Exam 2 lecture 5 Flashcards
(34 cards)
How many times can we fill a prescription with 3 refills
4 times. once for the original fill and 3 more times. Makes sense if you think about 0 refill meds
Are refills allowed for C II prescriptions
NOT ALLOWED
How long are C II scripts good for? Is there a limit on the amount of C-II that can be prescribed?
C-II prescriptions are good for a year from the date written
No limit on the amount a C II can be prescribed for, meaning a prescriber could write a script for 365 days
What can be used in Lieu of refills for C II drugs
Prescribers may authorize multiple prescriptions for a patient to receive up to a 90 day supply of a controlled substance
When prescribing multiple C IIs simultaneously, what are rules that must be followed
- Each prescription must be written in accordance with CS prescribing responsibilities
- Prescriber must date each prescription with the date it was issued and provide written instructions on each prescription indicating the earliest date of fill.
- Prescriber must decide that multi[le prescriptions to a patient does not create a risk of diversion
- Must adhere to state statutes and regulation
- Must meet al; other C II prescription requirements
Is there a limit on C V refills federally
No
How many refills for C III and IV prescritions in indiana
May have up to 5 refills (6 total fills), regardless of day supply
For C III and C IV prescriptions, if fewer than 5 refills is authorized, can they authorize additional refills on original prescription
Yes
The total refills may not exceed 5, nor exceed beyond six months from the original issue date
For C III and IV refill documentation, how must all refill documentation be documented
- writing on the back of the prescription or another appropriate document
- Documenting in an electronic prescription record
What information must C III and IV documentation required
Name and dosage form of controlled substance
Dare filled and refilled
Quantity dispensed
Initials of dispensing pharmacist for each refill
Total number of refills for that prescription
When using alternative records, what needs to be included in the alternative computer application
Original prescription number
Date of issue
Name and address of patient
Name, address and DEA of prescriber
Name, strength, dosage form, quantity prescribed (and dispensed if different than prescribed) of drug
Refills authorized
Refills history
If an alternative record system is utilized for C III and IV refill documentation, pharmaciest must employ one of the following record keepting methods for refills
Print out all controlled substance refills with the information of the pharmacist who refilled the prescription. The printout must be reviewed and signed by the pharmacist who refilled the prescription, and stored for a period of two years
Or
Maintain a bound logbook that each pharmacist involved in dispensing shall sign each day, attesting to the fact that refill information entered has been reviewed and is correct
What are the 3 circumstances in which you may partially fill a C-II prescription
- At the request of the patient, patient representative, or prescribing practitioner
- If the pharmacy cannot provide the full amount of the prescription
- For a patient in a long term care facility or who has a medical diagnosis documenting terminal illness
The comprehensive addicvtion and recovery act of 2016 allowed for partial filling of C II prescriptions so long as the following criteria are met at request of patient or prescriber
It is not prohibited by state law
The patient, representative, or prescriber requested the partial fill
The total quantity of all partial filling does not exceed the total quantity prescribed
The remaining portions are filled no later than 30 days from the date the prescription is written
Does not apply related to stock shortages or insurance limitations
What happens for C II partial fills if pharmacy is out of stock
Pharmacy may refill partial amount
The remainder must be ready for pick up within 72 hours of partial fill
What happen in the case of partial fills when remainder of the fill can not be prepared wuthin 72 hrs
Pharmacist must notify the prescriber of the partial fill, including quantity and reason for partial. The remainder of the prescription is then voided
For partial fills of C IIs for LTCF/ terminal illness, for how long may it be partially filled for from dat eissues
60 days
What are things that must be documented for LTCF/ terminal illness partial filling
Date of partial filling
Quantity dispensed
Remaining quantity to be dispensed
Identification of dispensing pharmacist
For partial filling of C-III, IV and V, when can we partially fill
- total quantity dispensed does not exceed total quantity prescribed
- No amount is dispensed after the prescription expires
Difference between partial fills and refills for C III, IV and Vs
partial refills can be dispensed in any amount and must be recorded in the same manner as refills (not more than original number prescribed)
Unlike refills, you may partially fill a prescription more than 5 times
What is the only time C II prescriptions may be taken over the phone
In an emergency situation
What are the defiitions of emergency situations for C II prescriptions
- The immediate administration of a controlled substance is needed
- There is no appropriate alternative available including non controls and
- It is not possible for prescriber to provide a written prescription before dispensing the medication
what are rules when giving emergency prescriptions for C II emergency prescriptions
Should only be for the amount needed to cover the emergency period
Must be followed by a covering prescription sent by the prescriber within 7 days or authorizing the emergency prescription
What are prescription documentation/ follow up for C II emergency fills for paper, electronic.
For a pper covering prescription, attach the covering prescription to the emergency prescription previously dispensed
For an electronic covering prescription, the pharmacist must annotate the prescription with the oral orders original authorization and date
