on your own:

What is a legend drug?
What is a generic drug?
What is the NDC Number?
Explain the sections of the NDC number (xxxxx-xxxx-xx):
What is a DEA number?
How do you verify if the DEA number is legitimate?
What does DAW mean? Review the guidelines for Rx substitution in Illinois.
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Prescriptions for Controlled Substances
What is a controlled substance?
List the classes of controlled substances and give an example of one drug in each class:
Class of Controlled Substance Example of Drug in this Class
Schedule II (CII) prescriptions:
Who can write a CII prescription?
What prescriber and patient information is required on a CII prescription?
What is the maximum day supply a CII prescription can be written for?
What can or cannot be changed on a CII prescription?
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How can a prescriber write for a 90 day supply of a CII drug?
Schedule II (CII) Prescription Document Requirements
Required
CII Prescription Documentation Comments
Yes/No
Drug Name & Strength
Date written by the prescriber
Quantity prescribed
Directions for use
Signature of practitioner
Dosage form
How many times can a CII prescription be refilled?
By what methods can CII medications be transferred to the pharmacy according to Illinois law?
How can a CII drug be dispensed for an emergency? What are the regulations?
Can a CII prescription be faxed?

⎕Yes
⎕No
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From the time a CII prescription is issued, how long does the patient have to get the prescription filled before
Illinois law requires them to get a new prescription?
Answer the following questions with a pharmacist:

Write a brief summary of the CII drug ordering process.
Describe the process for inventory control of CII drugs.
What documentation occurs when a prescription is filled with a CII medication?
Drug Enforcement Agency (DEA) Forms: Please complete the following chart:
DEA Form DEA Form Number Comments

Theft or Loss of Controlled
Substance Inventory
Registrants Inventory of
Drugs Surrendered
DEA Order Form
Describe the procedure for destroying controlled substances.
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Answer the following questions with a technician:
Prescription Filling
Observe and discuss the process of filling a prescription, date and ask a technician to sign the following:
Date
Technician
Process Reviewed/ Comments/Documentation
Signature
Observed
Prescription received at counter

and/or drive thru window
(What questions are asked by the
technician/ pharmacist?)
Prescription that is e-prescribed
Prescription that is faxed to the

store
Review a patient profile on the

computer that shows the patient’s
allergies and demographics
What technology does the

pharmacy use to ensure quality of
Rx filling?
Does your pharmacy fill any

compounded prescriptions?
If so, give an example.
If not, how are these prescriptions
handled?
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Answer the following questions on your own:
In the pharmacy, where are the fast moving drugs kept?
In the table below, list 5 drugs found on the fast mover/shelf and write the generic name and common indication in
the chart below. Please use reliable drug information resources such as Lexi-comp or Micromedex which is
available on the MWU Library Resources page. The library also offers free mobile access to Micromedex drug
information and UpToDate which contains Lexi-Comp drug information.
Drug (Brand name) Generic name Common indication (use)
Are the drugs stored alphabetically by brand name, generic name, or both?
Answer the following questions with a pharmacist or technician:

Examine the information found on the prescription label. Review the Illinois Pharmacy Practice Act Section 22
(http://www.ilga.gov/LEGISLATION/ILCS/ilcs3.asp?ActID=1318&ChapterID=24) regarding what type of information
must be on a prescription label. List below what 7 items are required on a label by law.
1.
2.
3.
4.
5.
6.
7.
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What information on the label is not required by law?

Examine the printed information or handouts given to patients with each prescription.
What type of information is found on these handouts?
Communications written for the general public should be written at the 6 th grade level. Many authors use a SMOG
(Simplified Measure of Gobbledygook) calculator developed by Harry McLaughlin, PhD. Dr. McLaughlin designed
the calculator to determine what readability or grade level a sample of writing is appropriate for.
Go to the webpage: http://prevention.sph.sc.edu/tools/SMOG.pdf. Use the formula or online calculator to determine

the readability level of a medication handout that would be given to a patient.
What grade level was the handout written?
What did you like or dislike about the printed medication information?
How does the pharmacy accommodate patients who read/speak another language? (i.e., handouts, counseling,
prescription labels)
How does the pharmacy accommodate patients who are hearing impaired?
How does the pharmacy accommodate patients who are visually impaired?
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Does the pharmacy required an I.D. to pick up a prescription? If so, when?
Case: A 58 year old male patient comes into the pharmacy with a prescription for Xanax (alprazolam) 0.5 mg
TID. The patient states that he is a strict vegetarian with an allergy to red dyes and a lactose intolerance problem.
He would like the brand or generic Xanax medication that does not have any conflicts with his diet, allergies, or
lactose intolerance. Pull off and read the package insert from the stock bottle to check the inactive ingredients in the
medication. (If the store does not have the package insert then look on the drug company web site under
professional information to find the inactive ingredients. Be sure to review the package inserts of other medications
so you are familiar with them.)
Where do you find the inactive ingredients listed?
Does the pharmacy carry alprazolam that does not contain lactose?
Are red dyes a concern with the alprazolam 0.5 mg tablets stocked at your site?
Why would a gelatin capsule be of concern to a patient who is vegetarian?

