Ch 8: Controlled Substances, Part III

Question 1

FED Who are the only providers with unlimited, independent prescribing authority federally

Answer 1

Physicians, MD/DO

Question 2

FED What does the first and second letter of a DEA number indicate

Answer 2

First letter: type of practitioner or institution, registrant type

Second letter: first letter of prescribers last name

Question 3

FED How many numbers follow the two letters in a DEA number, and which one is considered to be the “check digit”

Answer 3

7 numbers, the last number is the “check digit”

Question 4

FED If a practitioner is authorized to prescribe narcotics such as buprenorphine for opioid addiction treatment, they will receive a ____

Answer 4

DATA 2000 waiver unique identification number (UIN)

Question 5

FED T/F prescribers in a hospital or other institution including medical interns, residents, and visiting physicians, can prescribe meds under the DEA registration of that hospital or institution

Answer 5

True, pg 137

Question 6

FED If an intern, resident, or visiting physician is to prescribe medication under the DEA registration of that hospital or institution, what must be done

1) They must be assigned an internal code number to each practitioner, which will follow the last number of the hospitals DEA number
2) Nothing can be done, they must have their own separate DEA registration

Answer 6

1

Question 7

FED The first letter of a DEA number being an “M” indicates

1) hospital or clinic
2) practitioner
3) mid-level practitioner
4) DATA waived practitioner

Answer 7

3

Question 8

FED The first letter of a DEA number being __ or ___ indicated a manufacturer, distributor, researcher, analytical lab, importer, exporter, reverse distributor, or narcotic treatment program

Answer 8

P/R

Question 9

FED How can you determine the validity of a DEA number

Answer 9

1) Add 1, 3, 5th digits
2) Add 2, 4, 6th digits
3) Multiply (result of step 2) * 2
4) Add result of (step 1) + (step 3)
5) The last digit of that number should be the same as the last digit of the DEA number

Question 10

FED T/F A pharmacist is legally obligated to dispense a controlled prescription if they have any concerns about legitimacy, as long as the patient has used the medication recently

Answer 10

False, if RPh has any concerns about the legitimacy of the script, they are NOT required to dispense it

Question 11

FED Describe a drug cocktail and what it may indicate if a patient drops off a script for one

Answer 11

opioid + benzo + muscle relaxer

may indicate “red flags” of diversion

Question 12

FED T/F Under federal law, each state must have a PDMP database to help combat drug diversion and abuse

Answer 12

False…. the DEA highly recommends it, though

Question 13

FED Each PDMP is regulated by:
A) DEA
B) FDA
C) DoJ
D) a specified state-wide administrative, regulatory, or law enforcement agency

Answer 13

“Each PDMP is regulated by a specified state-wide administrative, regulatory or law enforcement agency, not by the DEA” pg 139

Question 14

FED T/F There is no federal law that prohibits self-prescribing controlled substances

Answer 14

True

Question 15

FED Select all. Which of the following are required on a controlled substance prescription
A) Patients full name
B) Patients DOB
C) Patients address
D) Patient or other related/affiliated persons drivers license number or other identification number associated with a photo ID

Answer 15

A) Full name: yes
B) DOB: no
C) Address: yes
D) License number: no

pg 140

Question 16

FED Faxed prescriptions are appropriate for what schedules of controls

Answer 16

III-V

Question 17

FED Select all. A prescriber faxes a CII script. What is the likely purpose?
A) To have filled immediately
B) To reduce the patients wait time, they are likely sending a paper script
C) The patient is likely a hospice patient

Answer 17

B….. the CII drug cannot be dispensed to the pt until the pharmacy receives the written prescription, faxing just gives the pharmacy a head start

C… Also true, a patient enrolled in hospice can use a faxed script for the original copy, only if it is NOTED on the face of the script that its for hospice

pg 142

Question 18

FED What 3 scenarios allow a faxed CII script to serve as the original copy

Answer 18

1) Drug compounded for administration to a pt by parenteral, IV, IM, SC, or intraspinal route
2) A prescription for LTCF resident
3) Prescription for pt enrolled in hospice–must be NOTED on face of script

Question 19

FED What two methods can be used to sign and transmit an EPCS (electronic prescriptions for controlled substances)

Answer 19

1) a two-factor authentication method (includes a list of something you know/have/are)
2) digital certificate issued by the DEA

can use either of these, pg 142

Question 20

FED A prescriber using a two-factor authentication method to sign and transmit EPCS needs to use ___ different factors

Answer 20

Two… its two factor

Question 21

FED What are the 3 categories a prescriber can choose from while using 2-factor authentication to sign and transmit an EPCS

Answer 21

Something you know (password, response)
Something you have (hard token, cryptographic key)
Something you are (fingerprint, iris scan)

Question 22

FED Under which circumstances can a prescriber use the same digital signature
A) Signing multiple scripts for the same pt
B) Signing multiple scripts for dif patients for the same med on the same day
C) Cannot be used, must be a new one for each separate script

Answer 22

A

Question 23

FED If transmission of an escript for schedule III-V fails, what must be done:
A) Resend it
B) Send it by another method

Answer 23

B

The replacement must specify that an initial transmission has failed, with the date, time, and pharmacy where it was sent

Question 24

FED What are the 3 items that cannot be changed/fixed/added if there is a mistake for all controlled substances

Answer 24

1) patient name
2) prescribed DRUG
3) prescriber signature

Can change the dose, form, amount, can change 18mg to 36mg, etc etc.. just cant change methylphenidate to adderall

Question 25

FED What is the federal limit for a CII script on:

1) Expiration date
2) Days supply
3) Refill limit

Answer 25

1) Exp date: NEVER
2) Days supply: NO LIMIT
3) Refills: ZERO refills permitted!