Healthcare Provider Details

Question 1

Across different states there are differences in which healthcare providers are granted prescribing authority. List thirteen (13) provider types that are considered relevant to prescribing authority

Answer 1

1. Physicians
2. Physician assistants
3. Dentists
4. Advanced registered Nurse Practitioners
5. Midwives
6. Optometrists
7. Emergency medical technician, paramedics
8. Podiatrists
9. Doctors of homeopathy
10. Veterinarians
11. Naturopathic doctor
12. Psychologists
13. Pharmacists

Question 2

List two types of physicians

Answer 2

1. Medical doctors MD

2. Doctors of osteopathic medicine DO

Question 3

List five (5) types of Advanced Registered Nurse Practitioners

Answer 3

1. ARNP
2. Certified clinical nurse specialists (CNS)
3. certified nurse midwives (CNM)
4. Certified nurse practitioners (CNP)
5. Registered nurse anesthetists (CRNA)

Question 4

List the acronym for podiatrists

Answer 4

DPM

Question 5

List the acronym for veterinarians

Answer 5

DVM

Question 6

Which providers have independent prescription authority?

Answer 6

1. Physicians (MD and DO)
2. Dentists (DDS)
3. Advanced Registered Nurse Practitioners (all five)
4. Optometrists (limited to contact lenses only, therapeutically certified optometrists may also prescribe oral steroids up to 14 days)
5. Podiatrists
6. Veterinarians

Question 7

What is prescribing authority of Physician assistants (PA)

Answer 7

1. Dependent and limited prescribing authority (must have supervising physician, does not include schedule II)

Question 8

What is prescribing authority of pharmacists?

Answer 8

None but may practice collaborate drug therapy management under supervision of a physician

Question 9

Per chapter 39.13 (expanded practice standards: collaborative practice therapy), providers who enter a collaborative practice agreement must be authorized to do so by their licensing agency. Which types of providers have been granted such authorization?

Answer 9

1. MDs

2. DOs

Question 10

Which providers can dispense non-controlled legend drugs without a prescription? (i.e. without a pharmacy/pharmacist) (hint: 5)

Answer 10

1. Physicians
2. Physician assistants (on the direct order of the supervising physician)
3. Advanced registered nurse practitioners
4. Emergency medical technician paramedics
5. Veterinarians

Question 11

Which providers can dispense controlled substances without a prescription?

Answer 11

1. Physicians, if holds valid state registration to dispense CS
2. Physician assistants (on direct order of supervising physician), if holds valid state registration to dispense CS
3. Dentists, if holds valid state registration to dispense CS
4. Advanced registered nurses practitioners if holds valid state registration to dispense CS
5. Emergency medical technician paramedics (under protocol) if holds valid state registration to dispense CS
6. Veterinarians if holds valid state registration to dispense CS

Question 12

Which provider can possess non-controlled legend drugs or controlled substances, but can not dispense them without a prescription?

Answer 12

Pharmacists

Question 13

What are three (3) things to keep in mind when dispensing ARNP prescriptions?

Answer 13

1. They have independent authority so do not need supervising physician
2. They can only prescribe in their specialty practice (e.g. community vs. hospital or outpatient surgery)
3. Prescription orders for controlled substances must include the DEA number assigned to the ARNP.

Question 14

List three things to keep in mind when dispensing medications written by a physician in which the prescriber/patient relationship is broken and the prescriber no longer available to treat patient or oversee use of prescription medication.

Answer 14

1. Discretion of pharmacist to supply remaining refills for a suitable amount of time so that the patient can establish a new prescriber/patient relationship.
2. Pharmacist shall consider the patient’s health status and access to healthcare services.
3. ref: IAC 8.20

Question 15

List two rules for the packaging and labeling when a physician dispenses a medication directly to a patient (e.g. physician-based dispensing)

Answer 15

1. Administrative rules of the Iowa Board of Medical Examiners require label to contain name and strength of dispensed medication.
2. Dispensing physicians in Iowa must also comply with packaging requirements of the federal Poison Prevention Packaging Act
3. And directions of manufacturers regarding the use of light-resistant containers.

Question 16

When must a dentist, physician or podiatric physician that dispenses drugs without a prescription report with their respective boards?

Answer 16

1. Biennially: every 2 years.

2. Only if it’s other than a drug sample

Question 17

May an Iowa pharmacy prepackage and pre-label a supply of medications for a physician who will later dispense them from his/her office?

Answer 17

1. No, unless that pharmacy could qualify to adhere to the FDA current good manufacturing practices and would register with the FDA as a drug re-packager.

Question 18

May a prescriber in Iowa post-date a prescription?

Answer 18

1. No a prescriber may not post-date a prescription. Must sign and date the prescription on the date that the prescription was written.

Question 19

What should a prescriber do if they want to write a prescription today but don’t want it filled until a later date?

Answer 19

1. If a prescriber wishes to have the prescription filled at a later date, they may indicate so in the directions to the pharmacist.
2. In the case of Schedule II, a pharmacist may not fill the prescription before the earlier date indicated, AND may not call the prescriber for authority to fill the prescription prior to the date indicated.