Does your site utilize off-site verification of prescriptions? ⎕Yes ⎕No
If yes, what percentage of prescriptions are verified off site?
Does your site utilize off-site filling of prescriptions? ⎕Yes ⎕No

If yes, what percentage of prescriptions are filled off site?
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Medication Errors
Observe two different pharmacists completing a final check on a prescription. Describe his/her method of
completing a final check. What do they do differently?
Pharmacist 1:
Pharmacist 2:
Discuss with the pharmacist the process for incident and/or error reporting and describe below.
Review and/or observe how to fill out a prescription incident report online (using a reporting program such as
the Strategic Tracking and Analytical Reporting System or STARS®). Describe the process.
Who has access to the reports?
What is the purpose of the reporting system?
Discuss with the pharmacist the methods/technology used for quality control and error prevention. Describe
below.
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Common Medication Errors
Complete the following table of medications that commonly have errors and what steps are used to prevent errors. List 3 other medications that have high potential
for error.
Medication Possible Error Steps to Prevent Error
Insulin
Warfarin
Digoxin
Potassium
Acetaminophen
Albuterol
Levothyroxine
Metoprolol
Other:
Other:
Other:
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Ethical Dilemmas
Case for Discussion with the pharmacist:
During a busy day in the pharmacy a student pharmacist on his/her community rotation accidently printed two
prescription labels. Rushed, the student placed the extra label in their lab coat pocket to shred later when it was
less busy. The student left for the day forgetting to shred the label and when they got home realized she/he
forgot their lab coat on the train. Was this a HIPAA violation?
⎕Yes ⎕No
What is the reason for your answer?
Discuss with the pharmacist what methods are used to comply with HIPAA regulations. Describe below.
Ask the pharmacist to describe an ethically challenging situation that occurred and how it was handled.
How would you have handled the same situation?
When does the pharmacist or store manager contact the authorities (police department) when handling a forged
prescription?
Discuss with the pharmacist how they handle forged prescriptions. How does the pharmacist confront the
patient?
Document the company procedure for handling forged prescriptions.
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On Your Own: Complete this Chart of Commonly Used Prescription Medications
Drug Brand Name Indication Pharmacologic Category
Albuterol
Allopurinol
Atorvastatin
Diclofenac
Furosemide
Gabapentin
Latanoprost
Lisinopril
Metoprolol
Montelukast
Nitroglycerin
Olmesartan
Oxybutynin
Oxycodone
Pioglitazone
Prednisone
Pregabalin
Rivaroxaban
Sildenafil
Sitagliptin
Thyroid
Tiotropium
Tolterodine
Tramadol
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Immunizations and Patient Care Services
Complete the following questions and chart on your own:
What are the Illinois regulations for pharmacist administration of vaccines?
According to Illinois law, what is the minimum age for a patient to obtain an immunization from a pharmacist?
Use the template below to make a chart of what vaccines are live versus inactive that the pharmacy carries.
Indicate on the chart the brand name of the vaccines, where they are stored, and which ones may have allergy
precautions. Name the allergen if a precaution is present. Note the minimum age of the patient to whom the vaccine
can be administered and the route of administration.
Route of
Live or Storage Minimum age
Vaccine/Brand Name Allergy Precautions administration
Inactive location of patient
(e.g. IM or SQ)
Influenza
Pneumonia 13
Pneumonia 23
Herpes Zoster
Complete the following questions with a pharmacist:
Discuss with a pharmacist the immunization services at your site. What training and/or certification is required for
pharmacists to give immunizations?
Review the anaphylactic reaction kit with a pharmacist. What is in the kit?
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What is your site’s protocol (procedure) to handle an anaphylactic reaction to a vaccine?
What is the site’s protocol for a “needle stick”?
Discuss with the pharmacist what patient care services are offered at the site and fill in the appropriate boxes.
Observed/
Service Observed N/A Comments
Discussed
MTM- what program is used
to facilitate MTM at your site
(i.e. Mirixa® or Outcomes®)?
Diabetes
Hypertension
Dyslipidemia
Smoking Cessation
Osteoporosis
Asthma
Other
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Section 2: Managed Care, Third Party Payer Programs (Insurance) and Legal Issues
Managed Care Programs
Answer the following questions with a technician (or on your own if you currently work in a community
setting):
Discuss common problems encountered with insurance processing. Discuss what a third party reject (TPR) is
and what can cause this rejection.
Observe a pharmacy member resolve a TPR; describe the process.
List the reasons that an insurance company may require “prior authorization” for a prescription.
List 3 common examples of medications that most frequently require a prior authorization.
What is the process for obtaining a “prior authorization”?
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Medicare
Check the appropriate box to indicate what part of the Medicare program, Part B or Part D the following medical
items are billed.
Item Medicare Part B Medicare Part D
Insulin
Syringes
Pen Needles
Blood Glucose Meters
Lancets
Test Strips
Nebulizer Solutions
Medicare requires additional documentation on certain prescriptions for coverage. Complete the following chart.
Prescription Information required to be written on a prescription to be covered by Medicare
Glucose Testing
Inhalation Medications
Cancer Drugs

Medicaid (Managed Care)
How does the pharmacist determine which managed care program a Medicaid patient is enrolled in if they do
not have their insurance with them?
Legal Issues
On your own:
Pseudoephedrine (PSE)
What is the Illinois Methamphetamine Precursor Control Act (MPCA)? What drugs are covered in this Act?
28
Pseudoephedrine Legal Requirements
Packages per transaction
Grams allowed to be purchased per day/month by state law
Grams allowed to be purchased per day/month by federal law
Age required for purchase
ID type required
What documentation is required at time of purchase?
Where are MPCA (Pseudoephedrine) logs kept?
How long do logs need to be kept?
Who is allowed to sell PSE containing products?
Insulin- Which insulin products/supplies can be purchased without a prescription?
Product Yes/No If yes, what quantity is allowed by law to be dispensed
Regular Insulin U-100

