Lecture 4: Intro to Prescription Writing Flashcards
What are the 9 legal requirements of when writing a prescription?
- Name/address of prescriber
- Name/address of patient
- Date prescription was written (include year!)
- Name and Strength and Dosage form of med
- Directions for use (acceptable abbre.’s only)
- Quantity to be dispensed (Wt., Vol./Number and Spelling)
- Number of refills allowed (Number and spelling)
- Prescriber’s Signature (2 lines to choose from*)
- Prescriber’s DEA number (for controlled drugs only)
What is the life-span (aka how long prescription is valid) for non-controlled legend prescriptions?
12 months OR # of refills (whichever occurs first!)
What is the legal limit on refills and number dispensed for non-controlled legend prescriptions?
No legal limit on # of refills or quantity dispensed during 12 month life span (limits set by insurance)
What is the life-span (aka how long prescription is valid) for controlled/scheduled legend prescriptions?
Exception?
- 6 months or # refills (whichever occurs first)
- Exception is C-V’s, which have life-span of 12 months
What is the legal limit on the number of refills for controlled/scheduled legend prescriptions (C-II to C-V)?
- For C-II = NONE (0 refills)
- For C-III thru C-IV = 5 refills over 6 months
- For C-V = no limit on refills (as prescribed)
What is the legal limit on quantity dispensed for controlled/scheduled legend prescriptions (C-II to C-V)?
- 90 days for C-III thru C-V
- 30 days for C-II; up to 90 days w/ documentation of medical reason
The state of Missouri recently passed a bill in regards to opioid prescriptions which placed what limits?
Limits initial new prescriptions of opioids to a 7-day supply
What is the law for partial filling of controlled/scheduled legend prescriptions (C-II thru C-V)?
- For C-III/IV/V possible until full quantitiy of prescription and all refills dispensed or expiration
- Not possible for C-II, unless: pharmacist doesn’t have full quantity (will have 72 hours to get full quantity to patient), or long-term care/hospice
What is the law in regards to physicians/their “agent” using a telephone/fax for a new prescription or refill of a controlled/legend drug?
- Legally allowed for all legend drugs, except for C-II
- C-II only telephone called in by physician only during an “emergency”
- Faxed prescriptions only from prescriber/agent, not the patient!
Is the use of security paper with a prescription required?
- Required by state of Missouri
- Strongle recommended by BNDD
What is the law for prescription transfers of controlled/legend drugs?
Which orders cannot be transferred
- C-III thru C-V transferred only once; transfer is allowed if still in-date and with refills; not a limitation if the pharmacies share a real-time, online database
- C-II cannot be transferred
- Nursing home order (refills) are not transferable outside of facility (need to be converted to a new order/prescription)
What 4 things can never be changed/added in regards to controlled substance prescriptions?
- Patient’s name
- Drug name
- Prescriber’s name
- Prescriber’s signature
What constitutes an “emergency” prescription and when are they applicable?
- Immediate administration is necessary for proper treatment of patient, or
- No appropriate (alternative) treatment is available, including administration of a drug which is not a C-II substance, or
- It is not reasonable possible for prescriber to provide written prescription to the pharmacist prior to dispensing (physican must call in the prescription)
What are the associated restrictions in regards to an “emergency” prescription?
- 72 hours allowed for delivery of Rx to dispensing pharmacy
- Quantity limited to amount needed during emergency time (i.e., until physician is back from vacation)
What is required for a prescription being written by a collaborative practive (APRN/RPh) or Supervisory (PA)?
- May write for any legend drug if documented in a signed agreement
- Need name and contact info of physician AND personnel writing prescription
- Physician AND personnel writing prescription must be regiestered with the BNDD and DEA to prescribe controlled substances
- Limits are different based on the provider
