Errythang Else Flashcards
(110 cards)
1
Q
verifying DEA for a physician, what will the first letter be?
A
first letter: A, B, F, or G
2
Q
verifying DEA for a mid-level practitioner, what will the first letter be?
A
first letter: M
3
Q
2nd letter when verifying DEA
A
first letter of his / her last name
4
Q
DEA number is composed of
A
2 letters and 7 numbers
5
Q
Verify the DEA number AB2648612
A
Add 1st, 3rd, and 5th (=12); add 2nd, 4th, and 6th, and multiple by 2 (=15*2=30); add these together (30+12=42); the last digit here (2) should be the same at the last digit in the DEA number
6
Q
Do hospital pharmacies need to register with the DEA?
A
No. They are covered under the hospital DEA number
7
Q
Hospital pharmacies are considered
A
institutional practitioner
8
Q
individual practitioners may dispense controlled substances if
A
permitted by state law (MDs, PAs, NPs)
9
Q
no CII rx shall be dispensed more than “BLANK” after the date the rx was issued
A
6 months
10
Q
schedule II rx’s are allowed refills?
A
no
11
Q
CII’s can only be prescribed via
A
written or electronic rx
12
Q
true / false: there is no quantity limit per federal law on CII’s
A
true
13
Q
how long does the provider have to supply to the pharmacy a written / signed emergency rx for a CII?
A
7 days (may be mailed or sent electronically)
14
Q
for partial fills, RPH must record
A
date of partial fill, quantity dispensed, quantity remaining, ID of dispensing RPH (either on back of rx or recorded in computer)
15
Q
Partial fill time clocks
A
pharmacy unable to supply (72 hours from partial fill); pt requests partial (30 days from when rx was written); terminally ill pt (60 days from when rx was written)
16
Q
targeted controlled substances
A
refers to any schedule II opioid and select schedule III opioids (buprenorphine and codeine combo products)
17
Q
prescribing requirement for targeted controlled substances
A
must be issued electronically
18
Q
board of pharmacy is composed of….
A
6 members (5 licensed pharmacists and 1 public representative who is not a healthcare provider)
19
Q
types of discipline the BOP may give (to pharmacist, tech, or pharmacy)
A
issue letter of reprimand; suspension (active / stayed / summary); restrict; revoke; refuse to grand or renew a license; require the licensees to successfully complete remedial education
20
Q
Pharmacist license requirements
A
complete BOP form; pay the required fees; submit criminal record report; graduate form approved pharmacy school; pass NAPLEX and MPJE; receive 1500 hours of practical experience
21
Q
foreign graduates must
A
pass the foreign pharm graduate equivalency exam (FPGEE); complete 1500 hours; pass the test of English as a foreign language; pass the test of spoken English; pass NAPLEX / MPJE
22
Q
out of practice up to two years need
A
15 hours of CE for each year out of practice, 5 of which must be live; take and pass the MPJE
23
Q
out of practice > 2 and < 5 years need
A
500 hours of internship from a NC licensed pharmacist; 15 hours of CE for each year out of practice, 5 of which must be live; take and pass the MPJE
24
Q
out of practice > 5 years need
A
1500 hours of internship from a NC licensed pharmacist; take and pass the NAPLEX and the MPJE
25
pharmacist license renewal date
December 31st with a 60 day grace period (same for techs)
26
How many days do pharmacists and techs have to report a change of address / name / place of employment to the BOP?
30 days
27
How many days does the new pharmacist manager have (after they take over) to complete the required inventory of ALL controlled substance? How long must this record be kept?
10 days; record must be kept for 3 years
28
Pharmacist manager pharmacy presence requirements (for a full service pharmacy, not limited service)
shall be present for at least 1/2 of the hours the pharmacy is open or 32 hours a week (whichever is less); 20 hours per week for limited service
29
how long can a pharmacy operate without a permanent or a temporary pharmacist-manager?
no longer than 30 days
30
how long can a pharmacist serve as a temporary PM? how many hours per week do they need to be present?
no more than 90 days; must be present at least 20 hours per week
31
PM shall notify the BOP of any change in pharmacy personnel within...
