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Indiana Law Flashcards

1
Q

If a controlled substance prescription is written in IL but filled in IN, which states’ laws must be followed?

A

Illinois (must follow rules of state where it was written)

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2
Q

Compare APN vs PA

A

Both: Limited to scope of overseer, can get DEA#, must be licensed in IN to write Rx in IN
PA: Works under physician only, requires 1800 practice hours before CS, has to be within travel distance of supervisor
APN: Works under physician, podiatrist, or dentist; no practice hours required; can practice independently

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3
Q

Optometrist prescribing

A

Can prescribe independently off of a formulary

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4
Q

Definition of a practitioner

A

Anyone with a license

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5
Q

What rights do people undergoing sanction have?

A

Hearing and legal representation

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6
Q

What are the types of sanction (6)?

A

Revocation - minimum of 7 years before license can be reinstated; will get new license
Suspension - cannot practice until license is reinstated; will have same #
Probation: can continue to work but must be requirements of board
Letter of reprimand: Formal written reprimand
Censure: Formal verbal reprimand (still in record)
Fine: up to $1000, can’t be punished if cannot afford to pay

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7
Q

Summary suspension

A

An emergency suspension for up to 90 days to stop a practitioner from practicing if they present a clear & immediate danger to the public

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8
Q

Surrender of license

A

Someone gives up license without a hearing, but has to follow whatever restrictions the board decides (possibly never getting license reinstated)

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9
Q

Does a phone call count as telemedicine?

A

No - must have video component

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10
Q

Can medications be prescribed via telemedicine?

A

Yes

If not licensed in IN, provider must have certificate to prescribe for patient in IN

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11
Q

Can controlled substances be prescribed via telemedicine?

A

Yes, but only if the patient was seen by a provider in person and the person prescribing is basing prescription off of the plan of whoever saw them in person

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12
Q

What are the restriction on quantity limits for prescribing control substances?

A

Opioids are limited to 7 days at first fill (unless for cancer, palliative care, SUD, or prescriber determines increased need documented in medical chart)

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13
Q

Rules for partial filling CS in IN

A

Partial filling opioids must be complied if requested by patient - can get second fill within 30 days of written date
OPIOIDS specifically

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14
Q

Drug order vs prescription

A

Drug order is for immediate administration in a facility

Prescription is for medication that the patient will take home

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15
Q

What are the requirements for drug ORDER?

A 
Name of patient
Bed # of patient
Name of drug
Strenght of drug
Quantity
Directions for administration
Prescriber name
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16
Q

What are the requirements for prescription?

A 
Pt name/address
Drug name/strength
quantity
directions
practitioner name/signature
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17
Q

What is required on a prescription label?

A 
Name/address/phone # of pharmacy
Rx #
date filled
Name of prescriber
Name of patient (or species of animal + owner's name)
DIrections
Name of drug
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18
Q

What are IN’s additional restrictions on samples?

A

Cannot repackage to sell

Can’t dispense expired samples

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19
Q

When is generic substitition NOT allowed?

A

When prescriber signs DAW

or for ANIMALS

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20
Q

When is generic substitution required even if prescriber signs DAW?

A

Medicare patients when the generic is less expensive than brand - unless prescriber writes in their own handwriting “Brand medically necessary”

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21
Q

What needs to be on the label for generic substitutions?

A

“____ generic for ____” + manufacturer

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22
Q

What are the rules for substituting biological products?

A

Must inform the patient
Must be equivalent
Provider must have signed may substitute

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23
Q

How is naloxone dispensed?W

A

Under a standing order (no Rx needed) as long as you tell how to administer, to call 911, and give info for treatment program

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24
Q

Legally what is a pharmacy?

