Controlled Substances Flashcards
Hospital registrations with the DEA are issued to the entire hospital as how?
An institutional practitioner
A DEA registration expires after how long?
36 months after initial expiration date
How soon are DEA registration forms mailed out?
60 days before expiration
When should you notify the DEA if registration form isn’t at the pharmacy?
45 days before expiration date
How should you notify the DEA if your registration form has not showed up at your pharmacy?
In writing
Does federal law require a DEA applicant for registration to be a pharmacist?
No
How can other individuals sign applications for a DEA applicant?
Must sign a Power of Attorney
What locations must have a DEA registration?
Anywhere controlled substances are manufactured, distributed, or dispensed.
Are warehouses that store controlled substances required to register with the DEA?
No
If a practitioner prescribes CS, but not administers or dispenses them, do they have to register with the DEA?
No
Do common carriers or delivery companies have to register with the DEA?
No
Any registered person with the DEA may apply to be registered when?
Not more than 60 days before expiration date
Commercial containers containing controlled substances must have what on the label?
The symbol designating the products controlled substance schedule.
How large must a controlled substance symbol be on a commercial container?
Large enough to be easily seen without taking it off the shelf
Do schedule 1 meds have accepted medical uses?
No
What illicit drugs are schedule 2?
Cocaine
PCP
What barbitals are schedule 2?
Pentobarbital
Secobarbital
Amobarbital
What schedule are anabolic steroids?
Schedule 3
What schedule are schedule 2 barbitals when formulated as an salt or with other active ingredients?
Schedule 3
If schedule 2 barbitals are in suppository form, what schedule are they?
Schedule 3
What schedule are benzos?
4
What schedule is phentermine?
4
What schedule is phenobarbital?
4
What schedule is modafinil?
4
What schedule is soma?
4
What schedule is lomotil?
5
What schedule is phenergan with codeine?
5
What is required for the transfer of sale of a schedule 1 or 2 controlled substance?
DEA 222 form
Is a 222 form required when controlled substances are transferred from a central fill to a retail pharmacy?
No
How many 222 forms will come mailed in an envelope?
7 or 14
How many items can be entered on each line of a 222 form?
Only 1
How can a person fill out a 222 on behalf of the purchaser?
Creating a Power of Attorney for each individual
A purchaser retains which copy of the 222 form?
Copy 3
Which copy’s of the 222 form go to the supplier?
Copy 1 and 2
If a supplier can’t completely fill a CS order, how long do they have to complete it?
Within 60 days
What must a purchaser do with its 222 copy once the items are received?
Must record each item received and the dates when they were received
Who keeps the original copy of the 222 form?
The person who fills the 222 order
What happens with copy 2 of the 222 form?
First goes to supplier then forwarded to the DEA
If a supplier endorsed a CS order to another supplier, can the original supplier fill any part of the order?
No
What provides an electronic equivalent of the DEA 222 form?
Controlled Substances Ordering System (CSOS)
How many lines is a 222 order form limited to?
10
Is the CSOS limited to any amount?
No
In the CSOS can you only order schedule 1 and 2 items?
No can order anything, including non-controlled substances
No CS order is valid how long after its executed by the purchaser?
60 days
Is a registrant purchases controlled substances to repackage them, how just the registrant register?
As a manufacturer
A pharmacist can compound CS for office use as long as the product is compounded in what form?
Aqueous
Oleaginous
Or solid
A pharmacist can compound CS for office use if the product doesn’t contain more than what % of CS?
20%
A pharmacist can compound CS for office use if it’s only distributed to who?
A practitioner who’s authorized to dispense
Who can communicate a prescription issued by a practitioner to a pharmacist?
An employee or agent of individual practitioner
Who is responsible for correctly dispensing a controlled substance?
Corresponding liability
Both pharmacist and practitioner
Can a practitioner prescribe CS for office use?
No
How must a practitioner obtain his CS if he wishes to dispense?
Directly from a supplier
What date must be on a CS prescription?
