CS G Flashcards
Incomplete CS Prescriptions
If missing the RPh may obtain orally from the PR:
Prescriber’s DEA number,suffix #
Prescriber’s name (institutional blank only), telephone #
Drug strength, directions,MDD
Information may not be filled in for these items:
Date
Controlled substance name
Name of user
Prescriber name
Changes to CS Prescriptions
PR may verbally authorize changes to Rx.
Provide Reason for the change
Items that can be changed:
Prescriber’s DEA number,suffix #
Prescriber’s address, telephone #
Patient’s address, age, sex
Drug strength, directions,MDD,quantity
DAW
Codes
Items that may not be changed:
Practitioner signature
Date
Controlled substance name and quantity
Name of prescriber
What happens when quantity is changed on rx
If a quantity is changed on an ONYSRx the remaining quantity on the ONYSRx is void.
Does not apply to out-of-stock situations
ONYSRx Written RXs Schedule II, Anabolic Steroids, Benzodiazepines: Partial Fill
A pharmacist may only partially fill an ONYSRx under the following circumstances:
1. Out of stock situation
Make a note on the face of written Rx or written record of the emergency oral Rx
Remaining amount must be filled within 72 hours of the first filling
If you can not fill the remainder then you must notify practitioner
No further quantity may be supplied beyond the 72 hours
- Terminally ill patient
- Resident in a Residential Health Care Facility (RHCF)
Record on the ONYSRx that the patient is
Terminally ill or
RHCF patient
Record on the back of the ONYSRx
Date of partial filling
Quantity dispensed
Quantity remaining
Signature of dispensing pharmacist
The ONYSRx shall be valid for a period of not exceeding 30 days from the date the ONYSRx was issued by the practitioner unless
Terminated sooner upon notification from the practitioner
All partials must be filled within 30 days of the date written.
The date of the filling on the face of the prescription shall be the date when the Rx
Filled to completion
Notified by practitioner that it was discontinued
Submit to DOH as usual.
If the partial fillings of the prescriptions issued for more than a 30 days supply for patients residing in a RHCF or Hospice must occur within 60 days from the date on the prescription.
Schedule III, IV, V Written
- Manner of issuance same as before
Patient’s name
address
age
if animal, then name and address of owner
Prescriber
printed name
signature
address
DEA
Telephone number
Specific directions for use including but not limited to: dosage, frequency and MDD
Other requirements as NON controlled
Substitution
- Missing Information/changed info: same as previous
Days supply
PR write max 30 day supply
EXCEPTIONS:
MAY WRITE FOR up to 3MONTH SUPPLY OF DRUGS FOR:
- Panic disorders Code A
- ADHD Code B
- Chronic debilitating neurological conditions characterized as a movement disorder or exhibiting seizure, convulsive or spasm activity. Code C
- Relief of pain in patients suffering from diseases known to be chronic and incurable. Code D
- Narcolepsy Code E
Dispensing III,IV,V
Must endorse the original filling on the FACE of the prescription:
Date of filling
Serial number of RX
Signature of Pharmacist
Substitution la
Refills
May only be refilled if authorized on RX
Not more than the number authorized
limited to a maximum of 5x or 6 months from date of issue. whichever is first
More than a day supply (exceptions)?
RX may be refilled only ONCE
No oral authorization may be given by PR
No written RX may be refilled earlier than 7 days prior to the date that previous supply would be exhausted.
interpretation: PR may authorize an earlier refill.
What about vacations? OPTIONS:
At the end of 5 refills / 6months…you need a new RX
RXs that indicate to refill an RX number are not allowed: e.g. “refill Rx # 234543
When refilling RX, RPH must indicate on BACK:
Date of refilling, signature, amount dispensed
RPh must sign off the first refill, but it is not required for remaining refills
Not required for eRx
Partial Refills
Partial refills are allowed by Education Law: Federal & State
Schedule III,IV and V Verbal or Fax to Fax
Only a PR may phone in a C.S. to a RPH
NOT AN AGENT!
Meets the manner of issuance of written C.S. RXs
Patient’s name, address etc
Meets the labeling of written C.S. RXs
Reduced immediately to writing and oral order is labeled “TELEPHONE ORDER”
Verbal Orders Fax to Fax Schedule III,IV,V
Contemporaneously reduced to writing
Telephone Order
No refills
File in III, IV, V file
Follow up 72 hours
Identify practitioner and patient
Date filled
RPh’s signature (intern + RPH)
Serial number of the RX
Quantity limitations:
Schedule III and IV : Can be refilled five times within a six month period
Schedule V: Refilled five times within six months, Federal only controlled fives prescriber can prescribe as many tablets as possible (ex. 500 tablets) AND can give samples, along with nurses being able to call the script in
Within 72 hours after telephone order, the PR must deliver to RPH a follow up EXACTLY covering oral order
• Not receive a follow up? • RPH shall record on telephone order
RPH endorses on the FACE of the follow up: RPH signature Date of filling RX number Statement this is follow up to prior order.
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Pharmacies must submit to the DOH BNE all original fillings of all controlled substance prescriptions, including out-of-state controlled prescriptions
Must be done electronically
Within 24 hours
Within 14 days for zero filling of CS
Federal Controlled ONLY
CII’s
Dronabinol oral solution (Syndros)
Olicerdine (Olinvyk)
CIII’s
Perampanel (Fycompa) 40
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)
DEA Rules Federal III or IV only (NYS = noncontrolled
May dispense.
Written or electronic or verbal or fax
Written/fax must be on Rx and signed
You may dispense what the physician wrote for.
Must sign, date
File in III, IV, V file
Up to 5 refills/6months
For CIII and CIV only
DEA Requirement and BNE
Must printout a daily log
The printout must be provided to each pharmacy that uses the computer system within hours of the date on which the refill was dispensed.
The printout must be verified and signed by each pharmacist who dispensed the refills.
In lieu of such a printout, the pharmacy must maintain a bound logbook or a separate file in which each pharmacist involved in the day’s dispensing signs a statement, verifying that the refill information entered into the computer that day has been reviewed by him/her and is correct as shown.