(Humulin R, Novolin R)
Regular Insulin U-500
(Humulin R U-500)
NPH Insulin U-100
(Humulin N, Novolin N)
Insulin Aspart, Glulisine, Lispro
(NovoLog, Apidra, Humalog)
Insulin Detemir, Glargine, Degludec
(Levemir, Lantus, Toujeo, Tresiba)
Syringes with Needles
Pen Needles
29
iPledge
Review the iPledge program online (www.ipledgeprogram.com). What is the purpose of the program?
List the details of the iPledge program.
Answer the following question with a pharmacist:

Discuss and document the steps taken to fill a prescription for isotretinoin at your site.
Fill out the following the chart and answer the question on your own:
Emergency Contraception (EC) Products
Effective how many

Minimum Age Prescription
EC Product Active Ingredients days after
of Patient Required?
intercourse?
Generic
Ella®
Plan B One Step®
Next Choice®
Where are the EC products located in the store?
30
Prescription Monitoring Program:
Review the Prescription Monitoring Program online at the Illinois Department of Human Services website:
https://www.ilpmp.org. Does your pharmacy site use this website?
What steps must the pharmacist take in order to be eligible to use this site?
What types of information can be found at this site?
Ask and discuss with the pharmacist how often they use the Prescription Monitoring Program site and if it is
helpful to them.
Pharmacist Dispensing of Opioid Antagonists

Over the last 15 years the United States rate of deaths involving overdoses of opioids including prescription pain
relievers and heroin has quadrupled. CDC statistics report that the State of Illinois experienced 1,705 overdose
deaths in 2014. In September 2015, the State of Illinois passed a new law increasing access to the opioid
antagonist naloxone. Naloxone may be used to reverse overdoses caused by prescription pain relieving opioids and
heroin. As a result of the law, trained pharmacists can follow a standardized procedure to dispense naloxone.
Read the webpage http://www.idfpr.com/Forms/DPR/NaxoloneStdProcOpioidAntInit.pdf to learn about the

requirements for pharmacists to dispense naloxone for opioid overdose reversal (naloxone is misspelled on the
state website).
Pharmacists are required to have 2 training certifications in order to dispense naloxone. List the required
certifications.
What types of information can be found at this site?
31
Once a pharmacist has completed the training requirements and wishes to participate in the Illinois Naloxone
Antagonist Overdose Prevention Program, they can contact ILPMP at: www.ILPMP.org to request a copy of the
Standardized Procedures for Naloxone Opioid Overdose. The standardized procedures used to implement the
program must be filed at the pharmacy before the start of the program.
Once the program is established, who may the pharmacist legally dispense naloxone to? List 4.
List the 7 steps a pharmacist must follow when dispensing the naloxone kit (Hint: see the Naloxone
Standardized Procedures as found in the webpage listed above):
Complete the following chart regarding naloxone kits:

Naloxone Kits When is this dosage form
Contents of Kit
(List Different Dosage Forms) contraindicated?
1.
2.
3.
Where does the pharmacist

report each naloxone kit
dispensed?
How often does the pharmacist
have to report when a naloxone
kit is dispensed?
32
Resources available:
Federal Agencies:
Opioid Treatment Program Directory SAMHSA http://dpt2.samhsa.gov/treatment/
Hotline and Internet Assistance www.drugabuse.gov 1-301-443-1124
Seeking Drug Abuse Treatment: Know What to Ask (2011). NIDA Publ. #12-7764 Five questions to ask when
searching for a treatment program. Drugabuse.gov/publications/seeking-drug-abuse-treatment.
For Veterans- www.mentalhealth.va.gov/substanceabuse.asp
Illinois Agencies:
Illinois Department of Human Services HIS 1-800-843-6154 www.dhs.state.il.us/
Check for county agencies in your local area.
33
Section 3: Over the Counter (OTC)/Self Care Medications and Patient Counseling and Communications
Over the Counter (OTC)/Self Care Medications
Complete the following charts on your own:
There are many OTCs that are used to treat the same indication but have different ingredients. In the chart below list the active ingredients that are used to treat
the indication listed and note the pharmacologic category/categories.
Indication Active Ingredient(s) Pharmacologic Category/Categories

