CS F Flashcards
Q
A
What controlled substances can be filled?
How many systems are allowed
Schedule 2
Schedule 3,4,5 c(including benzos)
Non controlled (including syringes and needles)
NYS practitioners have to be registered with ____ to receive ONYSRx’s
BNE (even if they prescribe only non-controlled substances)
Who needs a DEA number to register or order ONYSRx?
Non-practitioners (Practitioners not required)
Who can issue ONYSRx’s?
Registered practitioners (BNE)
Facilities duly registered with the department to be issued ONYSRx
Practitioners working for these facilities (staff practitioner)
Renew registration every 2 years
Diversion of drugs
Possession, delivery or use of a drug or a prescription by a person in a manner not specifically authorized by law.
Do all prescriptions written in NYS have to be issued upon an ONYSRx
Yes! Controlled and non-controlled
Identity of person picking up/ delivering prescription
pharmacy shall make a good faith effort to verify the identity of any person accepting delivery or a dispensed prescription for a controlled substance by requiring such person, if unknown to the pharmacy, to present appropriate identification.
Who can use issued ONYSRX’s
ONYSRx’s may only be used by the practitioner to whom they are issued
ONYSRx’s issued to a facility
Staff practitioners may use but must imprint or stamp their name.
ONYSRx’s:
Time
Facility close
Practitioner dies
ONYSRx’s are valid only for a limited time
Forms must be returned to BNE
Responsibility of the estate or lawful designee to return forms to BNE
ONYSRx’ forms:
Safety
Whose responsibility is it?
When to report to BNE?
What needs to be recorded?
How do forms need to be treated when they are not in use?
What to do if a practitioner is fired?
Adequate safeguards against: Loss, Destruction, Theft, Unauthorized use/diversion of drugs due to unauthorized use
Responsibility of the practitioner and registered facility
Practitioners shall immediately notify the department: loss, destruction, theft or unauthorized use, failure to receive official New York State prescription forms within a reasonable time after ordering them from the department.
Record of all forms received
Record forms assigned to practitioners
System requiring security of the forms when not in use
System to surrender forms if practitioner is terminated from the facility
System whereby the facility has a reserve quantity of ONYSRx’s
Practitioner stickers on ONYSRx
Stickers of any kind (patient name, drug name, prescriber name etc) not allowed anymore
Can pharmacists use sticker? Yes of patient’s info
Is photocopy of ONYSRx required?
No if at min. The PR keeps the name of CS & Quantity in chart
How long do ONYSRxs records need to be kept for?
5 years (HIPAA)
How must quantity prescribed & no. of refills be stated on prescription?
Must be indicated in numerical AND written word form
How must prescriptions be written for controls for ONYSRx? Days supply, refills
Schedule 2, anabolic steroids, benzodiazepines
Only 1 Rx per blank
Not transferable
Cannot be refilled
Max 30 days supply (cannot fill if prescription exceeds 30 days)
No refills
7 day rule
The amount of drug must be used up so there is only a 7 day supply left
Multiple prescriptions of C2 Federal: Conditions
May issue multiple prescriptions authorizing the patient to receive a total of up to a 90-day supply of a schedule II controlled substance provided the following conditions are met:
Each separate prescription is issued for a legitimate medical purpose by an individual practitioner acting in the usual course of professional practice.
The individual practitioner provides written instructions on each prescription (other than the first prescription, if the prescribing practitioner intends for that prescription to be filled immediately) indicating the earliest date on which a pharmacy may fill each prescription.
The individual practitioner concludes that providing the patient with multiple prescriptions in this manner does not create an undue risk of diversion or abuse.
The issuance of multiple prescriptions is permissible under applicable state laws.
NYS SAYS NO!
The individual practitioner complies fully with all other applicable requirements under the Controlled Substances Act and Code of Federal Regulations, as well as any additional requirements under state law.
Exceptions to 30 day rule: conditions
30 day/ up to 3 months (condition codes A to E)
30 day/ up to 6 months (codes F)
Condition or code must be on face of prescription
No refills
Must write for/ fill entire quantity at once
Partially fill a prescription with a code on it: Not allowed except for hospice or nursing home
Code A, B, C, D, E, F
Code A: Panic Disorders
Code B: ADHD
Code C: Chronic debilitating neurological conditions characterized as a movement disorder or exhibiting seizure, convulsive or spasm activity
Code D: Relief of pain in patients suffering from diseases known to be chronic and/ or incurable
Code E: Narcolepsy
Code F: Hormone deficiency states in males, gynecologic conditions that are responsive to treatment w/ anabolic steroids or chorionic gonadotropin, metastatic breast cancer in women, anemia, angioedema
Endorsement of ONYSRx
Signature of prescriber
His/ her signature
The date of filling
No. of prescription under which it is recorded in the pharmacy prescription file
Substitution law: pharmacists can substitute without informing the patient.
Quantity if different
Emergency administration/ prescription (sched. 2, anabolic steroids, benzodiazepines): conditions
Immediate administration
No appropriate alternative
Not possible for PR to present written Rx to patient prior to dispensing
All 3 of these conditions must qualify
Quantity prescribed and dispensed does not exceed 5 day’s supply
Any amount beyond 5 days must have a new written Rx
Must reduce oral order to writing (memoranda)
(F = immediately)
Contain all the required information of written RX except signature of PR.(F)
“Telephone Order”
Memoranda is filed with Schedule II file (if a CII) or in the Schedule III, IV,V file if a benzodiazepine
RPH indicates on FACE of Telephone order: RPH’s signature
Date filled
Serial Number of RX
Substitution law
Quantity if different
Prescriber must within 72 hours: deliver an original ONYSRx to RPH covering oral order.
EXACTLY COVER
ONYSRx or electronic follow up must conform to all other legal
Requirements: must have statement: “Authorization for emergency dispensing”
Emergency administration/ prescription (sched. 2, anabolic steroids, benzodiazepines): follow up
If you receive follow up:
RPH endorses original
Date of delivery
RPH signature
DEA number of pharmacy
Attaches original to telephone order in the Sch II file or III, IV V file.
Must transmit the information to the BNE.
Only the PR may phone in for emergency authorization. NOT AGENT!
DEA Rules Federal Only CS Drugs - NYS Noncontrol
May dispense what the physician wrote for. Verbal/fax you may dispense what the physician wrote for
To cover the emergency situation:
Must sign, date
File in II file
NO Refills
Follow up must occur within 7 days
Must be inventoried at the time of initial scheduling.
Note: It may go on NYS Scheduling at any time.
Practitioner may give samples
Nurse (or agent) may phone in the prescription
Federal Controlled
ONLY CII’s
Dronabinol oral solution (Syndros)
Olicerdine (Olinvyk)
CIII’s
Perampanel (Fycompa)
CIV
Alfaxalone (Alfaxan)
Brexanolone (Zulresso)
Eluxadoline (Viberzi)
Lemborexant (Dayvigo)
Locaserin (Beviq)
Solriamfetol (Sunosi)
Suvoresant (Belsomra)
CIV Benzodiazepine
Remimazolam (Byfavo)
CV
Brivaracetam (Briviact)
Cenobamate (Xcopri)
Lasmiditan (Reyvow)
Prescription for any quantity of condition codes: how must they be prescribed
Must be either a written Rx or an e-Rx
Cannot be verbal