30 days
32
When a pharmacy is closing permanently, the pharmacy must return the permit to the BOP within BLANK days of closing.
10 days
33
When a pharmacy is closing permanently, if possible, provide the public with BLANK days notice. How many days must they keep the sign posted after the closing date?
30 days; 15 days
34
Pharmacy permits expire annually on.... and are considered lapsed if not renewed by....
December 31st; march 31st (after which they must re-apply
35
Each pharmacy permit identifies:
the PM and all pharmacy personnel
36
Pharmacy permits are issued pursuant to a joint application by:
the owner and the PM
37
Pharmacy permits are not valid until....
signed by the PM
38
For mail order pharmacies, each container of dispensed drug must contain:
a toll-free number to facilitate communication between patients and pharmacists
39
True or false: technicians must be CERTIFIED to receive called-in prescriptions or call for refill authorizations
true
40
certified pharmacy techs have done the following:
passed a nationally recognized pharmacy technician certification board exam; obtains and maintains that certification
41
Non-certified pharmacy techs have done the following:
have a high school diploma or its equivalent (may also be currently enrolled in a program which awards one); must complete a required training program provided by the supervising PM
42
how many days does a non-certified pharmacy tech have to complete his / her training program?
must be completed within 180 days of the date the pharmacy tech began employment
43
Tech to pharmacist ratio
2:1
44
If the pharmacist petitions the BOP to increase the tech to pharmacist ratio (and it is approved), then the following must be true:
additional pharmacy techs must be CERTIFIED
45
Schedule I drug examples
marijuana (federal law), LSD, peyote, mescaline, heroin, bath salts
46
True / false: Schedule I drugs have no accepted medical use
true
47
In terms of dependence, schedule II drugs may lead to.....
severe physical or psychological dependence; high potential for abuse
48
In terms of dependence, schedule III drugs may lead to...
moderate / low physical dependence or high psychological dependence; potential for abuse is less than that of schedule II
49
In terms of dependence, schedule IV drugs may lead to...
limited physical or psychological dependence relative to schedule III's
50
In terms of dependence, schedule V drugs may lead to...
limited physical or psychological dependence relative to schedule IV's
51
NC controlled substance schedule VI
no currently accepted medical use; low potential for abuse and psychic / physiological dependence; need further studying; examples: marijuana and tetrahydrocannabinols
52
when can a NC schedule VI drug be dispensed?
only for scientific or research purposes
53
Hemp extract
considered a NC schedule VI; may only be used by a person with intractable epilepsy (and the hemp must be acquired in another jurisdiction)
54
True / false: every entity that handles controlled substances must be registered with the DEA or be exempt
true
55
The following are exempt from registering with the DEA:
agents / employees of registrants; drug reps; common carriers; ultimate users; law enforcement officers; prescribers and dispensers in the service of the US government
56
practitioners do not need more than one DEA registration for controlled substances if they prescribe from multiple offices UNLESS
they are administering, storing, or dispensing controlled substances in each office
57
practitioner requirements for providers who are agents or employees of a hospital that is registered with the DEA and dispense / prescribe controlled substances using hospital's DEA:
dispensing / administering / prescribing is done in the usual course of his / her practice; practitioners are authorized to do so within the state; the institution has assigned a specific internal code number to the practitioner
58
Manufacturers and distributors must renew their DEA registration
annually
59
dispensers (aka pharmacies) and practitioners must renew their DEA registration
every 3 years
60
true / false: ophthalmologists have their MD
true
61
true / false: optometrists have their MD
false
62
true / false: psychiatrists have their MD
true
63
true / false: psychologists have their MD
false
64
Who can a controlled substance be dispensed to at a retail pharmacy?
the patient or a family member in their household
65
In general, CII's can only be prescribed via
written or electronic prescription
66
how long is a CII prescription valid for after the date the rx was issued?