When written
What must be on a CS prescription?(10)
- Full name of pt
- Address of pt
- Drug name
- Drug strength
- Dosage form
- Quantity prescribed
- Directions for use
- Name of practitioner
- Address of practitioner
- Registration # of practitioner
Can an agent of a practitioner prepare a prescription for a practitioners signature?
Yes
If an individual practitioner is exempted from registration under the CSA, what must they include on a CS prescription?
Registration # of hospital/institution
Special internal code they are assigned
Who can fill a prescription for a CS?
Only a pharmacist is who individually registered or who works at a registered pharmacy
Is use of electronic prescribing of CS mandatory or voluntary?
Voluntary
Can a practitioner print copies of electronic prescriptions for CS?
Yes
Must write copy only- not valid for dispensing
When can copies of electronic prescriptions of CS be printed?
Only after transmission
Is a practitioner allowed to sign multiple prescriptions for a single pt at one time?
Yes
Can a practitioner print, sign, and fax a failed to send electronic prescription?
Yes as long as the practitioner provides info with it about the failed to send prescription
How often must electronic pharmacy systems back up files?
Daily
If administering or dispensing narcotic meds for use of detoxification or maintenance treatment, what must a practitioner do?
Register separately with the DEA
If a practitioner is not registered to conduct narcotic treatment programs, can he administer narcotic drugs to these people?
Yes only for acute withdrawal while making arrangements for referral treatment
Can a practitioner administer a schedule 2 med for maintenance or detox treatment without registration?
Yes only for acute withdrawal symptoms while referral being arranged
Not more than how much detox maintenance treatment can be given at once if the practitioner isn’t registered?
1
How long can short term detox maintenance treatment last of practitioner isn’t specially registered?
3 days
Can a pharmacist dispense an emergency supply of a schedule 2 med?
Yes only upon oral authorization of a prescribing practitioner
What must a pharmacist immediately do for an oral authorization of a emergency prescription?
Reduce it to writing
What must the written emergency prescription contain?
Everything required expect the practitioners signature
The pharmacist what do what if she is unsure if the prescriber who authorizes an oral emergency fill of schedule 2
Make reasonable efforts to identify them
Within how many days should a prescriber deliver a written prescription to the pharmacist for the emergency quantity prescribed?
7 days
What must be written on an emergency authorization written prescription? 2
Authorization for Emergency Dispensing
Date of oral order
If a written prescription for an emergency fill is mailed, when must it be postmarked by?
Within 7 days or oral authorization
Can central fill pharmacies fill emergency schedule 2 prescriptions upon oral authorization?
No
Do pharmacists have to register with the DEA for controlled substances?
No
In mississippi, within how long should a complete inventory of controlled substances be done if suspected loss?
Within 48 hours
Within how long of a CS loss should a pharmacy send a written report to the mississippi bop?
What else should the report include?
Within 15 days
A copy of the CS inventory
What things can a pharmacist NOT make changes to on a CS subscription?
Patients name
CS prescribed
Prescribers signature
What three situations can a schedule 2 prescription be faxed to a pharmacy?
Home infusion pharmacies
Resident of LTCF
Written for hospice pt
Can you refill a schedule 2 prescription?
No
Can a schedule 2 prescription be partially filled?
Yes
What must a pharmacist do when he partially fills a schedule 2 prescription?
Notate quantity supplied on face of written prescription
How long does a pharmacist have to fill the remainder of a partially filled schedule 2 prescription?
72 hours
Can a pharmacist partial fill a schedule 2 prescription if a patient requests it?
No only if the pharmacist is unable to supply the full quantity prescribed
What two situations can a schedule 2 prescription be filled in partial quantities?
Patients in LTCF
Patient with terminal illness
When partial filling a schedule 2 script, what must a pharmacist write on the script? 4
Date of partial filling
Quantity dispensed
Remaining quantity
Identification of dispensing pharmacist
How long are schedule 2 prescriptions for LTCF of terminal illness patients good for?
60 days
When do labeling requirements for schedule 2 prescriptions begin to take affect?
When more than 7 days supply is dispensed at once
The schedule 2 med is in possession of ultimate user
Can schedule 3 4 and 5 prescriptions be electronically prescribed?
Yes
A schedule 3 4 or 5 script can be refilled no more than how many times?