A

A place where prescriptions are filled and drugs are dispensed - drugs = primary purpose

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25
What is the qualifying pharmacist?
The person legally responsible for the pharmacy/operations
26
Who is on the board of pharmacy?
7 members - 6 pharmacists + 1 member of the community | At least 1 has to be from hospital setting
27
How long are BOP terms?
4 years
28
How are BOP members decided?
APpointment by governor
29
What is a quorum on the BOP?
4 - need a majority of quorum to pass things
30
How many times does the board have to meet a year?
8 times
31
What are the boards required functions?
Establish standards of practice Establish counseling Establish procedures to return expired drugs Develop rules for e-prescribing and OTC Sudafed
32
How does the board handle impaired pharmacists?
They can enroll in and complete a treatment program without ever having to go before the board as long as they comply. IF they don't comply, the program can tell the board
33
Inactive license
Still paying fees but not doing CE
34
Invalid license
When someone forgot to renew license - can pay to have it revalidated within 3 years, but if longer may have to complete additional training/licensure
35
When is it appropriate to release health information without patient approval?
When it's in the best interest of patient health To the law enforcement For a criminal proceeding Requested by BOP
36
What are the categories of pharmacy permits?
Category 1: Retail Category II: Hospital Category III: Not open to the public
37
Can a pharmacist be qualifying pharmacist in 2 different locations?
No - unless category II when you can't find another person who will do it
38
Requirements to get pharmacy permit
Qualifying permit Tell board operating hours, pharmacist on duty during those hours Sufficient medical supply Separation of legend drugs from OTC/non-drug items
39
How many techs can a pharmacist supervise at once?
6
40
What are requirements to close a pharmacy that's located in a store remaining open?
1. 20x30 sign saying pharmacist is not available 2. Drugs locked away 3. Only pharmacist has access to the secure area
41
What must be displayed in a pharmacy?
Pharmacy PERMIT and pharmacist LICENSE
42
Can permits be transferred between locations or to new owners?
nope
43
What do you do with permit if new ownership?
New ownership has to apply for permit within 10 days of the change and send the old permit back
44
How long is a temporary closure? And what do you have to do about it?
5 days max; tell the board
45
How to permanently close a pharmacy? (steps)
1. Tell the board 20 days before you get rid of controlled substances 2. Remove all legend drugs from stock (either return, transfer, or destroy) 3. Submit to BOP inspection 4. Remove all pharmacy words/images/etc 5. Return permit within 10 days of drugs being removed
46
Who is responsible for ensuring proper closing of a pharmacy?
The owner & qualifying pharmacist
47
How long and how to store prescriptions?
2 years in chronological order
48
When is an emergency refill allowed?
The patient requires the medication for health, it is a continuous medication that was originally given refills, attempts to contact the prescriber have been made (& documented), only the minimum amount of drug needed is dispensed (unless packaging requires more), and you have to notify prescriber
49
Can CS have emergency refills?
No (not under the normal policy)
50
If you get a prescription for 90 tablets and insurance only covers 30 so you only dispense 30, what needs to be documented?
the original quantity (90) | and the quantity dispensed (30)
51
You get a prescription for lisinopril 10mg 1 tablet daily x 30 with 11 refills. Patient has been taking this medication for a year and requests a 90 day supply. Can you fill 90?
Yes! The patient has been taking it for more than 30 days and it is not a controlled substance
52
Dr. X dies. Can you fill prescriptions that Dr. X wrote?
Only if it is in the best interest of the patient's health
53
Patient KJ dies. Can you fill her prescription?
Nope
54
When can returned medications be reused?
Medication was dispensed to someone in facility Storage was appropriate (so nurse stored it) Medication was in original packaging (unopened) or unit-dose packaging (unopened) Returned to pharmacy it came from
55
Can CS be returned for reuse?
No
56
What immunizations can a pharmacist administer?
``` Flu Pneumonia Hep A Hep B HPV MMR Varicella Zosters Hib Tdap ```
57
What is the age limit on administering vaccinations?
Must be 11+ | or 50+ for pneumonia
58
Who do you ahve to tell after giving a shot?
