MassPAT

Question 1

MassPAT

Answer 1

mass prescription awarness tool

Question 2

dentist prescribed most opiods to which age group

Answer 2

10-19 years old

prescribed 8% of the opioids at this time

Question 3

differences in mu opioid receptors?

Answer 3

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

Question 4

study showed combo therapy best wit

Answer 4

ibuprofen 400 mg and oxycodone 5 mg

Question 5

where pain relievers were obtained

Answer 5

53 % FREE from friend / relative

21% - from one doctor

14 % took / bought from friend / relative

Question 6

shift of Co2 response with opiods

Answer 6

right -shifted

Question 7

sedation occurs before respiratory depression T/F?

Answer 7

true – this is a warning sign

Question 8

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?

Answer 8

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

Question 9

age at risk for misuse

Answer 9

under 45

Question 10

% dentist ask patietns about alcohol use

Answer 10

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

Question 11

opioid disposal

Answer 11

1. local take back programs if availble
2. DEA - authorixed collection sites
3. disposal in trash in bag with kitty liter, coffee grounds
4. flush down toilet t if appropriate – consult the FDA

Question 12

CFR 1206.04

Answer 12

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

Question 13

refilling opiod rx without seeing pt good clinical practive?

Answer 13

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

Question 14

schedule II?

Answer 14

basically all besids tylenol with codeine (#3) which is a number III – moderate dependence liability vs high abuse potential with schedule II

Question 15

time limit with scheudle II

Answer 15

no but must be SIGNED by practioner

oral order may be permitted in emergency situation

Question 16

schedule III rx can be communicated how

Answer 16

orally, wrinig or by calling

Question 17

MassPAT has what info

Answer 17

rx history for the prior 12 months

- date dispensed, patient, prescriber, pharmacy, medication and dose

Question 18

DPH annually sends out

Answer 18

info to individual prescribers on how they are prescribing schedule II and III opioids in coparison to other prescribers wihin the specialty

Question 19

benzo with MassPAT?

Answer 19

require prescribers to utilize the PMP each time a prescription for a benzo is issued

Question 20

use of MassPAT

Answer 20

when using schedule II-III opioid or benzo

Question 21

T/F 7 day supply?

Answer 21

true - no more than 7 day suppy for opiate for outpatient use for the first time

Question 22

if need more than 7 days?

Answer 22

documented in the patients medical record and the practioner shall indicate that a non-opiate alternative was not aporopriate to address the medical condition

Question 23

7 day does not apply to

Answer 23

not apply to medications designed for the treatment of substance abuse or opiod dependence

Question 24

section 18C commonwealth of mass

Answer 24

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

2. inform – the patient of the risks associated with the opiod prescribed

“partial fill upon patient requet”

Question 25

CARE Act

Answer 25

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

Question 26

CARE Act creates?

Answer 26

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