Controlled Substances Part 3: Prescribing and Dispensing Flashcards
Which controlled substance schedules (if any) can each type of mid-level practitioner prescribe?
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.
List the schedules of drugs collected in the state’s prescription drug monitoring program (PDMP).
Schedules II - V
In what timeframe must a pharmacy submit the records of dispensed controlled substances to the state’s PDMP?
No later than the next business day
Which healthcare professionals are authorized to access the prescription drug monitoring program (PDMP)?
Prescribers and pharmacists and individuals they delegate access to.
Is there a limit to the number of medications that can be written on one prescription form?
Schedule II drugs: One per official prescription form
Schedule III - V and non-controlled drugs: No limit
Other than prescriptions for Medicaid patients, what prescriptions require tamper-resistant security forms?
Schedule II drugs
What security elements must be present on tamper-resistant security forms?
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)
What changes can be made, at the pharmacist’s discretion, to schedule II prescriptions?
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.
What changes can be made, at the pharmacist’s discretion, to schedule III - V prescriptions?
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)
What is the time limit (i.e., days/months) that a schedule II prescription must be filled from the date of issue?
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.
Can controlled and non-controlled drugs be written on the same prescription form?
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.
Is there a maximum quantity or days’ supply that a patient can receive of a schedule II drug?
Prescriptions for schedule II drugs cannot exceed a 90-day supply with the exception of opioids for acute pain, which cannot exceed a 10-day supply.
Are partial fills for schedule II prescriptions permitted at the request of the patient or prescriber?
Yes
Are there any additional requirements for an emergency oral schedule II prescription compared to federal law?
No, Texas follows the federal law.
What is the time limit (i.e., months) that schedule III - V prescriptions must be filled from the date of issue?
6 months
