Controlled Substances

Question 1

Can Schedule I’s be prescribed?

Answer 1

no medicinal use and cannot be prescribed.

Question 2

high potential for abuse and severe psychological or physical dependence.

Answer 2

Schedule II

Question 3

moderate potential for abuse and high psychological dependence or moderate to low physical dependence.

Answer 3

Schedule III

Question 4

lower potential for abuse and limited psychological or physical dependence.

Answer 4

Schedule IV

Question 5

AB2456279. Is this a bad or good DEA number?

Answer 5

• Add digits 1, 3, and 5: 2 + 5 + 2 = 9
• Add digits 2,4, and 6 then multiply by 2: 4 + 6 + 7 = 17 * 2 = 34
• Add these two numbers: 9 + 34 = 43
• The last digit of this number must match the last digit of the DEA. The 3 does not match the 9, therefore this is a bad DEA number.

A=physician
B=first letter of patient name

Question 6

When does opioid prescription have to be filled?

Answer 6

14 days (just schedule II’s)

Question 7

On an outpatient basis, the law prohibits dispensing more than a 30-day supply of an opioid analgesic for new and refill prescriptions. True or False

Answer 7

False, On an outpatient basis, the law prohibits dispensing more than a 90-day supply of an opioid analgesic for new and refill prescriptions.
* The 90-day supply limit includes the initial dispensing and all refills

Question 8

For opioid prescriptions, the “fill within 14 days of the date written” does not apply to the refills of schedule?

Answer 8

III-V opioid analgesics.

Question 9

The opioid prescription has to be filled within 14 days, does the patient have to pick it up in 14 days?

Answer 9

no, they can pick up beyond the 14 day limit.

Question 10

What is not classified as a opioid?

Answer 10

buprenophine (treatment of opioid dependence/addiction) or an antidiarrheal

Question 11

Opioid Prescriptions written by out-of-state prescribers dispensed in Ohio must meet these requirements (14 days to dispense and 90-day supply). True or False

Answer 11

True

Question 12

Opioid Partial fill schedule II prescriptions – If the initial fill of the prescription is dispensed within 14 days of the date it was issued, then will it impact outpatient partial fill prescriptions?

Answer 12

If the initial fill of the prescription is dispensed within 14 days of the date it was issued, then it will not impact outpatient partial fill prescriptions.

Question 13

This opioid law applies to inpatient. True or False

Answer 13

False, only outpatient!

Question 14

This opioid law applies to compounded opioid prescriptions. True or False

Answer 14

False, This law does apply to compounded opioid analgesic prescriptions

Question 15

For opioid prescriptions, can the issue date of the prescription be changed?

Answer 15

yes, The issue date of the prescription can be changed by the pharmacist after consultation with and agreement of the prescriber.

Question 16

What is the exemption to law for opioids?

Answer 16

Pharmacies who dispense opioid analgesics to be delivered outside of Ohio by mail, parcel post, or common carrier to a patient outside of Ohio are exempt from these requirements.

Question 17

What is the day supply limit for adults if physicians prescribe opioid for acute pain?

Answer 17

7 day supply
* Health care providers may exceed these amounts if they provide a specific reason in the patient’s medical record

Question 18

What is the day supply limit for minors if physicians prescribe opioid for acute pain?

Answer 18

5 day supply
* Health care providers may exceed these amounts if they provide a specific reason in the patient’s medical record

Question 19

All schedule II prescriptions must be issued:

Answer 19

electronically

Question 20

Are there refills with schedule II’s?

Answer 20

no, new prescription every time

Question 21

Are pharmacists required to verify that the prescriber meets these expectations for schedule IIs?

Answer 21

No, for example if you get a written prescription you still just fill it

Question 22

All Medicare Part D prescriptions for controlled substances must be issued:

Answer 22

electronically

Question 23

What DEA form do you order CII’s on?

Answer 23

DEA 222

Question 24

A patient brings you a prescription for Percocet 5 #100, one tablet QID. The patient only wants to get 50 filled. Can the patient get the other 50 in one week?

Answer 24

Yes they can; they can split a CII prescription up to 30 days

Question 25

What are 3 things you can never change or clarify on a schedule II prescription:

Answer 25

1. patient’s name
2. prescriber’s name
3. drug prescribed

Question 26

Do schedule II’s have a time limit for when prescription needs to be filled?

Answer 26

No, it is 6 months like everything else. Opioids is the only one with the 14 day time limit

Question 27

For schedule II, the quantity prescribed and dispensed should be:

Answer 27

The quantity prescribed and dispensed should be enough for only the emergency period (not a 72 hour maximum).

Question 28

when does the pharmacist have to receive the written prescription from the presciber for schedule II’s?

Answer 28

7 days

Question 29

For schedule II’s, what must be attached to the written prescription?