Cough/Cough-Cold
Robitussin Night Time Cough DM®
Robitussin Cough & Chest Congestion DM®
Robitussin Multi Symptom Cough & Cold & Flu®
Robitussin Long Acting Cough®
Acne
Neutrogena On The Spot Acne Treatment®
Neutrogena Rapid Clear Spot Gel®
34
Indication Active Ingredient Pharmacologic Category/Categories
Acid Reducer
Prilosec®
Pepcid Complete® Tablets
Pepcid AC® Tablets
Mylanta Maximum Strength® Liquid
Maalox Regular Strength® Tablets
Allergies
Zyrtec® Dissolve Tabs
Flonase® Nasal Spray
Nasal Crom® Spray
Chlor Trimeton® Tablets
Pain
Motrin IB® Tablets
Motrin PM® Caplets
35
Aleve® Capsules
Tylenol®
Advil®
Constipation
Citrucel®
Milk of Magnesia®
Colace®
Peri-Colace®
Dulcolax®
Diarrhea
Imodium AD®
Pepto Bismol®
Culturelle ®
36
Allergic Conjunctivitis
Naphcon A®
Murine Sore Eyes®
Zaditor®
Some OTC products have active ingredients that have more than one use or indication. List below the different indications the active ingredient may have in different
products.
OTC Active Ingredient Indications
1.
Zinc Oxide
2.
1.
Diphenhydramine
2.
1.
Acetaminophen
2.
1.
Calcium Carbonate
2.
1.
Phenylephrine
2.
1.
Miconazole
2.
1.
Benzocaine
2.
37
Common Counseling Points
Complete the following chart about OTC medications and common counseling points that you will need to know in order to recommend and counsel patients about the
product.
May cause
OTC Take with or drowsiness
Symptom Time to take Dosing and administration instructions
Medication without food
Avoid alcohol
⎕AM ⎕Lunch ⎕With food ⎕Yes ⎕No
Bisacodyl tablet ⎕Dinner ⎕HS ⎕Without food
⎕N/A ⎕N/A ⎕Yes ⎕No
Psyllium ⎕Dinner ⎕HS ⎕Without food
Constipation
Powder ⎕Yes ⎕No
⎕N/A ⎕N/A
Docusate
⎕Dinner ⎕HS ⎕Without food
Capsule ⎕Yes ⎕No
⎕N/A ⎕N/A
Bismuth ⎕AM ⎕Lunch ⎕With food ⎕Yes ⎕No
Subsalicylate ⎕Dinner ⎕HS ⎕Without food
liquid ⎕N/A ⎕N/A ⎕Yes ⎕No
Diarrhea
Loperamide
tablets ⎕Yes ⎕No
⎕N/A ⎕N/A
Tolfnaftate
Anti-fungal ⎕N/A ⎕N/A ⎕N/A
Powder
Esomeprazole
capsules ⎕Yes ⎕No
⎕N/A ⎕N/A
Calcium ⎕AM ⎕Lunch ⎕With food ⎕Yes ⎕No
Acid Reducer Carbonate ⎕Dinner ⎕HS ⎕Without food
tablets ⎕N/A ⎕N/A ⎕Yes ⎕No
Omeprazole ⎕Dinner ⎕HS ⎕Without food
capsules ⎕N/A ⎕N/A ⎕Yes ⎕No
38
May cause
OTC Take with or
Symptom Time to take drowsiness Dosing and administration instructions
Avoid alcohol
⎕AM ⎕Lunch ⎕With food
⎕Yes ⎕No
Ibuprofen ⎕Dinner ⎕HS ⎕Without food
Headache/ ⎕AM ⎕Lunch ⎕With food
⎕Yes ⎕No
Pain ⎕Dinner ⎕HS ⎕Without food
Aspirin tablets
⎕Yes ⎕No
Acetaminophen ⎕Dinner ⎕HS ⎕Without food
⎕Yes ⎕No
Guaifenesin ⎕Dinner ⎕HS ⎕Without food
Expectorant
liquid ⎕N/A ⎕N/A ⎕Yes ⎕No
⎕Yes ⎕No
Orlistat ⎕Dinner ⎕HS ⎕Without food
Diet Aid
capsules ⎕N/A ⎕N/A ⎕Yes ⎕No
⎕Yes ⎕No
Motion Meclizine ⎕Dinner ⎕HS ⎕Without food
Sickness tablets ⎕N/A ⎕N/A ⎕Yes ⎕No
⎕Yes ⎕No
Cetirizine ⎕Dinner ⎕HS ⎕Without food
Allergy/
Rhinitis ⎕AM ⎕Lunch ⎕With food
⎕Yes ⎕No
Fluticasone ⎕Dinner ⎕HS ⎕Without food
Spray ⎕N/A ⎕N/A ⎕Yes ⎕No
39
May cause
OTC Take with or drowsiness
Symptom Time to take Dosing and administration instructions
Avoid alcohol
Phenylephrine ⎕Dinner ⎕HS ⎕Without food
Spray ⎕N/A ⎕N/A ⎕Yes ⎕No
Congestion
Pseudo- ⎕AM ⎕Lunch ⎕With food ⎕Yes ⎕No
ephedrine ⎕Dinner ⎕HS ⎕Without food
Methyl
Muscle Pain Salicylate & N/A N/A N/A
Menthol topical
⎕Yes ⎕No
Diphen- ⎕Dinner ⎕HS ⎕Without food
Sleep
hydramine ⎕N/A ⎕N/A ⎕Yes ⎕No
Acne Benzoyl
N/A N/A N/A
Peroxide topical
40
Vitamin and Mineral Products
Visit the OTC section at your site, compare and contrast the vitamins, dietary supplements and natural products. Complete the following tables.
Vitamin Common Indication Cautions/common side effects
Vitamin A
Vitamin B12
Vitamin C
Vitamin D
Vitamin E
Calcium
Iron
Niacin
Folic Acid
41
Natural Products
Product Common Indication Counseling Point Cautions/common side effects
St. John’s Wort
Valerian Root
Echinacea
Glucosamine
Ginseng
Ginkgo
Saw Palmetto
Black Cohosh
Cranberry
Melatonin
Probiotic
Turmeric
Cinnamon
Omega 3
(Fish Oil)
42
Enteral Nutrition
Review the OTC Enteral Nutrition products stocked on the shelves at your site. Match the products listed
below to appropriate category of use. There may be more than one product in a category.
Vivonex plus T.E.N. Boost Glucerna
Ensure Plus Pediasure Boost Glucose Control
Boost Kid Essentials Novasource Renal Thicken Up
Compleat Pediatric
Category Product(s)
Diabetes
Renal Dysfunction
Lactose Free
Gluten Free
Pediatric
Soy Free
Thickener for swallowing difficulties
Meal Replacement
OTC Calculations
For the following two cases find the corresponding product in the OTC isle. If your site does not have the product
stated in the case use the package labels from Blackboard.
Case 1: A customer calls and states that her child has 103 degree fever. Her prescriber told her to give her 2 ½ y/o
child Ibuprofen. She wants to know how much to give her child. The child weighs 22lbs (the recommended dosing
range is 5-10 mg/kg/dose).
How many kg does the child weigh?
Calculate the dose from the recommended dosing range stated above.
43
What product have you chosen from the shelf or Blackboard?
What dose is recommended on the package?
How does the package recommendation compare to your calculated dose using the recommended dosing
range?
Case 2: A 38 y/o patient comes to your counter and states that they are having an allergic reaction to an insect sting.
Their prescriber told them to take 50 mg of Benadryl ASAP. The patient does not swallow pills or capsules. He said his
weight at his last doctor’s visit 2 months ago was 75 kg.
How many pounds does the patient weigh?
What product would you recommend for this patient?
Calculate the dose you would recommend for this patient to take.
With a Pharmacist:
The Consumer Health Products Association reported, “Today more than 700 OTC drugs use ingredients
and dosages that were only available by prescription less than 30 years ago”.
List 5 products recently switched from prescription to OTC.
44
How does the switch from prescription to OTC affect the cost of medications to patients?
How does the switch from prescription medications to OTC impact questions for the pharmacist?
Complete this section on your own:

Making an OTC recommendation:
Which of the following questions should a pharmacist ask before making an OTC recommendation?
What symptoms does the patient have? Yes No
Details about the symptoms? (e.g., type of cough? pain location?) Yes No
How long has the patient had the problem? Yes No
What treatments has the patient tried? Yes No
What makes it better? Yes No
What makes it worse? Yes No
What insurance does the patient have? Yes No
Who is the OTC product for? Yes No
What medical conditions does the patient have? Yes No
What OTC/Herbal/Vitamin medications is the patient taking? Yes No
What prescription medications is the patient taking? Yes No
What allergies does the patient have? Yes No
Complete this question and the following cases with a pharmacist:
Discuss with the pharmacist what questions you should ask a patient when they request an OTC.
45
Review and compare OTC products, read the packages carefully to respond to the following case
scenarios:
Case 1: Children’s Fever medicine

A young father comes to the prescription counter and asks you to recommend a medication to reduce the fever in his
young children who are at home with their mother. The children are aged 23 months (20 lbs) and 4 years old (45 lbs).
The four year old dislikes grape medicine.
List the questions you would ask before giving advice.
What product(s) would you recommend and why?
What feedback did you pharmacist have about this case and what would your preceptor do differently?
Case 2: Pregnant Woman

A soon to be mom has a headache and would like you to advise her about what pain medication she can
take. She is about 29 weeks pregnant.
List the questions you would ask before making a recommendation.
What product(s) would you recommend and why?
46
Case 3: OTC Medications for Stress
A 55-year-old patient is picking up his thyroid medication; he tells you that pressure from work is getting to
him lately. You notice he is buying St. John’s Wort and Valerian Root capsules.
List the questions you would ask the patient before giving advice.
What advice would you given him and why?
At your site, what reference does the pharmacist use for herbal medications?
List the comments your preceptor had for suggestions about the above cases.
Case 4: OTC Medications and Diabetes

Phyllis from the cosmetic department has a cold; her symptoms are runny nose, sneezing, and a cough.
You recently filled prescriptions for her blood pressure and diabetes medications. Phyllis asks you to
recommend an OTC cold medication for her symptoms.
List the questions you would ask Phyllis before giving her advice.
What would you recommend and why?
What non-pharmacotherapy recommendations would the pharmacist suggest for cough/cold for children
under 6 years old?
47
Patient Counseling and Communication
Complete the following questions your own:

Dealing with Patients
Observe and check one of the following situations:
⎕A patient thanked the pharmacist or technician for help with a problem.
⎕A situation where the patient was upset and how it was resolved.
⎕A situation where the pharmacist or technician had difficulty communicating with a patient and how it
was resolved. Describe why the communication was difficult.
⎕A situation where the customer did not have enough money to pay for the prescription.
Reflect on the situation that occurred and what was your reaction?
Counseling a patient about a Prescription
Who can counsel a patient?
What are the “3 Prime Questions” used to counsel patient on new medications?
48
What are the “3 Prime Questions” used to counsel patients on refill medications?
According to Omnibus Budget Reconciliation Act of 1990 (OBRA 90) what specific information should the
pharmacist review with the patient or caregiver when he/she accepts the offer to counsel?
(https://www.cms.gov/Medicare-Medicaid-Coordination/Fraud-Prevention/Medicaid-Integrity-
Education/Downloads/drugdiversion-patientcounseling-booklet.pdf )
Where does the pharmacist counsel the patients at your site? (Describe the physical layout of the
counseling area)
What is discussed in a typical counseling session?
49
Counseling to Assess Potential Adherence Problems Checklist
Discuss the following concepts with the pharmacist:

Date Pharmacist
Concept Comments
Reviewed Initials
How does the pharmacist assess
medication adherence?
What medication reminder devices
are patients advised to use?
How does the pharmacist assist
patients with reminder devices?
Section 4: Side Effects and Adverse Drug Reactions

Side Effects
Explain the difference between a side effect and an adverse drug reaction.
Select 5 different prescriptions that were filled during your site visit. Provide the name of the drug and 3 of
the most common side effects of that drug and note the reference in the box. Please use reliable drug
information resources such as Lexi-comp or Micromedex which is available on the MWU Library Resources
page. The library also offers free mobile access to Micromedex drug information and UpToDate which
contains Lexi-Comp drug information.
Drug Name 3 Most Common Side Effects for Each Drug Reference Used
50
Advice Regarding Medication Side Effects
Complete the following cases on your own:
Case 1:
A 24-year old male patient phones the pharmacy complaining of an upset stomach after taking the
azithromycin prescription he picked up this morning.
What question(s) would you ask the patient?
What advice would you give him to prevent the side effect from happening again?
Case 2:
Mrs. Crabbits, your favorite senior citizen, called you because she can’t sleep at night, as she frequently
gets up to use the bathroom. You notice on her profile that she is taking a diuretic once daily.
What question(s) would you ask Mrs. Crabbits?
What advice would you give Mrs. Crabbits to help her sleep at night?
Answer this question with a Pharmacist:

List the comments your preceptor had for your suggestions about the 2 cases.
51
Answer the following questions and complete the charts on your own:
MedWatch Program:
What is the purpose of the MedWatch program?
Who manages and monitors the MedWatch program?
Who can report to MedWatch?
List 5 issues that can be reported to MedWatch.
What are the benefits of the MedWatch program?
52
Common Drug Interactions:
Potential for drug-drug interactions:
Complete the chart below. In the center columns check to see if there is a drug interaction between the drugs listed in the left column and each of the drugs listed in
the center columns. Note if there is an interaction and comment on what the interaction is when one exists. Indicate what reference you used to find the interactions
in the right column. Please use reliable drug information resources such as Lexi-comp or Micromedex which is available on the MWU Library Resources page. The
library also offers free mobile access to Micromedex drug information and UpToDate which contains Lexi-Comp drug information.
Is there a drug interaction with this medication and the one listed in the far left column?
Drug name Reference used
If yes, what is the interaction?
Sulfamethoxazole/Trimethoprim Amiodarone Cimetidine
⎕Yes ⎕Yes ⎕Yes
⎕No ⎕No ⎕No
Warfarin
If yes: If yes: If yes:
Lovastatin Diltiazem Acetaminophen

⎕No ⎕No ⎕No
Fluconazole
Bismuth Subsalicylate Lopinavir/Ritonavir Amoxicillin

⎕No ⎕No ⎕No
Clarithromycin
Escitalopram Phenytoin St. John’s Wort

Oral Contraceptives ⎕No ⎕No ⎕No
(i.e., ethinyl estradiol, If yes: If yes: If yes:
norethindrone)
53
Potential for drug-disease interactions:
In the center column comment on the possible interaction of the drug and disease listed in the left columns. Indicate the reference used in the right column, as noted
above use reliable references.
Common disease
Drug name Describe possible interaction References
interaction
Ibuprofen Hypertension
Prednisone Diabetes
Potential for drug-food interactions:

In the center column comment on the possible interaction of the drug and food listed in the left columns. Using reliable references and indicate the reference used in
the right column.
Common food
Drug name Describe possible interaction Reference
interaction
Simvastatin Grapefruit Juice
Warfarin Spinach
Metronidazole Alcohol
54
Complete with a Pharmacist:
Drug Related Problems
Ask your preceptor or other pharmacists to share any drug related problems that occurred at your site each week.
Drug related problems could include concerns with the medication’s effectiveness, appropriateness, or safety.
The events may occur on days of the week you are not at the site, but your preceptor or another pharmacist that was
working can print and save the event that occurred to discuss it with you.
 You MUST complete 3 event forms by the end of this rotation.
 You can complete more than one event form during one site visit.
Event 1
Check the type of drug related problem: ⎕ Cost
⎕ Unnecessary Drug Therapy/Duplicate Therapy ⎕ Allergy
⎕ Needs Additional Therapy ⎕ Adverse Effect
⎕ Ineffective Drug Therapy ⎕ Lab Monitoring Needed
⎕ Dosing Concerns (Dose too low or too high) ⎕Drug Interactions (Drug-Drug, Drug-Disease, Drug-Food)
⎕Other __________________________________________
Describe:
55
Event 2
⎕Other __________________________________________
Describe:
Event 3
⎕Other __________________________________________
Describe:
56
Appendix A: Recommending an OTC Medication Role Play
Role Play with a Pharmacist:
After completing Section 4, (Over the Counter Medications (OTCs)/Self Care and Communication with
Patients/Counseling) of this workbook, role play the following OTC recommendation cases with a pharmacist.
Have the pharmacist be the patient in the following cases. He or she will use the Role Play Checklist on the next
page to evaluate your ability to make good OTC recommendations based on the information you gathered from the
patient or caregiver. Your preceptor will have details of the case and a copy of the role play checklist given to them at
the start your rotation.
Case 1: Constipation/Diarrhea
Student Information: Mr. Rogers hobbled up to the counter on crutches asking you to help him choose a product for
“his problem”.
Case 2: Cough, Cold, and Allergies
Student Information: Between sneezes and blowing his nose, Jesse Student asks you to recommend something that
will help him so he can study for his therapeutics test.
Case 3: Pain Fever
Student Information: Susie Q came into the pharmacy today asking for help choosing ibuprofen.
**Similar cases will be used in the Clinical Skills and Simulation Center as part of your final exam**
57
OTC Recommendations “Role Play” Checklist
Information Gathering
1. The student introduced himself/herself Yes No N/A
2. The student asked who the OTC product was for Yes No N/A
3. The student asked the age of the patient when appropriate Yes No N/A
4. The student asked the weight of the patient when appropriate Yes No N/A
5. The student asked what symptoms the patient is having (including questions that
Yes No N/A
lead to detailed answers)
6. The student asked how long the patient has had the symptoms/problem Yes No N/A
7. The student asked what treatments the patient has tried Yes No N/A
8. The student asked if the patient had any medical conditions Yes No N/A
9. The student asked if the patient is taking any prescription medication Yes No N/A
10. The student asked if the patient is taking any OTC medications Yes No N/A
11. The student asked what allergies the patient has Yes No N/A
Recommendation
12. The student made an appropriate product recommendation Yes No N/A
13. The student’s product recommendation included dose, frequency and appropriate Yes No N/A
directions on how to use the product.
14. The student appropriately counseled the patient on potential side effects from the Yes No N/A
recommended product
15. The student did not use medical jargon but spoke in laymen’s language Yes No N/A
16. The student asked one question at a time (not compounded questions- e.g. what Yes No N/A
other prescription and OTC medications are you on?)
17. The student exhibited confidence in their behavior. Yes No N/A
18. The student had an acceptable tone of voice and rate of speech (e.g. not too soft Yes No N/A
spoken, not too fast or too loud, not accusatory or condescending)
19. The student used an appropriate closure to the interview Yes No N/A
Student Name:
Product Recommended:
Comments:
Pharmacist’s Signature ___________________________________________ Date_________________________
58
Assignments and Due Dates:
Due on Friday, May 12, 2017
1. Observations Form (Pages 60-61) signed by preceptor or other pharmacist
2. Time log (Page 62) signed by preceptor or other pharmacist
Paper Copy of Observations Form & Time Log To Be Hand Delivered to OEE
3. Experience Summary via RMS
59
Observations
Students are required to turn in a completed paper copy of the Observations sheet to
The Office of Experiential Education.
This is worth points towards your assignments grade.
Due date: Friday, May 12, 2017 (2 pages)
Over the course of the 10 nine-hour site visits, each student is to observe and /or review with your preceptor or a pharmacy
technician each of the following procedures listed below. These do not need to be completed in any particular order. After
the observation is complete, the preceptor must sign and date the item on this sheet.
STUDENT NAME _______________________________________________________________________________________
Date Reviewed/ Preceptor Not available

Procedures Observed For Prescription Processing
Observed signature at site
Taking in a prescription at the in-window
Data entry of patient information
Data entry of physician information
Data entry of a new prescription
Data entry of a refill prescription
Prepare Rx for dispensing (count, label)
Final verification of a prescription
Handling prescription errors
Procedures Observed Date Reviewed/ Preceptor Not available

For Handling of Adverse Drug Events Observed signature at site
Drug allergies
Drug-drug or drug-disease interactions
Adverse drug reaction

For Third Party Prescription Processing Observed signature at site
Data entry of patient and insurance information
Insurance formularies
Prior/special approval
Medicare Part D
60
Procedures Observed For Patient Counseling
Counseling of a new prescription
Counseling of a refill prescription
Counseling for OTC selection or recommendation

Procedures Observed For Pharmacy Law Compliance
Generic substitution/state formulary
Transfer of prescriptions
HIPAA compliance

Procedures Observed For Inventory Control
Ordering drugs from the wholesaler
Putting the drug order away
Stock rotations/out of date drugs
Drug recalls

For Handling of Controlled Substances Observed signature at site
Storage of controlled drug (CD)
Record keeping process for administration of CD
Sale of products containing pseudoephedrine
Procedures Observed For Patient Education Services: Date Reviewed/ Preceptor Not available
List/describe service below (e.g. immunizations, MTM) Observed signature at site

Procedures Observed For Prescription Compounding
Calculation of ingredients
Preparation of compound
61
Paper Copy to be handed in to the Office of Experiential Education no later than Friday, May 12, 2017*.
*There will be a 10% point deduction for each day late.
Midwestern University Chicago College of Pharmacy

Office of Experiential Education
Student Rotation Log Class of 2020 IPPE I
Student Name: _________________________________________________________________

Site: __________________________________________________________________________
Preceptor: _____________________________________________________________________
Time Time Preceptor Workbook

Week What I learned today:
In Out Initials Sections Completed*
Sections 1 and 2
3 completed
Mid-Rotation Progress
5 Note Due
7 Appendix A completed
8 Sections 3 & 4 completed
10
*Certain sections to be completed by weeks 3, 7, and 8