5 times
A schedule 3 4 or 5 prescription can only be refilled 5 times in what time frame?
6 months
Can prescribers orally authorize refills on schedule 3 4 or 5 meds?
Yes
Can you partial fill schedule 3 4 or 5 prescriptions?
Yes
Original prescription info of CS schedule 3 4 or 5 can be transferred how many times according to federal law?
One time
None for mississippi
Pharmacies sharing real time online database may transfer up to how many times a schedule 3 4 or 5 prescription?
Max number of refills allowed
Only who can dispense an OTC schedule 5 controlled substance?
A pharmacist
Who can complete sales of OTC schedule 5 controlled substances?
A non pharmacist
A pharmacist cannot sell more than how much of a codeine containing cough syrup in a 48 hour period?
4 ounces
How old must you be to purchase schedule 5 OTC products?
18 yo
What must be maintained by a pharmacist who’s selling schedule 5 OTC products?
Bound record book
How long must a bound record book be kept for dispensing a schedule 5 OTC product?
At least two years
When a pharmacy transfers a schedule 2 CS to a reverse distributor, what must be accompanied with it?
DEA 222 form or electronic equivalent
What is the max percentage of CS a pharmacy can transfer to another pharmacy without being considered a a distributor?
5 percent
A pharmacist can transfer up to what percent of total CS substances dispensed in a calendar year without getting a wholesaler permit?
5%
Is a 222 form required for transferring schedule 3,4 or 5 CS from one pharmacy to another?
No
Only when do practitioners have to keep records of what CS they prescribe for?
When prescribing for detox and maintenance treatment.
Must maintain inventories of schedule 1 and 2 CS how?
Separate from all others
What must be present in CS prescriptions if not electronically maintained?
Red letter C stamp
An inventory of all CS on hand must be first done when?
When the registrant first engages in manufacturing, distribution, or dispensing
A CS inventory must be done how often?
At least once every 2 years
What schedule of CS must you have an exact count on when conducting inventory?
1 and 2
When must you have exact counts on schedule 3 4 or 5 CS?
When the container holds more than 1000 tablets or capsules
When can a practitioner who is at an institution or hospital prescribe CS under the hospitals DEA registration?
If they allow him too and if they have their own internal code number
Do mid level practitioners receive a DEA number?
Yes
But authority to prescribe CS is decided by state
How must CS be stored when used for research by practitioners and non practitioners?
Securely locked cabinet
What form must be completed in a theft in CS situation?
DEA Form 106
If a shipment disappears of CS, who is responsible for reporting in transit losses of CS?
The supplier
Any recoverable CS after damage or spillage constitutes filling out what form?
DEA Form 41
What provides federal investigation of pharmaceutical thefts and robberies?
Controlled Substance Registrant Protection Act of 1984
What money amount stolen constitutes a federal investigation?
$500
What kind of harm must occur in a pharmacy robbery to constitutes federal investigation?
Significant bodily injury
What sort of commercial must be involved in planning or executing a robbery will constitute a federal investigation?
Interstate or foreign
How many options does one have for filing prescriptions?
3
What is max mg/day of PSE?
3,6
How much can you purchase of PSE in 30 days?
9 grams
All non liquid forms of PSE must be sold how?
In blister packs
NMT 2 doses/unit dose packet
What is max mail order pharmacies can sell to a person in 30 days?
7.5 mg
How must all PSE products be stored?
Behind the counter
Locked display cabinet on selling floor
Do different locations of the same company of pharmacy require individual registrations?
Yes
If there are multiple pharmacies in an institution, do they all require separate registrations with the DEA?
No one covers the whole institution
Controlled substance registrations must be renewed how often I’m Mississippi?
Annually
How much is a CS registration in mississippi?
$50
A physician is not allowed to do what with C2 prescriptions?
Order prescriptions for office use.
Only applies to C2’s
How must a practitioner request a C2 drug for office use?
Using a DEA 222 form
What does the person who has power of attorney write when signing for something?
Registrants name
His/her own name
Words “attorney in fact”
What forms do dispensers fill out to obtain CS?
