E2 Lecture 5 Flashcards
Requirements for Issuing Multiple C-II Prescriptions
- prescription must be issued for a legitimate medical purpose by a prescriber acting in usual course of practice
- prescriber must date the prescription with the date it was issued and provide written instructions on each prescription indicating the earliest date the pharmacy can fill prescription
- prescriber decide that providing multiple prescriptions to a patient does not create a risk for diversion or abuse
- issuance of multiple prescriptions must be legal in the state they are prescribing in
- all prescriptions must meet the requirements for C-II prescriptions
Limit Day Supply of Multiple C-II Prescriptions
90 day supply
Refill Documentation Requirements
- name and dosage form of controlled substance
- date filled or refilled
- quantity dispensed
- initials of dispensing pharmacist
- total number of refills for prescription
RETRIEVED VIA PRESCRIPTION NUMBER
Refill Documentation via Computerized Application Requirements
- original prescription number
- date of issue
- name and address of patient
- name, address, and DEA of prescriber
- name, strength, dosage form, quantity prescribed
- refills authorize
- refill history
Refill Documentation via Computerized Application Recordkeeping Requirements
- print out all controlled substance refills with information of the pharmacist who filled prescription
or
- maintain a bound logbook each pharmacist involved in dispensing shall sign each day attesting to the fact that the refill information entered has been reviewed and correct
C-II may be partially filled if:
- it is not prohibited by state law
- patient, patient representative, or prescriber requested the partial fill
- total quantity dispensed by all partial fillings does not exceed the total quantity
- remaining portions are filled no later than 30 days after the prescription was written
3 General Partial Fill Rules of C-II Prescriptions
- If requested by the patient, patient representative, or prescriber, we can partially fill for up to 30 days from the date the prescription was written as long as the amount of the prescription isn’t exceeded
- If the patient is in a LTCF or terminal ill, we can partially fill for up to 60 days from the date written unless the medication is discontinued. Must not “LTCF” or “terminally ill” on face of prescription
- If partial fill for any other reason, you can partially fill the prescription but the remaining portions must be ready for pickup in 72 hours. If you cannot do that, the remaining portions are voided, and you most notify the prescriber of the partial fill and the patient will need a new prescription
Emergency Situation
- immediate administration of controlled substance is necessary for proper treatment
- no appropriate alternative available (including non-controlled)
- not possible for the prescriber to provide a written prescription before dispensing the medication
ALL 3 MUST BE MET
Within how many days does the prescriber have to call in a covering prescription?
7 days
Covering Prescription
meet C-II prescription requirements
+
“authorization for emergency dispensing”
How must the covering prescription be given?
delivered in person
or
postmarked within 7-day period
or electronic
CENTRAL FILL PHARMACIES CANNOT FILL EMERGENCY PRESCRIPTIONS
CENTRAL FILL PHARMACIES CANNOT FILL EMERGENCY PRESCRIPTIONS
Requirements for Written C-II Prescription that Pharmacist sends to Central Fill location
“Central Fill” on face of prescription
name, address, and DEA of central fill pharmacy
name of pharmacist transmitting prescription
date of transmittal
Requirements for Electronic C-II Prescriptions that Pharmacist sends to Central Fill location
name, address, and DEA of central fill pharmacy
name of pharmacist transmitting prescription
date of transmittal
Storage for Local Retail Pharmacy
original prescription
record of receipt
date of receipt
method of delivery
employee accepting delivery
Storage for Central Fill Pharmacy
copy of prescription
name, address, and DEA of retail pharmacy
date prescription was received
name of pharmacist who filled prescription
date the prescription was filled
date the prescription was delivered to retail pharmacy
delivery method
What is added to retail pharmacy if C-III, C-IV, C-V
number of refills already dispensed
refills remaining
What is added to central fill pharmacy if C-III, C-IV, C-V
dates the prescription was filled AND refilled
C-II Prescription Requirements on Amber Vial
date of filling
dispensing pharmacy name and address
prescription number
name of patient
name of prescriber
directions for use
cautionary statements if any
ADD COMMUNITY PHARMACY NAME & ADDRESS + CENTRAL FILL DEA –> IF CENTRALLY FILLED
C-III, C-IV, C-V Prescription Requirements on Amber Vial
date of filling
dispensing pharmacy name and address
prescription number
name of patient
name of prescriber
directions for use
cautionary statements if any
ADD COMMUNITY PHARMACY NAME & ADDRESS + CENTRAL FILL DEA –> IF CENTRALLY FILLED
When do label requirements not apply to C-II prescriptions in institution?
as long as no more than 7-day supply of medication is dispensed at one time
When do label requirements not apply to C-III, C-IV, C-V prescriptions in institution?
as long as no more than 34-day supply of medication
or
no more than 100 dosage units are dispensed at one time
