Controlled Substances Flashcards

1
Q

What drugs are classified in a different schedule in this state compared to the federal schedule (e.g., cannabidiol, Fioricet, gabapentin, Lomotil, pseudoephedrine)?

A

None - Texas follows federal drug schedules

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2
Q

Can marijuana be legally obtained from a state-approved dispensary?

A

No

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3
Q

What agencies must a controlled substance loss or theft be reported to and within what time frame must this be reported?

A

Notify the Board of Pharmacy in writing immediately and the DEA within one business day of discovery.

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4
Q

How long does the pharmacy need to keep paper and electronic documents for scheduled drugs (e.g., DEA Form 222, DEA Form 106, prescriptions, invoices)?

A

2 years

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5
Q

Which controlled substance schedules (if any) can each type of mid-level practitioner prescribe?

A

NPs and PAs: schedule III-V drugs only if delegated by the supervising physician.

Can only prescribe for up to a 90 days’-supply at a time (this limit includes the original fill plus any refills), and the prescriptions expire 90 days after issuance.

Schedule II drugs: only if delegated by a physician in a hospital or as part of the treatment of a terminally ill patient receiving hospice care from a qualified hospice provider.

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6
Q

List the schedules of drugs collected in the state’s prescription drug monitoring program (PDMP).

A

Schedule II-V

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7
Q

In what timeframe must a pharmacy submit the records of dispensed controlled substances to the state’s PDMP?

A

No later than the next business day

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8
Q

Which healthcare professionals are authorized to access the prescription drug monitoring program (PDMP)?

A

Prescribers and pharmacists and individuals they delegate access to.

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9
Q

Can controlled and non-controlled drugs be written on the same prescription form?

A

Yes. Schedule II drugs must be written on an official prescription form, but other scheduled drugs or non-controlled drugs can also be written on the form.

Schedule III - V drugs and non-controlled drugs can be written on any prescription form and can be written together.

A direct image of the prescription must be maintained separately for each category of file the prescriptions should be stored in.

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10
Q

Is there a limit to the number of medications that can be written on one prescription form?

A

No

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11
Q

Other than prescriptions for Medicaid patients, what prescriptions require tamper-resistant security forms?

A

Schedule II drugs

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12
Q

What security elements must be present on tamper-resistant security forms?

A

A control number

A pantograph (word “VOID” appears if copied/scanned)

Thermochromic ink (a red Rx image that when rubbed or heat is applied will cause the red Rx to disappear briefly then reappear)

A watermark (the seal of Texas on the face of the prescription)

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13
Q

What changes can be made, at the pharmacist’s discretion, to schedule II prescriptions?

A

The following 4 items may NOT be changed:

Patient name
Drug name
Prescriber’s name
Date of the prescription

Any other item, such as drug strength, quantity and directions for use, may be changed.

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14
Q

What changes can be made, at the pharmacist’s discretion, to schedule III - V prescriptions?

A

Can correct the patient’s name (e.g., a misspelling or valid name change)

Can add the patient’s address if it is missing

Can correct obvious issuance date errors (such as the prior year when a new year has just begun)

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15
Q

What is the time limit (i.e., days/months) that a schedule II prescription must be filled from the date of issue?

A

Within 30 days from the date of issue (law changed 6/2021 from 21 days).

If a schedule II prescription is part of a multiple prescription set issued on the same day, then the prescription can be dispensed no later than 30 days after the earliest fill date indicated on the prescription.

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16
Q

Are partial fills for schedule II prescriptions permitted at the request of the patient or prescriber?

A

Yes

17
Q

Are there any additional requirements for an emergency oral schedule II prescription compared to federal law?

A

No, Texas follows the Federal Law

18
Q

What is the time limit (i.e., months) that schedule III - V prescriptions must be filled from the date of issue?

A

6 months

19
Q

Is there a maximum quantity or days’ supply that a patient can receive of schedule III - V drugs?

A

No

20
Q

How long are refills valid for schedule III, IV and V prescriptions?

A

6 months from the issue date

21
Q

What is the maximum number of refills allowed for schedule III, IV and V substances?

A

5

22
Q

What is the maximum days’ supply that can be dispensed for an emergency refill of schedule III – V drugs without prescriber authorization?

A

If the emergency is due to the pharmacist being unable to contact the prescribing practitioner, the pharmacist can dispense up to a 72-hour supply.

If the emergency is due to natural or manmade disasters, the pharmacist can dispense up to a 30-day supply.

23
Q

What controlled drug schedules require identification for dispensing (e.g., schedule II only)?

A

Identification is required for any controlled substance prescription unless the person picking up the prescription is known to the pharmacist or pharmacist-intern or if an emergency exists and the controlled substance is needed for the immediate well-being of the patient.

24
Q

Are pharmacists permitted to sell select schedule V cough syrups without a prescription?

A

No

25
Q

Is naloxone distribution by a pharmacist permissible in all situations, or is it pursuant to a standing order, a protocol or authorization from a prescriber?

A

It is permissible under a standing order or dispensed pursuant to a valid prescription.

26
Q

What requirements must the pharmacist meet in order to furnish naloxone under the protocol (e.g., training program)?

A

Must complete and obtain a certificate of completion of a one-hour, Texas-certified training course.

27
Q

Other than exceeding the quantity limit, are there any conditions in which a pseudoephedrine sale can be rejected?

A

No