24. TL:DR - Controlled Substances: Prescriptions Flashcards
Every written prescription in this state shall contain 2 signature lines. What do they indicate?
- brand name
- product selection permitted
state-specific controlled substance restrictions?
yes; AL has restrictions on the prescribing of controlled substances used for weight loss
Are there any restrictions for out-of-state prescribing
none
Every person who manufacturers, distributes, or dispenses controlled substances/who proposes to do so shall obtain registration _____.
annually
Annual registration to manufacture, distribute, or dispense controlled substances applies to
- pharmacists
- each pharmacy
Annual registration to manufacture, distribute, or dispense controlled substances DOES NOT apply to
- Physicians
- Dentists
- Veterinarians
(These are each registered by their own boards)
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
shall NOT have a requirement to do so
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
fax
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
fax (as an original)
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
fax, but must note that the patient is a hospice patient
On May 15, 2019, the State Committee of Public Health voted to make gabapentin a schedule ___ medication, effective on November 18, 2019
CV
How long is a CII valid
no time limit specified; however, the pharmacist should determine that the prescription is still needed by the patient
How long is a CIII valid
6 months or 5 refills, whichever happens first
How long is a CIV valid
6 months or 5 refills, whichever happens first
How long is a CV valid?
unspecified, unless partial fill in which case the remainder has 6 months or 5 refills, whichever happens first
day supply rstrictions
some states/insurances limit the quantity of controlled substances to 30 days, no such restriction is expressed in federal limits.
the amount of a controlled dispensed must be consistent with the
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
Refills for CII
none allowed; must be new prescription
CIIs cannot have altered issue dates, only
do not fill before dates
Postdating allowed?
no; all federal regulations require that prescriptions for controlled substances must be dated as of, and signed on, the date they are issued
The Comprehensive Addiction and Recovery Act amended the federal controlled substances act to allow pharmaicsts to partially fill a CII if
- such partial fills are not prohibited by state law
- The prescription is written and filled in compliance with state and federal law
- a partial fill is requested by the patient/prescribing practitioner
- The total quantity dispensed in all partial fillings does not exceed the quantity prescribed
remaining portions of partially filled prescriptions must be filled within _____ of the originally written prescription date
30 days
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
72 hours
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,
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.
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
notify the patient prior to partial dispensing
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
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
In an emergency situation, a pharmacist may dispense a CII for a
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
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)
72 hours
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
72 hours of the prescribed medication, with restrictions
which restrictions apply to the emergency refill of a 72-hour fill of a non-CII drug
- prescription is not CII
- the prescription is essential to life/continuation of therapy in chronic condition
- dispensing pharmacist created a written order containing the prescription information
- The dispensing pharmacist notifies the prescriber of the emergency dispensing within 72 hours
how long does a pharmacist have to notify a prescriber after filling an emergency 72-hour refill
72 hours