6 months
67
Emergency for the dispensing of an emergency CII rx is defined as:
1) immediate administration is necessary; 2) no appropriate alternative is available; 3) its not reasonable for the prescriber to provide an rx before the drug is dispensed
68
requirements for an emergency CII to be dispensed:
provider must PERSONALLY call-in the rx; the rx must be reduced to writing by the RPH and contain all the usual necessary info (except for the provider's signature); quantity must be limited to the emergency period
69
How long does the provider have to get a written and signed rx to the pharmacy for an emergency CII dispense?
7 days; if delivered by mail, must be postmarked within the 7 day period; rx may also be sent electronically
70
what must appear on the face of an emergency CII rx?
"authorization for emergency dispense"
71
True / false: the RPH must notify the local DEA office if a real prescription for an emergency CII dispense is not received?
true
72
General rule for faxing CII rx's (not asking for one of the 3 circumstances where fax rx would be valid):
prescriber may fax rx ahead of time so the pharmacy can start prepping it, but the patient must present with a written / signed / original rx to the pharmacy when they pick it up
73
true / false: a faxed prescription for a CII is considered valid
false (unless one of the 3 exceptions)
74
Three instances where a fax for a CII is valid:
1) schedule II NARCOTIC substance to be compounded for direct administration (parenteral / IV / IM / SQ / intraspinal infusion); 2) schedule II SUBSTANCE for a resident of a LTCF; 3) schedule II NARCOTIC substance for a patient in hospice
75
true or false: the prescriber must note "for hospice" somewhere on the rx for a faxed prescription for a CII narcotic
true
76
When partial filling for a CII b/c the pharmacy is unable to supply the full quantity, the remaining portion must be supplied within:
72 hours of the FIRST PARTIAL FILL DATE: note, the patient doesnt have to actually pick it up within 72 hours, but the rx must be ready / available for pick up
77
When partial filling for a CII b/c the pt or prescriber requests it, the remaining portion must be filled within:
30 days from the DATE on which the rx was WRITTEN
78
When partial filling for a CII b/c the pt is terminally ill or a resident of a LTCF, the remaining portion must be filled within:
60 days from the DATE on which the rx was WRITTEN
79
True / false: the RPH must write "terminally ill" or "LTCF" on the rx
true
80
the RPH must record the following for each partial fill for a terminally ill / LTCF patient:
date of partial filling, # dispensed, # remaining, ID of the dispensing RPH (may be written on back of RX or recorded in computer)
81
requirements for a provider to prescribe multiple CII rx's at one time
its for a legit medical purpose; each rx is on a separate prescription; total quantity prescribed doesn't exceed a 90 day supply total (could be 9 rx's for a 10 day supply, 2 rx's for a 45 day supply, etc. No cap on # of RX's, just the total day supply); writes earliest date each prescription can be filled; multiple rx's do not create an undue risk of diversion / abuse
82
CIII-CIV rx's may be prescribed via...
electronic / written / faxed / oral order called into pharmacy; only the pharmacist can take this oral rx; written and faxed rx's must contain the providers signature
83
how long is a CIII-CIV rx valid for? how many times can it be refilled?
6 months from the date it was issued; 5 times (do not confuse refills with partial fills)
84
How long are CV rx's valid for? How many times can they be refilled?
they do not expire; they do not have a limit on the number of refills
85
On-site VISIT requirement for PM for a pharmacy with a limited service permit (certain settings only):
AUX medication inventory: once per calendar quarter
Automated dispensing device: once per calendar quarter
Dispensing by NP or PA: once per week
Dispensing at a county health department by a nurse: once per week
86
On-site HOUR requirements for a PM for a pharmacy with a limit service permit (certain settings only):
Must be present 1/2 hours the pharmacy is open or 20 hours per week (whichever is less).
