Controlled substances Flashcards
Restrictions on out of state CS prescribing?
nope.
multiple Rx’s are allowed on one form if from out of state
Restrictions on out of country CS prescriptions
Out of Country CS Rx not allowed
Registrations required for a provider to prescribe CS
Register with DEA
Register prescribing application with NYS DOH BNE
DEA 224 form
required for pharmacies to dispense controlled substances
DEA 224a
DEA 224 renewal form
must renew every 3 years
Are pharmacists required to check PDMP before filling?
No
Are pharmacists required to report CS dispensing? If so, where to and how quickly?
Yes
Report to BNE (PDMP)
must report within 24 hrs of substance being delivered to patient
Are CS dispensing reporting requirements the same for mail order?
Mostly, but mail order pharmacies must report within 72 hrs of the meds being SHIPPED
Emergency verbal CS prescription: max day supply for C2s
5 day supply
Emergency verbal CS prescription: how long does the doctor have after giving the verbal order to send written or electronic authorization?
72 hrs
must have “Authorization for emergency dispensing” written (not typed) on the face of the script
Emergency verbal CS prescription: Do pharmacists have to report if they don’t get an authorization script?
Yes must report to DOH within 7 days of dispensing the CS
Emergency verbal CS prescription: max day supply for C3-5
C3 & 5: 5 day supply
C4: 30 day supply or 100 dosage units (Whichever is less)
Emergency verbal CS prescription: is a follow up prescription required?
yes due within 72hrs
When can CS prescriptions be sent via fax
- hospice or RHCF if they are contracted with the pharmacy
- rx for compounding for direct parenteral admin
both still follow 72hr and 7 day rules
Benzodiazepines are considered C___ for the purpose of refills
C2
Should benzodiazepines be filed with C2 or C3-5 paperword
C3-5
Is naloxone a controlled substance?
nope
CBD control schedule
C5
Anabolic steroid scheduling:
Federal vs NY
Fed: C3
NY: C2
How long are CS prescriptions valid?
C2: 30 days
C3-5: valid for up to 6 months
Day supply limit on CS prescriptions?
C2: 30 DS
C3-5: can be greater than 30 days, but if > 30 DS can only be refilled 1 time
What do CS codes on prescriptions do?
Allows up to 3 month supply of CS
exception: up to 6 month supply for anabolic steroids
Code A
panic disorder
Code B
ADD
Code C
convulsive, seizures, spasms
Code D
pain
Code E
narcolepsy
Code F
- male hormone deficiency
- gynecologic conditions responsive to anabolic steroids or chorionic gonadotropin -metastatic breast cancer
- anemia
- angioedema
Can you partial C2s?
yes, but remaining portion must be filled within 72 hrs. If it cannot be completed within 72hrs Rx is void and provider must send a new script
Exception to the 72hr rule when partial filling C2s
hospice/RCHF patients, partial fill must be completed within 30 days
if Rx was coded to have > 30 DS, partial must be completed within 60 days of written date
Do pharmacies need DEA numbers?
Yes if they want to dispense CS
what does an X in front of a DEA number mean
prescriber is registered for DATA 2000 waiver (for prescribing and dispensing buprenorphine
DEA 224 registration renewal fee
$731 every 3 years
DEA 41
disposal of CS
DEA 222
CS ordering
DEA 106
Theft/loss of CS
requirements to administer suboxone?
register for a DATA 2000 waiver
Can prescribers administer suboxone?
Only if they register for a DATA 2000 waiver
Which CS schedules can Physicians (MD, DO) order?
C2
C3
C4
C5
Legend/OTC
Methadone
Which CS schedules can Dentists (DDS/DMD) order?
C2
C3
C4
C5
Legend/OTC
MUST BE WITHIN SCOPE OF PRACTICE
Which CS schedules can Optometrists (OD) order?
Legend/OTC
- which agents vary by privilege
MUST BE WITHIN SCOPE OF PRACTICE
Which agents can OD’s with R privilege prescribe?
Topical agents
- antibiotic/microbials
- decongestants / antihistamines
- NSAIDs
- steroids
- antiviral agents
hyperosmotic/hypertonic agents
- cycloplegics (for dilation)
- Immunosuppressive agents
Which agents can OD’s with T privilege prescribe?
Glaucoma & ocular HTN meds
- beta blockers
- alpha agonists
- direct acting cholinergic agents
- prostaglandin analogs
- carbonic anhydrase inhibitors
Which agents can OD’s with O privilege prescribe?
Oral agents:
ABX
- Amox/clav
- cephalexin
- azithromycin
- co-trimazole
- doxycycline
- tetracycline
Acute inc in ocular pressure
- acetazolamide
- methazolamide
- 24h supply only
Herpes zoster
- acyclovir
- valacyclovir
Which CS schedules can Podiatrists (DPM) order?
C2
C3
C4
C5
Legend/OTC
WITHIN SCOPE OF PRACTICE
Which CS schedules can Veterinarians (DVM) order?
C2
C3
C4
C5
Legend/OTC
Which CS schedules can a psychiatrist (usually considered MDs) order
C2
C3
C4
C5
Legend/OTC
WITHIN SCOPE
Which CS schedules can physician assistants (PA, RPA) order?
C2
C3
C4
C5
Legend/OTC
Methadone
NYS Rx form must have imprinted name of RPA & supervising physician
Which CS schedules can Nurse Practitioners (NP or RN-CNP) order?
C2
C3
C4
C5
Legend/OTC
Methadone
may certify patients for medical cannabis
Collaborative agreement with physician
- do not need co-sign though
Which CS schedules can Midwives (NM, CNM) order?
C2
C3
C4
C5
Legend/OTC
WITHIN SCOPE
- management of uncomplicated pregnancy and up to 28 days post partum
collaborative agreement with an OBGYN
How soon must a supervising physician co-sign a PA’s CS prescription?
within 24 hrs
Which CS schedules can pharmacists prescribe?
None
May prescribe Legend/OTC meds within a CDTM agreement with a physician.
Medical Marijuana Dispensaries: Is a licensed RPh required on premesis
Yes, must be on premises and supervising
Medical Marijuana Dispensaries: max day supply allowed
60 DS
Medical Marijuana Dispensaries: how soon can MM prescriptions be refilled/new Rx filled
follows same 7 day rule as other controls
Does a pharmacist have to review the PDMP before dispensing medical cannabis?
yes, required
Medical Marijuana Dispensaries: are patient specific logs required
yes, dummy
