EXAM 2 TN Pharmacy Practice Pt1 Flashcards
Chapter 1
Can a non-US citizen obtain a healing arts license?
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?
-have to provide Rx or valid medical reason documentation within 3 days
-seek help with TPRN
When is an employer required to report a violation of the practitioner’s practice act (taking a substance) to the board?
if the professional fails to advocate to the substance abuse peer assistance or treatment program (TPRN)
Does a board member need to be a citizen of the state of Tennessee?
Yes
If someone who doesn’t require a background check was to be employed what is required instead?
if they had direct patient contact ->
registry check (sex offender, abuse registry) state by state for the last 7 years
Which drug classes should not be dispensed by providers?
Benzos and opioids
-but there are many exceptions
-> The goal is to be dispensed in pharmacies so that it goes through the CSMD
What are the exceptions for providers to dispense benzos and opioids?
-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
Who can grant a Naloxone statewide collaborative practice agreement to a pharmacist?
The chief medical officer
What does a pharmacist who seeks a Naloxone statewide collaborative practice agreement have to provide?
-provide documentation of the completion of
an opioid antagonist training program within the previous two (2) years
-follow the collaborative practice statutes
What does the Epinephrine-administration protocol – Law Enforcement say?
a pharmacist can dispense a prescription for epinephrine kits to law enforcement (for example police department)
What type of prescriptions do controlled substances shall be?
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
Can a pharmacist fill a written prescription of controlled substances?
Yes (also faxed)
even with verifying because it is a “shall” statement
Who can request partial fill of controlled substances?
Patient
Prescriber
-keep the original prescription at the pharmacy where it was first presented and partially filled
Where does any subsequent fill of partial fills of controlled substances need to occur?
in the pharmacy where it was filled first
-until the partial fill is completed
-any other refill can be filled in other pharmacies
In what time period does the subsequent fill of controlled substances need to be filled?
within 6 months from the original prescription
(same as federally)
-for C-II it would be 30 days
The pharmacist needs to notify who, about the partial fill.
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
When dispensing an opioid, when is a pharmacist not required to check CSMD and check for documentation?
-the Rx is for 3 day supply or less
-no more than 180 MME
If an Rx with an opioid is for an exempt category what needs to be on the Rx
-ICD 10 code
-“EXEMPT” on the Rx
-Check CSMD
-No MME limits
What are the exempt categories?
-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
What are the requirements for filling an opioid Rx for surgery?
-Check CSMD
-MME limit: 1200
-up to 30-day supply
-ICD 10 code and “SURGERY” or “MEDICAL NECESSITY” on the Rx
What are the requirements for filling an opioid to treat upper respiratory symptoms or cough?
-has to be for 14 days or less
-No CSMD check
-No documentation requirement
What are the requirements of an opioid Rx that is limited to a 10-day supply and 500 MME?
-CSMD check
-ICD 10 code on Rx
Which opioid Rx has a 1200 MME and a 30-day limit?
opioid Rx for surgery
Which opioid Rxs don’t need CSMD checks or documentation requirements?
-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
Do opioid Rx with 500 MME and 10-day limits need an ICD 10 code?
Yes
also check CSMD
When are CSMD checks required?
anything over a 3-day supply
When is an ICD-10 code required?
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
