IRAT/GRAT 2 Flashcards

Pharmacist DEA Manual and Red Flags

1
Q

What are list 1 chemicals under cmea

A

pseudophedrine
ephedrine
phenylpropanolamine-OFF MARKET

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2
Q

Definition of regulated seller

A

a retail distributor

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3
Q

What is the maximum amount of a list 1 chemical that may be sold to a purchaser in a single day

A

3.6 grams

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4
Q

What is the max amount for a non liquid product thats in a blister pack

A

2 dosage units per blister

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5
Q

What is the max amount you can purchase in a 30 day period?

A

9 grams

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6
Q

If you were to have pseudoephedrine or ephedrine delivered via USPS what is the max amount?

A

7.5 grams

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7
Q

What is requires by federal law for all regulated sellers under the cmea? How is this process completed?

A

Regulated sellers are required to complete a self-certification process that includes training their employees on new regulations and procedures. This is done online.

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8
Q

t/f once a regulated seller self certifies they never have to do it again

A

FALSE it must be done annually

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9
Q

What are the recordkeeping requirements for cmea products

A

name and address of purchaser
date and time of sale
name and amount of product sold

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10
Q

Is keeping a record for slcp required

A

yes!

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11
Q

When does the logbook requirement NOT apply under cmea

A

single sales package that DOES NOT contain more than 60 mg of psedophedrine (60mg tab or 2 30mg tabs)
this applies ONLY to pseudophedrine!!!

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12
Q

What are purchasers required to do during the sale of one of these products
(CMEA)

A

Give a state or federally issued photo id and sign a written or electronic logbook

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13
Q

The purchaser has presented id to the seller. What is the seller now required to do?
CMEA

A

-determine that the name in the logbook corresponds to the name on the ID and that the date and time are correct
-enter into the logbook the name of the product and quantity sold

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14
Q

What statement must the logbook include?

A

it must include a notice to purchasers that entering a false statement or mirespresentation may subject them ti criminal penalties

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15
Q

How long must logbook entries be maintained?

A

a minimum of two years

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16
Q

If lost or theft of one of the slcp has occurred, how do you report it and what is the time frame?

A

-make and oral report to the DEA diversion field office ASAP
-file a written report within 15 days after the pharmacist becomes aware of the theft

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17
Q

what form must you use to file the written report for loss and theft and what information should it include?

A

a DEA 107 form (report of loss or theft of listed chemicals) MUST be used
-report should include the DEA registration number, name, address, business address, telephone number, date and type of loss, and a description of the situation

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18
Q

definition of Schedule Listed Chemical Product

A

includes any product that may be marketed or distributed lawfully in the United States
under the Federal Food, Drug, and Cosmetic Act as a non-prescription drug, and that contains ephedrine, pseudoephedrine, or phenylpropanolamine (PPA) (including salts, optical isomers, and
salts of optical isomers)

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19
Q

T/F: SLCP applies to BOTH non rx and rx drugs

A

FALSE. It only applies to NON prescription drugs

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20
Q

4 main requirements of the CMEA important

A
  1. Requirement of regulated sellers to place the products BEHIND the counter or in locked
    cabinets.
  2. Requirement of regulated sellers to check the identity of purchasers and maintain a log of EACH sale that includes the purchaser’s name and address, signature of the purchaser,
    product sold, quantity sold, date, and time.
  3. Requirement of regulated sellers to maintain the logbook for at least TWO YEARS
  4. Requirement of regulated sellers to train employees in the requirements of the law and certify to DEA that the training has occurred.
21
Q

what are some acceptable forms of identification under the CMEA

A
  1. United States passport

2.Alien Registration Receipt Card or Permanent Resident Card, Form I-551;

  1. A foreign passport that contains a temporary I-551 stamp, or temporary I–551 printed
    notation on a machine-readable immigrant visa;
  2. An Employment Authorization Document which contains a photograph (Form I–766);

5.a foreign passport with an Arrival/Departure Record, Form I-94
(as defined in 8 CFR 1.4), or Form I-94A, bearing the same name as the passport and
containing an endorsement by DHS

  1. A passport from the Federated States of Micronesia (FSM) or the Republic of the
    Marshall Islands (RMI) with Form I–94 or Form I–94A
  2. a military identification card issued to such individual may be accepted
    only by the Armed Forces.
22
Q

T/F: all controlled substances are ordered with a DEA 222 form

A

FALSE only controlled 1 and 2
*DEA is required for each distribution or transfer of a schedule 1 or 2

23
Q

Lets say federally a drug has been moved from schedule 2 to 3, BUT in a certain state the drug is still considered a schedule 2 drug. Does a DEA form still have to be used?