Answer 29

This written prescription must be attached to the oral prescription taken by the
pharmacist. On this written prescription must be the statement
“Authorization for Emergency Dispensing”.

Question 30

For Schedule II’s, can the prescriber send written prescriptions instead of sendint the written prescription?

Answer 30

yes The pharmacist must document on the electronic prescription that is for “Emergency Dispensing”

Question 31

Where must schedule II be stored?

Answer 31

All schedule II controlled substances must be stored in a securely locked, substantially constructed cabinet or safe.

Question 32

Regulations in ordering CII’s: what must you record?

Answer 32

date and quantity

Question 33

Regulations in ordering CII’s:

Answer 33

1) order on a DEA 222 Form
2) The DEA 222 Form is a single form.
3) You record what you received: date and quantity
4) If the wholesaler does not have the product in stock, they have 60 days to fill the order before a new form is needed.
5) If you make a mistake, you must void the entire form. Do not erase.

Question 34

What are the 2 circumstances pharmacists can partially dispense from a prescription for Schedule II?

Answer 34

1. patient who is terminally ill
2. a patient in a long-term care facility or nursing home

**this information must be written on the prescription

Question 35

What are the requirements for partial dispensing?

Answer 35

a) Partial dispensing can only occur at the pharmacy where the original prescription is on file.

b) The total quantity dispensed through all partial fills cannot exceed the total quantity on the written prescription.

c) Partial dispensing of the prescription can only occur for 60 days from the date the prescription was written. Any quantity “left-over” after 60 days cannot be partially filled.

Question 36

how many days can partial dispensing occur from teh date the prescription was written?

Answer 36

60 days

Question 37

If the computer system does not permit “refilling” of a schedule II drug,

Answer 37

a new prescription number for the partial dispensing must be assigned.

Question 38

For patients who are not terminally ill or reside in a long term facility, a pharmacist can partially dispense a schedule II drug under the following circumstances:

Answer 38

It must be requested by the patient or prescriber
b) Total quantity partially dispensed cannot exceed total quantity prescribed
c) The remaining portion of the partially dispensed prescription must be dispensed within 30 days of the date the prescription was written.
d) Documentation on the back of the prescription is the same as for terminally ill and long-term care partial dispensing prescriptions.

Question 39

in general can Schedule II drugs be faxed to pharmacy?

Answer 39

no but there are 3 exceptions

Question 40

Can you take a fax for a patient in an assisted living facitility for schedule II?

Answer 40

no

Question 41

In general, prescriptions for Schedule II drugs cannot be faxed to a pharmacy. However, there are three exceptions to this rule:

Answer 41

1) Pharmacists may receive faxed prescriptions for Schedule II drugs for patients in a nursing home or long-term care facility.

2) Pharmacists may receive faxed prescriptions for Schedule II narcotic drugs for patients in hospice care. The prescriber will note on the prescription that it is for a hospice patient.

3) Pharmacists may receive faxed prescriptions for Schedule II narcotic drugs for a compounded sterile product prescription.

Question 42

For schedules 3, 4, 5: how many refills?

Answer 42

Five refills or 6 months (III and IVs): need to use refills in 6 months
One year’s worth of refills for CVs
Written, oral, fax or electronic Rxs

Question 43

For schedules 3 and 4, what are partial refilling rules?

Answer 43

The patient is entitled to the entire quantity prescribed, even is this means the number of “partial fillings” exceeds five. The total quantity dispensed in all partial fillings cannot exceed the total quantity prescribed.

3) However, all partial fills must be dispensed within 6 months of the date the prescription was written.

4) Each partial filling is recorded in the same manner as a refill.

Question 44

For schedule Vs, can you sell OTC if written previously for a prescription?

Answer 44

no

Question 45

For schedule Vs, only one preparation every how many hours?

Answer 45

48 hours

Question 46

Is ephendrine a schedule V?

Answer 46

yes

Question 47

What needs to kept in separate files?

Answer 47

invoices and prescriptions files

Question 48

what DEA form for disposal of controlled substances?

Answer 48

Form 41

Question 49

what DEA form for theft or loss of controlled substances?

Answer 49

Form 106

Question 50

when doing inventory for controlled substances, waht do you need to get the exact count of?

Answer 50

schedule II’s

Question 51

what schedules can you estimate if bottle is less than or equal to 1000?

Answer 51

3, 4, 5

Question 52

When do you have to do controlled substance inventory?

Answer 52

every 13 months

Question 53

What controlled substance can be dispensed for pain?

Answer 53

Methadone

Question 54

For controlled substances, preprinted prescription can only have 1 drug on it. True or False

Answer 54

True

Question 55

Can physicians write controlled substances for their family members?

Answer 55

no, cannot write for any immediate family