How many parts are there to the Axiron bottle and what are they called?
Three: What are the 1) Cap 2) Applicator Cup and 3) Bottle
100
What does AOC stand for?
What is Acknowledgement of Content
Each shipment of Axiron samples will include an Acknowledgement of Content form specifying the following:
• Ship Date
• Product Lot #
• Product Quantity Shipped
100
Secondary exposure to testosterone and virilization.
What is the Boxed Warning for Axiron.
100
Above normal calcium levels.
What is hypercalcemia.
200
The part of the office where we should NOT leave the Savings Card.
What is the waiting room.
200
The number of times you prime the pump and how often.
What is three times and only on the first application.
200
In the event a CSS cannot electronically sample, this is the procedure
If a CSS is not able to sample the physician through the SIMS/ESIG electronic system they are to contact TLAC and have the form sent directly to the doctor’s office. The office can then fill the form out and fax it back themselves.
200
The safety and efficacy of Axiron in males _______ years of age have not been established.
What is <18.
200
Benign enlargement of breast tissue in males.
What is Gynocomastia.
300
The person who activates the Savings card?
Who is the patient.
300
The amount of time you must wait: a) For Axiron to dry and b) before you can get the site wet-like swimming, showing, etc.
What are 3 minutes and 2 hours.
300
On the electronic sample form, this is the number of fields the CSS must ensure are filled in before submitting sample request. Give the number of fields and the names of each.
What is 2. Signature and Sample Quantity (2 or 4)
300
Flammability, edema, worsening of BPH, use in women, sleep apnea and changes in lipids are all examples of which section of the PI?
What are Warnings and Precautions
300
Term for increased hematocrit.
What is polycythemia.
400
Explain, as you would to a staff, how the Axiron Savings Card works.
Combines a 30 day free trial for the first fill plus the next 11 fills for no more than $25/fill-capped at $75. The card is good for 12 total fills. For commercial insurance only.
400
One pump actuation contains _____mg of testosterone in _______mL of solution.
What is 30mg in 1.5mL
400
Once an office receives an Axiron sample shipment, what action is required on their part?
What is An HCP or a responsible designee (Office Manager) must sign and date the Acknowledgement of Contents (AOC) form then FAX to Knipper.
400
Being a Controlled Substance means a product could cause: _______ & __________
What is abuse and dependence.
400
Diminished functional activity of the testes which may result in diminished levels of testosterone.
What is hypogonadism.
500
If the patient’s co-pay is $125, this is the total they would have to pay out of pocket.
What is $50. The patient pays the first $25, Lilly pays the next $75; then the patient would pick up the next $25 for a total of $50.
500
The number of pump actuations in one bottle of Axiron.
What is 60. So 60x 1.5mL = 90mL The bottle holds 110mL-some to spare.
500
What are the three validations that must be completed prior to shipping Axiron samples?
What is
1. State License # and DEA validation by Knipper
2. Sample Request Form validation by Knipper
3. Order Validation-prior to shipping from the Lilly Distribution Center
500
Axiron is a controlled substance: Schedule ______as defined by The ____________ ________ Control Act.
What is C-III Anabolic Steroid.
500
Secondary androgen exposure in children-pubic hair growth, accelerated growth and bone maturation, increased muscle strength and acne may refer to this condition.