County health department where someone other than an RN is dispensing medications: licensed RPH must be on site when pharmacy is open
Free / charitable pharmacy: licensed RPH must be on site when pharmacy is open
Critical access hospital pharmacy: may operate in absence of pharmacist
87
Certified pharmacy technician exams include:
Pharmacy technician certification board (PTCB) or exam for certification of pharmacy technician (ExCPT)
88
The pharmacy must be closed if the RPH is not present for BLANK minutes or more
90 minutes
89
These entities renew annually with the DEA:
Manufacturers and distributors
90
These entities renew every three years with the DEA:
Dispensers (pharmacies) and practitioners (prescribers)
91
The term dispenser includes the following three actions:
Prescribing, administering, and dispensing
92
System to record refills for a CIII-CIV prescription must include the following
Name / dosage form of drug; date filled and / or refilled; quantity dispensed; initials of dispensing pharmacist for each refill; total number of refills for that rx
93
When filling out a form 41, the following must be documented:
Drug name, NDC, strength, form, package quantity, number of full packages, and partial package count of each controlled substance to be disposed.
94
Sale of an over the counter CV must be logged in a bound record book with the following information recorded:
Name and address of purchaser (must be at least 18 y/o); name and quantity if controlled substance purchased; date; name or initials of RPH
95
Requirements for purchasing an over the counter CV and another controlled substance at the same time:
No more than 48 dosage units or 240 mL (8 oz) of an opium containing product may be dispensed within a 48 hour period; no more than 24 dosage units or 120 mL (4 oz) of any other controlled substance may be dispensed within a 48 hour period
96
When does a PA or NP have to consult their supervising physician prior to prescribing a targeted controlled substance?
when use is expected to exceed 30 days; the facility primarily engages in treatment of pain; if the targeted controlled substance is continuously prescribed, the NP / PA must check in with their supervising physician at least every 90 days
97
Who has prescribing authority in NC?
physicians, PA's, NP's (not CRNA), clinical pharmacist practitioner (CPP), Nurse midwife (not professional midwife)
98
what must appear on every rx a CPP writes? Regardless of control vs non-control.
their personal prescribing / license / approval number
99
True / False: A manufacturer's sales rep may distribute a controlled substance complimentary sample only upon the oral request of a practitioner.
False; must be a WRITTEN request
100
Restricted drugs (with respect to use in the treatment of COVID)
Hydroxychloroquine (plaquenil); chloroquine; lopinavir-ritonavir (Kaletra); ribavirin (rebetol); darunavir (prezista)
101
True/ False: The pseudoephedrine sale restriction does not apply to any pseudoephedrine product that is in the form of a liquid, liquid capsule, gel capsule, or pediatric product labeled pursuant to federal regulation primarily intended for administration to children under 12 years of age according to label instruction
True.
102
The following may never be changed on a CII prescription by the pharmacist (if the provider has mistakenly left it off or made an error):
patients name; the signature of the provider, and the name of the drug (except from brand to generic)
103
True or false: only a registered pharmacist can dispense a schedule V otc substance.
True. Not an intern, not a tech.
104
When dispensing a schedule V otc substance, which of the following must be recorded in the log book?
the name / address of purchaser, the name / quantity of drug, date of purchase
105
Examples of anabolic steroids
testosterone; most likely anything that ends with "olone" for example nandrolone
106
When sending rx's to a central fill pharmacy, the originating pharmacy must record the following (on the original paper rx or in the electronic record):
name / address / DEA number of central fill pharmacy; their name; date of transmittal; the words "CENTRAL FILL"
107
True / false: a retail pharmacy may double as a central fill pharmacy without a separate DEA registration, inventories, or records
true
108
what must be on a rx for an animal?
species of pt; pt name; caretaker info
109
who do hospitals also have to register with, in addition to the NC BOP?
NC drug control unit (basically a state level DEA)
110
a validating tech must
Register with BOP; be a certified tech; and hold an associates degree in pharmacy technology