A

Yes. some states may require a DEA 222 regardless of the federal classification

24
Q

who is entitled to obtain a DEA 222 form

A

any person with an active registration that is authorized to order schedule 1 and 2 controlled substances

25
Q

what information on a DEA 222 form CANNOT be altered by the DEA registrant?

A

-name, address, and registration number of the registrant.
-authorized activity
-schedules of the registrant

26
Q

if there is an error on the DEA 222 form how can it be fixed?

A

registrant must report any errors to DEA diversion field office or the Registration and Program Supoort Section of the Administration to modify

27
Q

I can fill out the DEA 222 form with a regular pencil

A

FALSE, a purchaser MUST complete a DEA 222 form by use of a compueter printer, pen, or indelible pencil

28
Q

between the purchaser and the supplier, who keeps the original and who gets the copy of the DEA 222

A

purchaser must make copy of the original and SEND the original to the supplier!!! the purchaser’s copy must be paper or electronic

28
Q

each DEA 222 form must be signed and dated by—

A

a person authorized to sign a registation application or a person granted power of attorney

29
Q

what must the purchaser do once items are received (section 4)

A

they MUST document on their DEA 222 copy the ACTUAL number of commercial or bulk containers received and the date it was received.

30
Q

even though the purchaser must retain a copy of each executed DEA 222 form, does this include copies of unaccepeted or defective forms?

A

YES

31
Q

how long should DEA 222 forms be kept available for inspection?

A

AT LEAST 2 years

32
Q

when should the supplier submit a copy of the DEA 222 to the DEA?

A

At the end of the month during which the order was filled

33
Q

For orders that are done through partial shipments, when should the supplier send a copy of the DEA 222 to the DEA?

A

Send the copy at the end of the month during which the FINAL shipment is made OR the 60 day validity period expires

34
Q
A
35
Q
A
36
Q
A
37
Q
A
38
Q

Red flags of pharmacy

A

doctor shopping
repeated dispensing of cocktail prescriptions
no individualization done by prescriber
filling MULTIPLE rx to strongest formulations
request for EARLY refills
doctor locates 100 miles away from pharmacy
large portion of rx were controlled substances written by ONE physician
pharmacist didn’t reach out to other pharmacists to see why they arent fillling a particular docotrs prescriptions
patient travels in groups to pharmacy
filling a LARGE % of cah=sh rx
verification of a prescription as legit was not simply satified because practicioer said so

38
Q

who enforces the controlled subdstance act

A

DEA-section under FBI

39
Q

definition of inventory

A

complete and accurate list of all stocks and form of con trolled substances in the possession of the registrant and shall be maintained in written, typewritten, or printed form at the registered location

40
Q

how is the inventory of schedule 2 determined

A

By a physical count

41
Q

how long should inventory records be maintained at the registered location

A

AT LEAST two years for copying and inspection

42
Q

in regard to inventory what should someone do when they are issued a DEA registration

A

take an initial inventory which is a physical count of ALL controlled substances in their possession

43
Q

information that should be included on an inventory record

A

date of inventory
whether the inventory was taken at opening or closing
the name of EACH inventoried controlled
the finished form of each of the substances
number of dosage units or volume in finished form
number of commercial containers of finished form
total count of the substance

44
Q

after initial inventory how often is it required to take a new inventory

A

AT LEAST every two years

45
Q

do you have to submit inventory info to the DEA?

A

no

46
Q

Drug x recently became a controlled substance this year. Does this drug have to be included in the inventory

A

yes

47
Q

what information do you need for damaged or defective controlled substances

A

name and total quantity of substance to nearest metric weight
reason for substance being maintained by registrant and wheher it is capable of use