62
Experience Summary
Instructions for your Experience Summary
Pharm D Class of 2020
As part of continuous quality improvement (CQI) of experiential education and assessment of professional rotation
competencies, students will be required to keep a reflective summary of their experiences; an electronic component
of your actual experiential education.
The experiential pharmacy practice program provides PharmD candidates the opportunity to integrate and apply the
knowledge, skills, attitudes and values learned throughout the curriculum. Professional competencies and life-long
learning are necessary in the practice of pharmacy.
To better assess your individual competency, a reflective analysis of your rotation experiences can be a useful guide
in identifying your strengths and weaknesses. This will not only be helpful for you throughout ALL of your rotations
(introductory and advanced), but can provide added direction for your self-study development, board examination
preparation as well as for your professional career.
A description of topics to be included in your experience summary can be found on the next page and on Blackboard.
Students will submit their summary at the end of each quarter while on IPPE and APPE rotations.
Experience summaries must be completed on RMS by the assigned due dates in order to receive full credit.
Experience summaries received after the due date will result in 10% point loss per day. Please refer to the dues
dates below:
IPPE rotations:
Rotation Type and Experience Summary

Academic Quarter Submission Due Dates
Spring 2017: Community Rotation Friday May 12, 2017
63
Experience Summary – Complete online -RMS
Class of 2020
Name: _______________________________________________________________________
Community Rotation:
Site: ___________________________________________Start Date: ____________________
Preceptor: ____________________________________________________________________
Description of experience:
My expectations prior to my first site visit were:
My best experience on my IPPE community rotation was:
Area(s) I did well:
Area(s) that could be improved:
Strategies for improvement:
Reflective topics:
1. Describe what professionalism means to you and reflect on how your perception of professionalism has changed
(if applicable) after completion of your IPPE community rotation.
2. List 3 ways a community pharmacist provides quality healthcare for their patients.
Additional reflections of the community rotation:
64
Evaluation Instructions
Completed Online via the Rotation Management System (RMS)
How to Complete Evaluations

PRECEPTORS:
We ask that the student midterm and final evaluations are completed online via RMS.
Please complete the evaluation no later than:
Thursday April 6, 2017 -- Midterm evaluation

Friday, May 12, 2017 -- Final evaluation
RMS instructions and paper copies of the evaluation forms will be provided to preceptors with the IPPE-1
community rotation packet mailing.
We ask for you to become familiar with the goals, objectives, and evaluation process.
STUDENTS:
Please complete the following evaluations no later than:
Friday, May 12, 2017
Items to be completed online via RMS:

 Self-evaluation
 Rotation site/preceptor evaluation
 Preceptor professionalism
STUDENTS - Please note:

Student evaluations received after the deadline date and time will result in a deduction in points as
outlined in the PPRAD 1530 syllabus.
65

IPPE 1 Community Workbook Class of 2020

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IPPE 1 Community Workbook Class of 2020

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MIDWESTERN UNIVERSITY

CHICAGO COLLEGE OF PHARMACY

 2017 Midwestern University Chicago College of Pharmacy

Office of Experiential Education Contacts 3

General Guidelines for Students and Preceptors 5

Guidelines for Successful Rotations 7

How to Set Up Your Rotation Binder and Experience Summary 8

Site Information Form (Due March 10, 2017) 9

Change in Preceptor/Site Notification Form 10

Section 1 - Prescription Processing and Pharmacy Patient Care Services 13

Appendix A: Role Play Cases for Recommending an OTC Medication 57

Assignments and Due Dates 59

Observation Check List (Due May 12, 2017) 60

Student Rotation Log (Due May 12, 2017) 62

Experience Summary (To be completed in RMS by May 12, 2017) 64

Carrie Sincak, PharmD, BCPS, FASHP 630/515-7658

Amy Lullo, BPharm 630/515-6043

Susan Cornell, PharmD, CDE, FAPhA, FAADE 630/515-6191

Kathy A. Price 630/515-7258

Cheryl DiVittorio 630/515-7677

Mary Mees 630/515-6477

Kim Gould, BPharm, MS 630/515-6397

Linda Haase, B.Pharm 630/515-6100

Office Fax 630/515-6103

Office Email CCPOEE@midwestern.edu

Written and Edited by:

General Course Description

Experiential Education Sites

The student is responsible for the material covered in this manual.

3. All rotation requirements are to be completed in approved experiential locations.

5. Transportation to the site is the student’s responsibility.

8. No personal calls are permitted on site phones.

9. Personal cell phones must be turned off while at the site.

2.  Be on time. Repeated tardiness will result in failure of the rotation.

8. Parking fees are your responsibility.

The reason you need one:

What kind of binder? What goes in it?

What does not go in it?

ANY PATIENT IDENTIFYING MATERIAL THAT WOULD CONSTITUTE A BREACH OF PATIENT

Introductory Pharmacy Practice Experience (IPPE-1): Community

Site / Store Name:

Preceptor Contact Phone Number and Email:

Store Manager’s Name:

Names of Pharmacists Other Than Your Preceptor:

Lead Technician’s Name:

Other Technicians’ Names:

Section I: Student name: ____________________________________________________________

Section II: My preceptor and site as assigned in RMS

Best way to communicate with preceptor? Email Phone

Sections should be completed in order. A suggested timeline is provided below:

No later than week 3: Sections 1 and 2 should be completed

(Sections 1 and 2 will be turned in by Friday March 27,

No later than week 7: Appendix A – role play should be completed

No later than week 8: Sections 3 and 4 should be completed

Workbook will be graded Monday, May 8, 2017

In addition to completing these activities, you are encouraged to participate in the

Use this page as your cover sheet when turning in documents

Student Name ____________________________________________________________________

Mail Box Number__________________________________________________________________

OEE Date Stamp:

Answer these questions on your own:

What is a generic drug?

What is the NDC Number?

Explain the sections of the NDC number (xxxxx-xxxx-xx):