224
What would make a DEA 222 form unacceptable?
Alterations
Erasing
Change of description
If a supplier cannot completely fill an order from a DEA 222 form, then what can the supplier do?
Endorse the entire order to a different supplier
If the first supplier endorses an order, can the first supplier fill any of the order before endorsing it?
No, just endorse entire DEA 222 order
Are DEA 222 forms transferable to another registrant?
No, specific for each registrant
How long are DEA 222 forms kept?
Minimum of 2 years
When an institutional pharmacy dispensing area is closed and area is available to non pharmacy personnel, where must CS be stored?
Securely locked cabinet
Who can access area of CS storage in institutional pharmacy when dispensing area is closed?
Pharmacist or person authorized by pharmacist
What registrations does mississippi require of reverse distributors?
DEA registration
MBOP registration
What must be filled out to destroy controlled substances?
DEA form 41
What DEA form 41 aka?
Inventory of drugs surrendered by destruction
If a drug changes schedules, do you have to do an inventory of it the day it changes schedules?
No only if it goes from not scheduled to scheduled
Mississippi wants another inventory of CS when what events occur? 3
Change in ownership
Change in PIC
Pharmacy is permanently closed
Every facility permitted by the MBOP must complete CS inventories how often?
Annually
How soon must you alert MBOP of remaining CS within discovery of CS loss?
Within 48 hours
Directly report missing CS to MBOP when?
Immediately
Must provide MBOP with written report of CS lost within how long of discovery?
Within 15 days
For codeine to be schedule 3, it may not exceed what g/100mL?
1.8 g/100mL
For codeine to be schedule 3, it must not contain how many mg/dose unit?
90 mg
Are there any codeine containing products that are schedule 4?
No
For codeine products to be schedule 5, it may not exceed what mg/100mL?
200mg
What schedule in mississippi are ephedrine / PSE containing products?
3
What are butalbital containing products scheduled in MS?
Schedule 4
What schedule is tramadol in Mississippi?
4
Who is given a DEA registration number?
Dispensers including prescribers
What can the first letter of a DEA number be?
A B X or M
What is the second letter of a DEA number?
First letter of last name
How many numbers are in a DEA registration number?
7
Do all people authorized to prescribe CS have a DEA registration number?
No
What is required in Mississippi for filling a c2 prescription?
Hard copy unless in an emergency
What does mississippi law say about how long you can fill a c2 prescription?
Cannot be filled 6 months after date of issuance
When is a prescription for a stimulant not valid?
When written for the treatment of obesity
What three things cannot be changed on a c2 script by the pharmacist?
Patients name
Drug name
Signature of practitioner
Can a pharmacist partially fill an emergency c2 script if they are short the med?
Yes
How soon does Mississippi regulations say a pharmacist has to complete a partial fill of a c2?
50 days
No more than how many sales of a OTC C5 in any 7 day period?
2 sales
No more than how many sales of an OTC C5 in any 30 days?
3 sales
Can additional sales of an OTC C5 be made past the 3 sales per 30 days limit?
Yes if the person has a prescription for it
How does MBOP say prescriptions should be filed?
Assigned a serial number
Maintained in numerical and chronological order
Kept for at least 6 years from dispensing
When are red C’s required for filing controlled substance prescriptions?
When C3 thru C5 prescriptions are mixed in a file with any other prescriptions
Can an agent of a prescriber manually sign a CS prescription for the prescriber?
No
When can c2 prescriptions be taken over the phone?
During emergency situations
What is the emergency time frame allowed for pharmacists to fill an emergency prescription in Mississippi?
48 hours
What kind of prescription must a practitioner get to the pharmacist for an emergency fill?
Written and signed
What two things must be written on the face of the covering prescription?
Authorization for Emergency Dispensing
Must be dated for date of emergency authorization
Can an authorization of an emergency c2 prescription be faxed in?
No only by telephone
What two situations can a c2 prescription be faxed in and serve as an original prescription?
For LTCF patient
For compounding for direct administration
Can a supplier endorse an order from an electronic order?
No
What must a purchaser do after receiving an CS order?
Record amount and date received
