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Pharmacy Law > Controlled Substances > Flashcards

Controlled Substances Flashcards

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1
Q

What defines a practitioner?

A
  • physician, dentist, vet, podiatric physician who holds a license to practice his profession in this state
  • advanced practitioner of nursing certified by state board of pharmacy/nursing authorizing him to dispense and/or prescribe CS
  • scientific investigator, pharmacy, hospital, other institution licensed
  • euthenasia tech licensed by NV state board of Vet Medical examiners
  • physician who holds license from board of medical examiners and authorized by board
  • PA
  • optometrist, within his scope of practice
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2
Q

Limitations of an optometrist

A

can prescribe if
has seen the pt and examined for the med
medication should only be for 72 hours
unable to refill

cannot prescribe analgesic of hydrocodone, codeine, or propoxyphene

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3
Q

directions for use

A

specify dosage
frequency
manner it is to be taken or applied

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4
Q

Registration

A

every practitioner who dispenses any CS

NOT required:
employee of registered dispenser
warehouse/man
ultimate user
physician (DO) who has a temp license and is registered with the DEA at another location
sales office who only displays
lawful distribution only for sample, not sale

need separate registrations for these:

  • manufacturing
  • distributing
  • dispensing, prescribing, conducting research, etc from CII-V
  • conducting research with any narcotic for rehab purposes
  • research and instructional activities with any CI
  • conducting chemical analysis of any schedule

certificate must have:

  • name, address, reg #
  • schedules of CS authorized to handle
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5
Q

dispensing of controlled substances

  • record keeping
  • record keeping of CII
A

records must contain:

  • name of pt
  • address if not RA
  • name, strength, quantity dispensed
  • date dispensed
  • name of PP and classification of license
  • DEA # of PP
  • initials of dispensing practitioner (DP) of not the same as PP
  • directions for use
  • sig of PP
  • CII files must be kept separate from other CS and dangerous drugs
  • locked/secured
  • clearly labeled packaging container of dispensed CS
  • package complies w/ all state and federal law
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6
Q

dispensing CII in emergency

A

oral authorization from prescribing practitioner if
-ltd to amt to treat pt during emergency period

pharmacist then:

  • reduces rx to writing, contains all info minus the signature
  • “authorization for emergency dispensing” and date of the oral order
  • within 72 hours: prescribing practitioner must give a written rx to dispensing rph. rph then attaches this to the oral emergency rx
  • rph reports if doctor fails to give this written rx
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7
Q

restrictions on CS rx

A

not for office use in large quantity

not issued for dependent pt for dependence

administering or dispensing is ok if for clinical trial or weening off addiction

III, IV, V – can all be faxed

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8
Q

ICD-10

A

tells you what the medication is for (indication)

ie: back pain

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9
Q

unlawful acts

A
  • only dispense for who its for
  • can request proper ID from person requesting CS
  • must not fill of shows evidence of alteration
  1. A pharmacist shall not fill a prescription for a controlled substance classified in schedule II unless it is tendered on or before the 14th day after the date of issue.

the day following
ex: if today is the 5th, it is good through the end of day on the 19th

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10
Q

content of rx

A
  • name of prescribing practitioner
  • ^ address
  • date prescription was issued MM/DD/YYYY
  • full name and DOB of pt
  • ^ address if not immediately available to RPh or pharmtech
  • name, strength, and quantity
  • directions for use
  • day supply (fewest number of days necessary to consume, determined by dr)
  • ICD-10 that corresponds to diagonosis
  • classification license of prescribing dr
  • DEA # of dr
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11
Q

a pharmacist cannot change or add on CII

A

The name of the patient;
The name of the controlled substance prescribed, may change the name to reflect the generic name of the controlled substance if the pharmacist substituted; or
On a written prescription, the signature of the prescribing practitioner.

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12
Q

the pharmacist CAN change or add to CII

A

Initial any addition or change made under 7a; and
Make a notation on the prescription of:
The date and time that the prescribing practitioner approved the addition or change; and
The reason for the addition or change.

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13
Q

what can a pharmacist change on a written rx of CS?

