EXAM 2 TN Pharmacy Practice Pt1

Question 1

Can a non-US citizen obtain a healing arts license?

Question 2

A pharmacist prescription was asked to take a drug test, and was tested positive or refused to submit one? What are they supposed to do?

Answer 2

-have to provide Rx or valid medical reason documentation within 3 days
-seek help with TPRN

Question 3

When is an employer required to report a violation of the practitioner’s practice act (taking a substance) to the board?

Answer 3

if the professional fails to advocate to the substance abuse peer assistance or treatment program (TPRN)

Question 4

Does a board member need to be a citizen of the state of Tennessee?

Answer 4

Yes

Question 5

If someone who doesn’t require a background check was to be employed what is required instead?

Answer 5

if they had direct patient contact ->

registry check (sex offender, abuse registry) state by state for the last 7 years

Question 6

Which drug classes should not be dispensed by providers?

Answer 6

Benzos and opioids

-but there are many exceptions
-> The goal is to be dispensed in pharmacies so that it goes through the CSMD

Question 7

What are the exceptions for providers to dispense benzos and opioids?

Answer 7

-Correctional facility
-Samples
-Surgical procedure (max 7 days, and max of 7 days post-procedure)
-Clinical trial
-Nonresidential substitution-based treatment center
-Health care facilities per 68-11-202
-Physician practices if they jump through the mentioned hoops

Question 8

Who can grant a Naloxone statewide collaborative practice agreement to a pharmacist?

Answer 8

The chief medical officer

Question 9

What does a pharmacist who seeks a Naloxone statewide collaborative practice agreement have to provide?

Answer 9

-provide documentation of the completion of
an opioid antagonist training program within the previous two (2) years

-follow the collaborative practice statutes

Question 10

What does the Epinephrine-administration protocol – Law Enforcement say?

Answer 10

a pharmacist can dispense a prescription for epinephrine kits to law enforcement (for example police department)

Question 11

What type of prescriptions do controlled substances shall be?

Answer 11

e-prescriptions (to minimize altered prescriptions)

exceptions:
-Veterinarians
-e-prescribing not available
-prescriber and dispenser are in the same entity
-non-patient specific standing order
-waiver, others that make sense

Question 12

Can a pharmacist fill a written prescription of controlled substances?

Answer 12

Yes (also faxed)

even with verifying because it is a “shall” statement

Question 13

Who can request partial fill of controlled substances?

Answer 13

Patient
Prescriber

-keep the original prescription at the pharmacy where it was first presented and partially filled

Question 14

Where does any subsequent fill of partial fills of controlled substances need to occur?

Answer 14

in the pharmacy where it was filled first
-until the partial fill is completed
-any other refill can be filled in other pharmacies

Question 15

In what time period does the subsequent fill of controlled substances need to be filled?

Answer 15

within 6 months from the original prescription
(same as federally)

-for C-II it would be 30 days

Question 16

The pharmacist needs to notify who, about the partial fill.

Answer 16

The prescriber
also, notify about the amount that was dispensed

-a notation on the patient record that is accessible to the prescriber is fine too

Question 17

When dispensing an opioid, when is a pharmacist not required to check CSMD and check for documentation?

Answer 17

-the Rx is for 3 day supply or less
-no more than 180 MME

Question 18

If an Rx with an opioid is for an exempt category what needs to be on the Rx

Answer 18

-ICD 10 code
-“EXEMPT” on the Rx
-Check CSMD

-No MME limits

Question 19

What are the exempt categories?

Answer 19

-Active cancer
-hospice or palliative care
-LCTFs
-sickle cell disease
-pain management specialist
-chronic pain (90 days or more/ 365-day period)
-Methadone clinic
-severe burn
-serious illness

Question 20

What are the requirements for filling an opioid Rx for surgery?

Answer 20

-Check CSMD
-MME limit: 1200
-up to 30-day supply
-ICD 10 code and “SURGERY” or “MEDICAL NECESSITY” on the Rx

Question 21

What are the requirements for filling an opioid to treat upper respiratory symptoms or cough?

Answer 21

-has to be for 14 days or less

-No CSMD check
-No documentation requirement

Question 22

What are the requirements of an opioid Rx that is limited to a 10-day supply and 500 MME?

Answer 22

-CSMD check
-ICD 10 code on Rx

Question 23

Which opioid Rx has a 1200 MME and a 30-day limit?

Answer 23

opioid Rx for surgery

Question 24

Which opioid Rxs don’t need CSMD checks or documentation requirements?

Answer 24

-opioid Rx for 3 days or less and no more than 180 MME

-opioid Rx for upper respiratory or cough treatment and 14 days or less

Question 25

Do opioid Rx with 500 MME and 10-day limits need an ICD 10 code?

Answer 25

Yes
also check CSMD

Question 26

When are CSMD checks required?

Answer 26

anything over a 3-day supply

Question 27

When is an ICD-10 code required?

Answer 27

Rx for more than 3 days and 180 MME

that means:
-EXEMPT
-SURGERY-1200 MME and 30-day supply
-500 MME and 10-day supply