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Pharmacy Law > Nevada Law > Flashcards

Nevada Law Flashcards

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1
Q

how long must the written record of refills be kept?

A

maintain for 2 years after the date of the last fill

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2
Q

refills of a controlled substance

A

a controlled substance may not be refilled more than 5 times or after 6 months after the date the prescription was written

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3
Q

every prescription written is good only for

A

one year, including non-controls

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4
Q

what is a narcotic

A

CII

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5
Q

what are legend drugs

A

anything that is NOT scheduled

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6
Q

if a pt is prescribed a 90 day supply, pharmacist may dispense not more than a 90 day supply if

A
  • pt has a used initial 30 day supply of the drug or has previously been prescribed a 90 day supply
  • total amt dispensed does not exceed total amt prescribed including refills
  • prescriber must not have specified a certain method as medically necessary
  • if prescribed for 90, can fill any # up to 90
  • if written for 30 and if there are refills allowed, and 90 is written, the initial fill can be for 90
  • if no file for 90, even if 3 refills are allowed, must be filled for 30
  • if insurance company only covers 90, and rx is only 30, must call doctor to change to 90
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7
Q

judgement by pharmacist on refills

A

if needed for chronic or continuing illness and unable to reach doctor

if a pt is out of refills even if out of refills, if in the best interest for the pt, rph can dispense but must inform physician

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8
Q

voided refills

A

can be done by original practitioner

  • if starting new rx and don’t need previous rx
  • if dr decides pt doesn’t need rx anymore
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9
Q

copies of rx

A

must say copy, references purposes only. original copy must be voided

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10
Q

generic substitution

A

must dispense generic if:

  • less expensive than drug
  • biologically eqv and prescribed by brand
  • same active ingredients or same strength, quant, dosage
  • same generic type as drug prescribed

if more than one generic, must dispense least expensive

must advise pt that their being given generic

if govt agency (medicaid/medicare), must dispense generic

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11
Q

when can a generic substitution be made?

A

must dispense generic if:

  • less expensive than drug
  • biologically eqv and prescribed by brand
  • same active ingredients or same strength, quant, dosage
  • same generic type as drug prescribed

if more than one generic, must dispense least expensive

must advise pt that their being given generic

if govt agency (medicaid/medicare), must dispense generic

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12
Q

when is it not allowed to make a generic substitution/a rph may not dispense generic if

A
  • dr. orally specifies before drug is dispensed
  • handwriting “dispense as written” including faxed, but not by pre-printed method
  • typed “dispense as written” in any rx that is given to the rph by electronic submission
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13
Q

generic substitution exceptions

A
  • rx dispensed to inpatient hospital by inpatient pharmacy
  • rx dispensed by mail order/internet pharmacy
  • if generic would violate terms of health care plans/coverage for prescription drug
  • would otherwise made transaction ineligible for reimbursement by third part
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14
Q

if generic substitution is made, what should the pharmacist do?

A

-note name of manufacturer, packer, or distributor of drug actually dispensed on prescription

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15
Q

employer of pharmacist cannot require rph to dispense specific generic drug if

A
  • not permitted by prescriber
  • against professional judgement of rph
  • violates sub requirements

-kickbacks

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16
Q

acts performed by rph and intern pharmacists only

A

taking new orders/rx
interpreting clinical data contained in pt med system of chart
consulting with prescriber
determine efficacy of drug, regimen, generic substitution, responsibility for pharmtech and interns, counseling pt

17
Q

acts not required by pharmaceutical professionals (aka what a clerk can do)

  • don’t HAVE to, but can
A
  • entering into into pharmacy comp except info contained in new rx concerning prescription drug and directions for its use
  • processing sales, op of cash reg
  • stocking shelves
  • delivering meds to pt or areas of a hospital where pt are cared for
18
Q

patient counseling (last chance to catch mistake before it’s made)

A
  • every new rx from that pharmacy (includes transfers)
  • if info would further improve the drug therapy of pt
  • reasonable concern relating to the safety or efficacy of drug

-even on refill
-if pt denies counsel, must be
documented

-must be recorded if pt accepted or denied counseling in real time

19
Q

patient counseling information - what you need to tell the patient

A
  • 3 prime questions

- quest scholar-mac

20
Q

review a pt’s record before dispensing

A

-over/under utilization
-therapeutic duplication
-interactions (drugs, disease, allergies)
incorrect dosage or duration of treatment

21
Q

computer system

A

can be electronically submitted but must have all requirements of regular prescription
must be hand signed by doctor

22
Q

can an agent transmit a dangerous drug?

A

yes, but not CS

23
Q

CS can only be transmitted by a

A

practitioner

24
Q

fax transmission

A

cannot fax CII narcotic to a pharmacy unless, LTCP, hospice

25
Q

what is considered a dangerous drug?

A

NRS 454.201

any drugs other than CS unsafe for use without a doctor overseeing use (prescription drug)

26
Q

what is considered a dangerous drug?

A

NRS 454.201

any drugs other than CS unsafe for use without a doctor overseeing use (prescription drug)

27
Q

what can be considered an original prescription?

A

escribe
fax
handwritten
oral

28
Q

transfers between 2 pharmacies

A

if legal to transer, rph cannot refuse to transfer

can be transferred orally or by fax

can also be done electronically if within the same system/pharmacy

rph and interns can do this

29
Q

procedure for oral transfers

A
  • write void on face of rx

- record name of rph who transfers info, date, name and address of pharmacy, name of pharmacist who receives info

30
Q

declination of pharmacist to fill prescription

A
  • if filling is unlawful
  • imminently harmful to the medical health of pt
  • prescription is fraudulent
  • prescription is not for a legitimate medical purpose

Pharmacy Law (3 decks)

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