24. TL:DR - Controlled Substances: Prescriptions

Question 1

Every written prescription in this state shall contain 2 signature lines. What do they indicate?

Answer 1

1. brand name
2. product selection permitted

Question 2

state-specific controlled substance restrictions?

Answer 2

yes; AL has restrictions on the prescribing of controlled substances used for weight loss

Question 3

Are there any restrictions for out-of-state prescribing

Answer 3

none

Question 4

Every person who manufacturers, distributes, or dispenses controlled substances/who proposes to do so shall obtain registration _____.

Answer 4

annually

Question 5

Annual registration to manufacture, distribute, or dispense controlled substances applies to

Answer 5

1. pharmacists
2. each pharmacy

Question 6

Annual registration to manufacture, distribute, or dispense controlled substances DOES NOT apply to

Answer 6

1. Physicians
2. Dentists
3. Veterinarians

(These are each registered by their own boards)

Question 7

Pharmacists shall/shall NOT have a requirement or obligation to access or check information in the controlled substances database prior to dispensing or administering medications or as part of their professional practices

Answer 7

shall NOT have a requirement to do so

Question 8

PART 1311 - Subpart C - Electronic Rxs:
A prescriptionwritten for a CII narcotic to be compounded in the direct adinistratoin by parenteral, IV, IM, subQ, or intraspinal infusion may be transmitted by the practitoiner or their agent by

Answer 8

fax

Question 9

PART 1311 - Subpart C - Electronic Rxs:
A prescription wrtten for CII substance by a long term care facility may be transmitted by the practtioner or their agent by

Answer 9

fax (as an original)

Question 10

PART 1311 - Subpart C - Electronic Rxs:
A prescription written for a schedule II substance for a patient in hospice certified/paid for by Medicare under Title XVIII or hospice licensed by the state may be transmitted by

Answer 10

fax, but must note that the patient is a hospice patient

Question 11

On May 15, 2019, the State Committee of Public Health voted to make gabapentin a schedule ___ medication, effective on November 18, 2019

Answer 11

CV

Question 12

How long is a CII valid

Answer 12

no time limit specified; however, the pharmacist should determine that the prescription is still needed by the patient

Question 13

How long is a CIII valid

Answer 13

6 months or 5 refills, whichever happens first

Question 14

How long is a CIV valid

Answer 14

6 months or 5 refills, whichever happens first

Question 15

How long is a CV valid?

Answer 15

unspecified, unless partial fill in which case the remainder has 6 months or 5 refills, whichever happens first

Question 16

day supply rstrictions

Answer 16

some states/insurances limit the quantity of controlled substances to 30 days, no such restriction is expressed in federal limits.

Question 17

the amount of a controlled dispensed must be consistent with the

Answer 17

requirement that a prescription for a controlled substance be issued only for a legitimate medical purpose by a practitioner acting in the usual course of professional practice

Question 18

Refills for CII

Answer 18

none allowed; must be new prescription

Question 19

CIIs cannot have altered issue dates, only

Answer 19

do not fill before dates

Question 20

Postdating allowed?

Answer 20

no; all federal regulations require that prescriptions for controlled substances must be dated as of, and signed on, the date they are issued

Question 21

The Comprehensive Addiction and Recovery Act amended the federal controlled substances act to allow pharmaicsts to partially fill a CII if

Answer 21

1. such partial fills are not prohibited by state law
2. The prescription is written and filled in compliance with state and federal law
3. a partial fill is requested by the patient/prescribing practitioner
4. The total quantity dispensed in all partial fillings does not exceed the quantity prescribed

Question 22

remaining portions of partially filled prescriptions must be filled within _____ of the originally written prescription date

Answer 22

30 days

Question 23

Where a pharmacist is unable to supply the full quantity of the prescription and makes a notation of the quantity supplied, the remaining portion may be filled within ___ of the first partial

Answer 23

72 hours

Question 24

if a pharmacist does not fill the remaining partial fill of a prescription in which they did not originally have the entirety of the stock within 72 hours,

Answer 24

they forfeit the remaining balance and a new prescription is required. This is generally related to inventory shortage in which a pharmacy is unable to acquire a schedule II drug to fill the remaining quantity owed to a patient.

Question 25

Where a pharmacist is aware, at the time of the partial dispensing, the pharmacy may not be able to obtain sufficient inventory within 72 hours, the pharmacist should

Answer 25

notify the patient prior to partial dispensing

Question 26

Partial refills of CIII, IV, and V Rxs are permissible under federal regulations provided that each filling is dispensed and recorded in the same manner as a

Answer 26

refilling, the total quantity dispensed in all partial fillings does not exceed the total quantity prescribed, and no dispensing occurs after 6 months past the date of issue

Question 27

In an emergency situation, a pharmacist may dispense a CII for a

Answer 27

LCTF resident, a patient receiving hospice care, or patient receiving home health care services pursuant to emergency oral prescription transmitted by the practitioner to the pharmacy

Question 28

The quantity dispensed pursuant to an emergency oral prescription shall be limited to the amount adequate to treat the patient durring the emergency period, not to exceed (CII)

Answer 28

72 hours

Question 29

for non-CII, in the event that a pharmacist receives a request for prescription refill and is unable to obtain authorization from the prescriber, the pharmacist may dispense a 1-time emergency refill of up to

Answer 29

72 hours of the prescribed medication, with restrictions

Question 30

which restrictions apply to the emergency refill of a 72-hour fill of a non-CII drug

Answer 30

1. prescription is not CII
2. the prescription is essential to life/continuation of therapy in chronic condition
3. dispensing pharmacist created a written order containing the prescription information
4. The dispensing pharmacist notifies the prescriber of the emergency dispensing within 72 hours

Question 31

how long does a pharmacist have to notify a prescriber after filling an emergency 72-hour refill

Answer 31

72 hours