Exam 2 lecture 6 Flashcards
In what cases can electronic prescriptions be transferred to another pharmacy, even if they have never been filled
Allowed by state law
Prescription was electronically prescribed
If communicated between two licensed pharmacists
If the prescription is maintained in an electronic format
WHat is a rule for non electronic controlled substance transfers
Any non electronic transfers are limited to C III, IV and V prescriptions. They must have been filled at least once before being eligible to be transferred
What must the transferring pharmacist do when transferring controlled substances
Write VOID on the face of the invalidated prescription, or for an electronic prescription, note that the prescription has been transferred in the prescription record
Record the name, address and DEA number of receiving pharmacy
Record the date of transfer and name of the transferring pharmacist
What are things the receiving pharmacist must note for transfer of CS
- date of issue of original prescription
- Original number of refills authorized
- Date of original dispensing
- Number of refills remaining, and the dates and locations of previous refills
- Transferring pharmacy name, address, DEA number and prescription number
- Name of transferring pharmacist
- original pharmacy name, address, DEA number and prescription number
Define SUD? Detox? What are the different types of detox? Maintenance?
SUD- probaematic pattern of using substance that results in impairement in daily life or noticable distress.
Detoxification- dispensing a narcotic drug in decreasing doses to bring a patient to a drug free state
Short term detox- 30 days or less
Long term detox- 30-180 days
Maintenance- maintaining a patient on a stable dose of a narcotic drug for more than 180 days
When can we issue a prescription for a detoxification treatment or maintenance treatment
Only iff it is a CIII, IV or V narcotic drug approved by the FDA specifically for use in maintenane or detoxification treatment and the practitioner complies with requirements
What are some exceptions to FDA approved CIII, IV or V drug that can be used for detox or maintenance
- Practitioner registered with DEA as a naroctic or opioid treatment program
- Practitioner dispensing from their office supply
3.Hospitalized patient - Prescription for direct administration
Can narcotic or opioid treatment programs (NTP, OTP) administer, dispense or prescribe a naroctic listed in any schedule for maintenance or detox treatment
Referred to as methadone clinics
They can administer, dispense but not prescribe
is methadone approved for detox or maintenance treatment by the FDA? Can we fill a prescription for this indication
NOT approved
Cannot fill a prescription for this indication
WHat are some rules when practitioner dispensing from office supply
Limited to a 3 day supply of medication to be dispensed
No extensions on the 3 days, it is one and done
Rules for administering or dispensing a narcotic drug to hospitalized patients
Patient must be hospitalized due to an issue outside of substance abuse disorder
Goal is not to interrupt their tx
What are rules when a pharmacist delivers a controlled substance based on aprescription to a practitioners office for practitioner to administer to patient
The controlled substance must be administered by injection or implantation
It must be administered to the patient named in the rpescription within 14 days of receiving the product from the pharmacy
What are the two ways pharmacies may distribute to registrants
- distributing to another registrant that wants to dispense the medication to their patient
- Pharmacy sending drugs to a reverese distributor registered as such
When may dispensing or instructing registrants distribute a controlled substance to another registrant
That registrant is appropriately registered with the DEA (2, 2N, 3, 3N, 4, 5)
The pharmacy records the distribution and receiving registrant as required
If a C I or C II, a DEA form 222 is completed by both parties AND
The number of dosage units does not excees 5% of the total dosage units of all controlled substances distributed and disppensed in the same calendar year
Do distributions to an auto dispensing system in a LTCF count towards the 5%
No
What is a reverse distributor? What are steps needed to complete this process
A reverse distributor is a person which accepts controlled substances for destruction.
- The pharmacy contacts the reverse distributor with a list of all drugs needing disposal
- The reverse distributor creates an invoice to the pharmacy with exact quantities of substances to be destroyed (DEA form 222 for C-I/C-II) (form 41 for all others)
- Pharmacy completes suppliers requirements and sends drugs to the reverse distributor for destruction.
- Reverse distributor fills out a DEA form 41
What are 4 methods of destruction or disposal of controlled susbatnces
- on-site destruction- two employees handle the destruction
- Delivery to reverse distributor
- Sending product back to distributor, warehouse or manufacturer
- Request assistance directly from local DEA field office
Does the form 41 need to be sent to the DEA?
Once completed, this form is maintained with other CS records. It does not need to be sent to the DEA unless requested.
What are things that must happen if a theft of a CS happenes?
Any theft or significant loss must be reported to the local DEA field office and board of pharmacy within one day of discovery
A DEA form 106 must be filed within 45 days of discovery (electronic submission)
When should theft and significant loss be rpeorted?
All theft must be reported, but only significant (non theft) losses must be reported
What form is used foe registrants who suffer CS theft or significant loss
DEA form 106
Who to send DEA form 106 to
Forwarded to DEA field office and state board of pharmacy as well.
