MT2 22-24 Prescribing and Regulatory Issues

Question 1

Scope of ODs

Answer 1

Doctors of Optometry who are certified to prescribe and use therapeutic pharmaceutical agents and may prescribe treatment for ocular disorders

Question 2

Elements of Prescription

Answer 2

verbal, written, electronic order

• required* patient name
• address (present on Rx)
• Date of Rx issue
• name of drug or device dispensed
• quantity of drug or device to be dispensed
• direction for use .
• Prescriber Name, phone Number, signature, license class
• TPA number (OD number)

Question 3

Controlled Substance Schedules

Answer 3

• dived into 5 schedules - based on accepted medical use, abuse potential, likelihood of dependence

Question 4

Schedule I controlled substance (Class I or C-1)

Answer 4

• have no currently accepted medical use, lack of accepted safety, high potential for abuse

Question 5

Schedule II (2/2N) = Class II or C-II

Answer 5

• high potential for abuse - No refills allowed - Rx must be written each time
• all hydrocodone-based products (Norco, Vicodin, Lortab)

Question 6

Schedule III (3/3N) = Class III

Answer 6

• less abuse potential than C-I or C-II
• ex: Tylenol with Codeine - only 3day for ocular pain (OD)

Question 7

Schedule IV = Class IV

Answer 7

• low potential for abuse relative substance compared to schedule III
• ex: tramadol

Question 8

Schedule V

Answer 8

• has low potential for abuse compared to Sched IV
• ex: cough preparations

Question 9

How can optometrists prescribe specific controlled substances?

Answer 9

Obtain TPA certification + Valid OD License

• register with the DEA – get DEA #
• C-III rx can be issued by OD

Question 10

Specially printed Rx forms

Answer 10

used for prescriptions for controlled substances
- valid printed security forms must include specific features

• • for Controlled Substances - # of substances prescribed must be marked
• *California Law -Prescribers of any C-II through C-V rx MUST use tamper-resistant prescription froms

Question 11

What are Prescription drug Monitoring Programs (PDMPs)

Answer 11

PDMPs are state-run electronic databases used to track prescribing and dispensing of controlled prescription drugs to patients

Question 12

What is CURES

Answer 12

PDMP program - Controlled Substance Utilization Review & Evaluation System – For CALIFORNIA

• database of Sched II, III, IV, V controlled substances in CA
• *must be a California-licensed health care practitioner possessing a DEA number

Question 13

Use Layman’s Language

Answer 13

I-M-D-A
- Introduce and Indications (what the medication is + pronounce)
- Mechanism of action
- Dosage regimen (directions)
- Adverse effects, Ask Questions, anything else?

Question 14

Bevacizumab (Avastin)

Answer 14

VEGF inhibitor
Off Label Tx for ARMD

Question 15

Brand Name Drugs vs Generic Drugs

Answer 15

generic drugs contain same active pharmaceutical ingredient
- same bioequivalence and bioavailability

Question 15

Brand Name Drugs vs Generic Drugs

Answer 15

generic drugs contain same active pharmaceutical ingredient
- same bioequivalence and bioavailability
- same therapeutic and pharmacologic activity

Question 16

FDA Therapeutic Equivalence Evaluation Codes

Answer 16

Two Basic Categories: A or B
- agency determination of approved product as therapeutic equivalent

A is tehrapeutically equivalent