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Pharm 584 > Basic Law > Flashcards

Basic Law Flashcards

1
Q

Legal Definition of the Practice of Pharmacy

A
  • Interpreting prescription orders
  • Compounding, dispensing, labeling, administering, and distribution of drugs and devices
  • Monitoring of drug therapy and use
  • Initiating or modifying drug therapy in accordance with written guidelines or protocols previously established and approved for his or her practice by a practitioner authorized to prescribe drugs
    • Collaborative practice agreements
  • Participating in drug utilization review and drug product selection
    • DUR, popups for allergies and interactions
  • Proper and safe storing and distributing of drugs and devices and maintenance of proper records thereof
  • Providing of information on legend drugs which may include, but is not limited to, the advising of therapeutic values, hazards and the uses of drugs and devices
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2
Q

Pharmacy Assistant: Who

A

Registered with PQAC

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3
Q

Pharmacy Assistant: What

A
  • Count and label individual prescriptions
  • Return used bottles to the shelf
  • Often responsible for cashiering in pharmacy
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4
Q

Pharmacy Assistant: May Not

A
  • (Counsel)
  • Pull a medication bottle from the shelf to fill a prescription
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5
Q

Pharmacy Technichian: Who

A
  • Registered with PQAC
  • Trained to perform non-discretionary manipulative functions related to the practice of pharmacy
  • Must act under the supervision of a licensed pharmacist
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6
Q

Pharmacy Technician: What

A
  • Enter prescriptions into Pharmacy Computer System
  • Retrieve the medication to fill a prescription
  • Specialized Functions IF trained
    • Prepare IV medications
      • Must be checked by pharmacist
      • Ambiguous if intern can check their work
    • Check and Stocking of auto drug distribution devices
    • Tech-check-tech for unit dose medications
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7
Q

Pharmacy Technician: May Not

A
  • Receive a verbal prescription other than a refill authorization
    • Intern/Pharmacist for changes
  • Consult with the patient regarding the prescription and/or regarding any information in the patient medication record
  • Consult with the prescriber regarding the patient and the patient’s prescription
  • Compound the prescription, except for bulk compounding
  • Some tech allowed for medication reconciliation, but have to have special training
  • Interpret the data in the patient profile
  • Take responsibility for the correctness of a dispensed prescription
  • Provide patient information (such as counseling)
  • Sign where a pharmacists signature is required
    • Ordering 2-2-2
    • Logbook for DEA controlled substances
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8
Q

Pharmacy Intern: What

A
  • “Engage in the practice of pharmacy, and the selling of items restricted to sale”
  • Must act “under the direct and personal supervision of a certified preceptor or a licensed pharmacist designated by the preceptor to supervise that intern during the preceptor’s absence from that site”
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9
Q

Pharmacy Intern: May Not

A
  • Supervise technicians
  • (Checking IVs)-can check in the med in community
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10
Q

Pharmacist: Who

A
  • Registered with PQAC
  • “A person duly licensed by the Washington State board of pharmacy to engage in the practice of pharmacy”
  • Practice and Responsibility for carrying out the duties defined as the practice of pharmacy
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11
Q

Drug Order/Prescription Must Include

A
  • Prescriber name and address
  • Patient name
  • Patient address (on rx or in profile)
  • Date written
  • Drug name, Strength & Quantity
  • Directions for use (sig)
  • Refills (if any)
  • Prescribers signature
  • Provision for generic substitution
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12
Q

Hard Copies of Prescriptions

A
  • Printed (not cursive)
  • Typed
  • Tamper Resistant
    • If patient doesn’t touch Rx, not need tamper proof prescription paper
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13
Q

Allowed Transmission

A
  • Hardcopy (all)
  • Phone, fax, and e-prescribing
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14
Q

Back Tag

A
  • Sticker to put on back of prescription
  • Rx numbed
  • Date filled
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15
Q

Valid Prescription

A
  • Issued for a specific patient
  • Issued by an authorized prescriber
  • Was it in due course of prescriber’s practice
    • Scope of practice
    • Prescriber-Patient relationship
  • Medical purpose
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16
Q

What makes a valid prescription label

A
  • Name and address of pharmacy
    • Phone number not required
  • Prescription number
  • Date dispensed
  • Patient name
  • Drug Name, strength and quantity
  • Directions for use
  • Refills
  • Expiration date
  • Warnings and/or precautionary statements
    • Federal Transfer Warning
  • May include name or initials of pharmacist making final check
  • May include FDA SE Warning
    • Call you doctor about medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088
17
Q

General Pharmacy Security

A
  • Only pharmacists allowed to enter/secure dispensing area
  • Pharmacist must be physically present if an employee in dispensing/compounding area
  • Dispensing area must be enclosed if employees in other part of building while pharmacist is not present
  • Pharmacies inside other establishments must be enclosed with barrier that prevents removal of items from dispensing area
18
Q

Entering Patient into Computer System

A
  • Create Patient Profile
    • Patient’s Full Name
    • Address
    • DOB
    • Weight, if applicable
    • Gender (not legal requirement, but usually for insurance)
    • Known allergies/sensitivity
    • List of chronic conditions
    • Record or drugs dispensed by pharmacy/Other drugs patient is receiving/taking
    • Pharmacist Notes re: therapy
    • Non-child resistant cap notations
19
Q

NDC Number

A
  • 1st 5 digits for manufacturer
  • 2nd 4 digits for medication strength/dosage form
  • 3rd 3 digits for package size
20
Q