PCP and immunization registry (CHIRP)
59
How should refills be tracked?
Electronically - must show prescription requirements and Rx#, and # of refills remaining System must be able to create a hardcopy printout if needed
60
What hoods used for sterile compounding of hazardous drugs?
BSC Class II
61
What is Class 100 Environement? How many particles?
ISO Class 5 | <100 particles/cubic foot of 5microns
62
What is the NSF?
National Sanitation Foundation
63
What does sterile pharmaceutical mean?
The preparation is free from LIVING MICROBES
64
What are requirements of sterile compounding area?
``` ISO Class 5 environment Sink w/hot and cold water in buffer area Disposal containers Fridge with thermometer Documentation of cleaning ISO 8 buffer zone environmental control Reference materials (King's, Trissel's, electronic equivilant) ```
65
What is required to have in pharmacy if preparing hazardous drugs?
a copy of OSHA - occupational safety and health administration
66
Labeling requirements of sterile compound
``` Date made Pt name/bed Drug name/strength/quantity Expiration date Pharmacist/tech who made it Storage/warnings If outpatient: Rx#, prescriber name, pharmacy info, directions for use ```
67
A quality assurance program is required for sterile compounding
True
68
How long do you have to certify ISO5 environments?
every 6 months
69
Can faxed control prescriptions be signed electronicallY?
no must have manual signature
70
What are the additional requirements for a faxed rpescription?
the name and address of pharmacy receiving Person transmitting statement on rx stating its for fax only
71
Can C2 prescriptions be faxed?
Only if the original is provided before the product is actually dispensed
72
Can a pharmacist refuse to transfer a prescription?
Not really - only if the prescription should not be filled at all (ie not in patient's best interest, helping with addiction, etc)
73
How do you offer counseling for mailed prescriptions?
Written notice with pharmacy's phone number on it
74
Do you have to offer to counsel on meds in institution?
No
75
What should be included in a patient profile?
Things you expect (patient name, address, phone #, birthday, gender, allergies) Disease states List of current meds/devices
76
What are the security features for CS prescription in IN?
``` "Void" if photocopied Opaque Rx in upper right corner Logo can only be in upper left corner watermark at 45 degree angle Quantity check boxes Refill options to be circled 4.25 x 5.5 inches 1 prescription per pad ```
77
What are the restrictions on writing C2's
They can't be pre-prepared before patient arrives and they can't be filled out with a stamp
78
T/F: Technicians can share information about a patient's profile/med list with providers
FALSE
79
How do you return expired drugs?
Manufactuers have to take them back - except for fluv accine or drugs used for malignant hyperthermia
80
What is an EDI?
The thing used in electronic prescribing to connect 2 computer system - it has to transmit the exact order and an identifying # for prescriber (DEA/NPI/license)
81
What are cognitive services?
All the thinking pharmacy services - usually things considered more clinical DOes NOT include 3rd party claims, things that techs can do
82
What are workspace requirements for remote pharmacy practice?
Must not be in living space (home office okay if not used for anything else) Have to allow board to inspect if they want to
83
Where to report dispensing of CS?
INSPECT - our PDMP
84
What info needs to go to INSPECT
Pt name, Pt ID, DOB Drug NDC, quantity, days supply, date dispensed Dispenser and prescriber DEA whether it was oral or written
85
How long do you have to report CS dispensing to INSPECT?
24 hours
86
Limits on OTC opium sales? Other OTC CV sales?
240 mL or 48 units 120mL or 24 units of other to person 18+ within 48 hours
87
Dispensing a syringe requirements?
Only intern/pharmacist can do it NO age limit Do not need reason for use Requires record of patient name, date, item dispensed, quatnity dispensed, pharmacist initial
88
Vaccinations can be administered under protocols that are approved by who?
Indiana physician
89
What is in the protocol for vaccination?
``` Name/strength/dose of vaccine Usually ROA and injection site Intended population Administration schedule per CDC Indications Emergency response procedures (epi dose, etc) ```
90
How long do you have to tell PCP after giving vaccine?
14 days (unless ADE - then 72 hours)
91
What is the requirement for interns to give immunizations?
They must tell the patient that they're an intern and ask if it's okay

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