Lecture 13 - Controlled Substance Filling Flashcards
How many refills are allowed for C2 prescriptions?
None
How long are C2 prescriptions valid to be filled?
A year from the date written
What is the limit for the amount a C2 prescription can be written for?
There is no limit so a prescriber could write a prescription for 365 days
What can a prescriber do instead of refills?
Prescribers may authorize multiple prescriptions for a patient to receive up to a 90-day supply of a controlled substance
What must a prescriber do when writing multiple C2 prescriptions at once?
-Each prescription must be written in accordance with controlled substance prescribing responsibilities
-Prescriber must date each prescription with the date it was issued, and provide written instructions on each prescription indicating the earliest date of fill
-Prescriber must decide that multiple prescriptions to a patient does not create a risk of diversion
-Must adhere to state statutes and regulations
-Must meet all other C2 prescription requirements
How many refills are valid for C3-C5 prescriptions?
-Up to 5 refills (six total fills), regardless of days supply
-A prescriber may authorize additional refills on the original prescription if it was originally authorized for less than 5 refills
-Refills may not extend beyond 6 months of the original issue date
How must refills be documented?
-Writing on the back of the prescription or another appropriate document
-Documenting in an electronic prescription record
What information must be documented about the refill on the back of the prescription?
-Name and dosage form of controlled substance
-Date filled or refilled
-Quantity dispensed
-Initials of dispensing pharmacist for each refill
-Total number of refills for that prescription
What information must be documented about the refill when documenting electronically?
-Original prescription number
-Date of issue
-Name and address of patient
-Name, address and DEA of prescriber
-Name, strength, dosage form, quantity prescribed (and dispensed if different than prescribed) or drug
-Refills authorized
-Refill history
What record keeping system must be used for keeping alternative records for refill documentation?
-Print out all controlled substance refills with the information of the pharmacist who refilled the prescription. The printout must be reviewed and signed by the pharmacist who refilled the prescription and stored for a period of two years
-Maintain a bound logbook that each pharmacist involved in dispensing shall sign each day, attesting to the fact that the refill information entered has been reviewed and is correct
What are the three circumstances in which you can partially fill a C2 prescription?
-At the request of the patient, patient representative, or prescribing practitioner
-If the pharmacy cannot provide the full amount of the prescription
-For a patient in a long-term care facility or who has a medical diagnosis documenting terminal illness
What criteria must be met when partial filling a C2 prescription?
-It is not prohibit by state law
-The patient, representative, or prescriber requested the partial fill
-The total quantity of all partial fillings does not exceed the total quantity prescribed
-The remaining portions are filled no later than 30 days from the date the prescription is written
-Does not apply related to stock shortages or insurance limitations
Can a patient request for more drug if a prescriber requests for a partial fill?
No
When must the remainder of a partial fill be filled when the pharmacy is out of stock?
-Within 72 hours of the partial fill
-If the remainder cannot be prepared within 72 hours, the pharmacist must notify the prescriber of the partial fill, including quantity and reason for partial. The remainder of the prescription is then voided
How long can a patient fill the remainder of the partial fill when in a long-term care facility or with a terminal illness?
Up to 60 days
What must be documented when partial filling for a patient in a long-term care facility or with a terminal illness?
-Date of partial filling
-Quantity dispensed
-Remaining quantity to be dispensed
-Identification of dispensing pharmacist
What criteria must you meet when filling a C3-5?
-Total quantity dispensed does not exceed total quantity prescribed
-No amount is dispensed after the prescription expires
How must partial fills of C3-5s be recorded?
-In the same manner as refills
-Unlike refills, you may partially fill a prescription more than 5 times
When is the only time a C2 prescription can be taken over the phone?
In an emergency situation
What constitutes an emergency situation?
-The immediate administration of a controlled substance is needed
-There is no appropriate alternative available, including non-controls
-It is not possible for the prescriber to provide a written prescription before dispensing the medication
What must be done when taking an emergency prescription?
-Should only be for the amount needed to cover the emergency period
-Must be followed by a covering prescription sent by the prescriber within seven days authorizing the emergency prescription
What must you do with a paper covering prescription after you receive it?
Attach the covering prescription to the emergency prescription previously dispensed
What must you do with an electronic covering prescription after you receive it?
Pharmacist must annotate the prescription with the oral orders original authorization and date
What should a pharmacist do if the covering prescription is not received?
Notify the nearest DEA office (this is misbranded if you do not do this)