Pharmacist Check

A
  • Drug Utilization Review (initial check)
  • Final prescription check
  • Records must indicate pharmacist making final check (and initial check if different pharmacist than final)
21
Q

Refills

A
  • Compounding or dispensing any drug pursuant to previously executed order
    • Use the same Rx number as previously filled prescription
  • Refills are valid up to a varying time from date of original prescription
    • Legend Rx: one year
    • Controlled: 6 months
  • Technician can take oral authorization for refills over phone
    • Technician name must be recorded
    • Name, initials or license of pharmacist making final check must be recorded
  • Records must indicate when/if NDC changes
22
Q

Transferring Prescriptions

A
  • Transfer of a prescription and its refill information from pharmacy to pharmacy may be done if the
    • Prescription is not expired
    • Refills remaining
  • Pharmacist (or intern) to pharmacist (intern)
    • Over the phone
    • Fax (questions have been arising over this)
  • Number of Transfers Allowed
  • None for CIIs
  • Once for CIII-V
  • Rx or Legend: Unlimited if refills remain
23
Q

Patient Counseling

A
  • OBRA 90
  • Oral communication by pharmacist or intern to patient or caregiver for ensuring proper use
  • Technician/Pharmacy Assistant’s Role
    • Not supposed to say “Is this new for you?” but rather “This is a new prescription. The pharmacist will be right over to review the medication with you.”
  • Refusal for counseling needs to be documented
24
Q

Controlled Substances

A
  • Medications with potential for abuse
  • Drug Abuse Prevention and Control Act (1970) (Controlled Substances Act of CSA)
    • Established strict limits on distribution and possession of set specific drugs/substances
    • Manufacturers, distributors, dispensers and prescribers must register with DEA
25
Q

Schedule I

A
  • Illicit
  • Drugs w/ high potential for abuse, no accepted use, lack of safety
26
Q

Schedule II

A
  • Rx only
  • Drugs w/ high potential for abuse, accepted use, (severe physical and emotional dependency)
  • Narcotics: fentanyl, hydromorphone (Dilaudid), meperidine (Demerol), methadone, morphine, oxycodone (OxyContin), hydrocodone
  • Narcotic combos: oxycodone/APAP, hydrocodone/APAP
  • Stimulants: Amphetamines (Adderall), Methylphenidate (Ritalin, Concerta)
27
Q

Schedule III

A
  • Rx only
  • Drugs w/ moderate potential for abuse, accepted use, moderate to low physical but high emotional dependence
  • Opiates: Codeine combos i.e. codeine/APAP (Tylenol #3)
  • Anabolic steroids: testosterone
28
Q

Schedule IV

A
  • Rx only
  • Drugs w/ low potential for abuse, accepted use, limited physical and emotional dependence
  • Opiate: Tramadol
  • Depressants: phenobarbital, sleep aids (Ambien, Sonata, Lunesta)
  • Benzodiazepines: Diazepam (Valium), Lorazepam (Atvian), midazolam (Versed), temazepam (Restoril), triazolam (Halcion)
  • Stimulants: phentermine (Fastin), sibutramine (Merdia)
29
Q

Schedule V

A
  • Behind Counter
  • Drugs with low potential for abuse, accepted use, limited physical and emotional dependence possible
  • Cough syrups: codeine (in certain strengths)
  • Diphenoxylate w/ atropine (Lomotil)
30
Q

Labeling

A
  • Manufacturer container must be clearly labeled with the control classification
  • CII-CV
31
Q

Precursor Substances

A
  • Precursor substances behind counter: pseudoephedrine, ephedrine, phenylpropanolamine
    • Generally must be recorded in log
    • OR Electronic Pseudoephedrine tracking program-NPLEX-National Precursor Log Exchange
    • Patient Name, address, photo ID number, type of photo ID, date of birth, date and time of sale, drug name and strength, and number of packages and tablets sold
    • Purchasing only for those 18 yo and older (if needs to be logged)
    • Exception-Precursor substances sold b/c of prescription
  • Limits on Quantities Sold
    • No more than 3.6g total in a day and 9g total in a month
32
Q

Controlled Substance Scripts

A
  • In addition to the normal requirement for prescriptions for legend drugs, controlled substance prescriptions must also include:
    • Patient Address
    • Provider Address
    • Provider’s DEA number
  • Special ordering forms or ordering process to order C-2 medications for wholesalers
  • Inventory
    • C-2s can be locked or interspersed
    • Special Inventory Counts required
  • Prescriptions for C-2s must be filed separately
33
Q

DEA Number

A
  • Required for HC Providers that prescribe controlled substances
  • Contains 2 letters followed by 7 digits
  • Sum of 1st, 3rd, 5th plus 2(sum of 2nd, 4th, 6th)= Last digit of DEA number
34
Q

Controlled Substance Scripts: C2

A
  • Written Order Required (no fax or electronic transmission)
  • Refills: none
  • Expiration: 6 months
  • Exception: fax allowed for LTC or hospice patient
35
Q

Controlled Substance Scripts: C-3 through C-5

A
  • Phone, fax, computer generated, and electronically transmitted orders allowed
  • Refills: Up to 5
  • Expiration: 6 months
36
Q

Tranferring

A
  • C-2’s none
  • C-3 and C-4: one time
37
Q

Diversion

A
  • Transfer of any controlled substance from a licit to an illicit channel of distribution or use
  • Must have a prescription
  • Possession pursuant to professional practice
  • Federal Offense=Felony
  • Unlawful to obtain a controlled substance by misrepresentation, fraud, forgery, deception
38
Q
A

Pharm 584 (13 decks)

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