MassPAT Flashcards
MassPAT
mass prescription awarness tool
dentist prescribed most opiods to which age group
10-19 years old
prescribed 8% of the opioids at this time
differences in mu opioid receptors?
yes – over 100 polymorphisms in the human MOR gene – why some patients may request differnt types and important to ask them which worked for them in the past
also patietns with impaired CYP2D6 metabolsm do not respond to codeine
study showed combo therapy best wit
ibuprofen 400 mg and oxycodone 5 mg
where pain relievers were obtained
53 % FREE from friend / relative
21% - from one doctor
14 % took / bought from friend / relative
shift of Co2 response with opiods
right -shifted
sedation occurs before respiratory depression T/F?
true – this is a warning sign
patient recieced 2 rx’s for hydrocodone 5mg and acetaminophen 300 mg (10 tabs each) from 2 diff doctors in past two weeks
how should you use this PDMP info when responding to pt’s request for opioids?
discuss PDMP with patient openly and nonjudgmental
- “I see you have received multiple opiod prescriptions from multiple providers filled at multiplepharmacies- can you tell me about this?”
use universal precautions
age at risk for misuse
under 45
% dentist ask patietns about alcohol use
less than half
54% said dont ask them about it and more than half of those people said felt uncomfortable
same with use of illegal substance
opioid disposal
- local take back programs if availble
- DEA - authorixed collection sites
- disposal in trash in bag with kitty liter, coffee grounds
- flush down toilet t if appropriate – consult the FDA
CFR 1206.04
if refilling an opioid rx without seeing patient legal?
an rx for a controlled substance must be issues for a legitmate medical purpose by an individual practioner acting in the usual course f his / her professinoal practice
responsibility of proper prescribing and dispensing of controlled substance rests on the prescribing practioner, but a corresponfng responsibility rests wit pharmacists who fills the rx
valid providor- patient relationship
rx must be issued for valid med reasons
rx must be therapeutic for condition
providor and pharmacist have corresponding responsibility to determine the rx is valid
refilling opiod rx without seeing pt good clinical practive?
NOT FOR NEW PT. who not certain can take correctly
not if patient has been non-adherenct with tx instrucitons in past
not if patients pain is persisting longer than anticipated
schedule II?
basically all besids tylenol with codeine (#3) which is a number III – moderate dependence liability vs high abuse potential with schedule II
time limit with scheudle II
no but must be SIGNED by practioner
oral order may be permitted in emergency situation
schedule III rx can be communicated how
orally, wrinig or by calling
MassPAT has what info
rx history for the prior 12 months
- date dispensed, patient, prescriber, pharmacy, medication and dose
DPH annually sends out
info to individual prescribers on how they are prescribing schedule II and III opioids in coparison to other prescribers wihin the specialty
benzo with MassPAT?
require prescribers to utilize the PMP each time a prescription for a benzo is issued
use of MassPAT
when using schedule II-III opioid or benzo
T/F 7 day supply?
true - no more than 7 day suppy for opiate for outpatient use for the first time
if need more than 7 days?
documented in the patients medical record and the practioner shall indicate that a non-opiate alternative was not aporopriate to address the medical condition
7 day does not apply to
not apply to medications designed for the treatment of substance abuse or opiod dependence
section 18C commonwealth of mass
prior to issuing a prescription for an opioid a practioner shall
1. consult – with patient regarding the quantity of the opioid and a patients option to fill the prescription in a lesser quality
- inform – the patient of the risks associated with the opiod prescribed
“partial fill upon patient requet”
CARE Act
a act for prevention and access to appropriate care and treatment of addiction
increased access to naloxone
liability protection: encourages braoder use of naxloxone by gauranteeing that practioners who prescribe and pharmacists who dispense naloxone in good faith will be protected from criminal or civil liability
allows patients to receive a portion of their full opioid prescription without invalidating the remainder– must return to the same pharmacy within 30 days to fill the remainder of the Rx
all prescribers must convert to secure electronic prescriiptions when prescribing controlled substances
CARE Act creates?
a commission for recommendations on appropriate prescribing practices for the most common oral and advanced dental procedures
- includes recommendations on approving the use of standardized, prepackaged does of commonly issued medications/ Rx to reduce the chance of over prescribing