A
  • strength
  • quantity
  • directions for use;
  • date that the prescription was issued;
  • days supply of the drug prescribed;
  • ICD-10 code that corresponds to the diagnosis for which the drug is prescribed; and
  • date of birth of the patient
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14
Q

a pharmacist CANNOT change or add on CII

A

-name of the patient;
-drug name of the controlled substance prescribed
( may change the name to reflect the generic name of the controlled substance if the pharmacist substituted); or
-on a written prescription, the signature of the prescribing practitioner.
-DEA

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15
Q

the pharmacist SHALL change or add to CII

A
  • initial any addition or change allowed; and
  • make a notation on the prescription of:
  • the date and time that the prescribing practitioner approved the addition or change; and
  • the reason for the addition or change.
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16
Q

Do Not Fill Until CIIs

A

only have 30 days from date written to get partial fills

  • date indicated must not be later than 3 months from date prescription was written
  • rx must be tendered to on or before 14th day after date indicated
  • may not exceed 90 day supply
  • cannot be combined rx w/ another CS or dangerous drug
17
Q

prescriptions for schedule II CS

A
  • rx blank can have more than one CII, other CS, other dangerous drugs
  • if multiple, must make copies of rx for each drug – must include serial number of rx CII and attached all serial numbers onto the first CII prescription
18
Q

pseudoephedrine

amount to be dispensed

A

3.6 - for 1 day
7.5 - by mail order
9 - for 30 day supply

19
Q

partial filling of CS rx

pharmacist may partially fill rx for CII if

and must keep on record of

may refuse to fill or partially fill any rx for a CS listen in;

A
  • requested by pt or PP and total quantity of CS dispensed does not exceed total quantity prescribed
  • remaining portion may be filled within 30 days of the day the rx was written
  • in emergency: remaining portion must be filled within 72 hours after rx was issued
  • if LTCP or terminally ill
  • pt is LTC pt or terminally ill
  • date of partial filling
  • quantity of med dispensed
  • remaining quant authorized to be dispensed
  • signature or initials of RPh must be recorded on back of rx
  • CII more than 30 days after the date the prescription was written
  • CIII, IV, V more than 6 months after the date the prescription was written
20
Q

partial filling of CS rx

pharmacist may partially fill rx for CII if

and must keep on record of

may refuse to fill or partially fill any rx for a CS listen in;

A
  • requested by pt or PP and total quantity of CS dispensed does not exceed total quantity prescribed
  • remaining portion may be filled within 30 days of the day the rx was written
  • in emergency: remaining portion must be filled within 72 hours after rx was issued
  • if LTCP or terminally ill
  • pt is LTC pt or terminally ill
  • date of partial filling
  • quantity of med dispensed
  • remaining quant authorized to be dispensed
  • signature or initials of RPh must be recorded on back of rx
  • CII more than 30 days after the date the prescription was written
  • CIII, IV, V more than 6 months after the date the prescription was written
21
Q

A doctor has checked a pre-printed box on a prescription that states “Dispense as Written”. The prescription is faxed to the pharmacy for a non-controlled medication. Is the pharmacist required by law to dispense the generic if it is less expensive than the brand name medication prescribed the doctor?

A

yes, if the pt is informed that the generic is being dispensed

yes, if the pt is part of government program

( checking a box means nothing in nevada )

22
Q

partial filling of CS rx

pharmacist may partially fill rx for CII if

and must keep on record of

may refuse to fill or partially fill any rx for a CS listen in;

A
  • requested by pt or PP and total quantity of CS dispensed does not exceed total quantity prescribed
  • remaining portion may be filled within 30 days of the day the rx was written
  • in emergency: remaining portion must be filled within 72 hours after rx was issued
  • if LTCP or terminally ill
  • pt is LTC pt or terminally ill
  • date of partial filling
  • quantity of med dispensed
  • remaining quant authorized to be dispensed
  • signature or initials of RPh must be recorded on back of rx
  • CII more than 30 days after the date the prescription was written
  • CIII, IV, V more than 6 months after the date the prescription was written

-partial filling of CII does not count as a refill until the fill has been completed

23
Q

NARCOTICS:

do not dispense until 11/06/2018

when is the last possible date the pt can tender this rx to a pharmacy?

A

11/20/2018

24
Q

When is it required by law that a pharmacist dispense the brand name product and not its generic equivalent?

A

When the patient requests it

When the doctor writes “brand medically necessary” on a precription

When an electronic prescription has the words “Dispense as written” on it

When the doctor orally requests brand name for the patient over the phone

25
Q

NARCOTICS:

do not dispense until 11/06/2018

when is the last possible date the pt can tender this rx to a pharmacy?

A

11/20/2018

14 days from do not dispense date

-can only have the one drug on the do not dispense prescription

Pharmacy Law (3 decks)

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