Rhode Island Multistate Pharmacy Jurisprudence (MPJE) Practice Exam

Under what condition can a pharmacist perform a therapeutic substitution?

1. If the patient requests it

2. If in a facility with a formulary approved by the pharmacy and therapeutics committee

3. If there is stock of the medication

4. If the drug is not on the formulary

The correct answer is: If in a facility with a formulary approved by the pharmacy and therapeutics committee

A pharmacist can perform a therapeutic substitution under the condition that it occurs in a facility with a formulary approved by the pharmacy and therapeutics committee. This formulary establishes guidelines for the substitution of medications to ensure that patients receive effective treatments that are therapeutically equivalent to the prescribed medications but may be more cost-effective or preferred for other reasons. The role of the pharmacy and therapeutics committee is crucial as it evaluates and makes decisions about which medications are included in the formulary, ensuring that substitution aligns with clinical guidelines and standards of care. This process is intended to maintain patient safety and optimize therapeutic outcomes while allowing flexibility in medication management. While patient requests and medication availability are important considerations, they do not establish the necessary framework for therapeutic substitution as outlined by pharmacy regulations and best practices. Additionally, if a drug is not on the formulary, the pharmacist would typically not have the authority to initiate a therapeutic substitution, as such actions need to conform to the protocols set out by the formulary.