NMBOP: Part 16, 17, 18, 19 Flashcards

1
Q

PART 16 SAMPLE DRUG DISTRIBUTION

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2
Q

Q: What is the definition of a “sample” in the context of pharmaceutical regulations?

A

A: A sample is a drug that is not intended to be sold and is intended to promote the sale of the drug.

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3
Q

Q: What items are prohibited from being bought, sold, traded, bartered, or exchanged according to 16.19.16.8 NMAC?

A

A: The following items are prohibited from being bought, sold, traded, bartered, or exchanged:
1. Pharmaceutical product samples.
2. Pharmaceutical products sold for export only.
3. Pharmaceuticals purchased by hospitals and/or clinics, including state and local government agencies, for exclusive use within those institutions and not intended for resale.
4. Pharmaceutical products donated or supplied at reduced prices to charitable institutions in the U.S. or abroad for their institutional use.
5. Complementary pharmaceutical product trade packages.

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4
Q

Q: Are there any exceptions to the prohibition on buying, selling, or exchanging pharmaceutical samples?

A

A: Yes, exceptions include:
1. Sales otherwise permitted by law to affiliated corporations within a health care corporate structure.
2. Sales by bona fide group purchasing arrangements to members.
3. Emergency borrowing or lending between licensed health care facilities.

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5
Q

Q: What are the consequences of violating the regulations related to pharmaceutical sample distribution?

A

A: Violations of these regulations can result in the revocation of licenses or permits issued by the Board of Pharmacy.

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6
Q

PART 17 DANGEROUS DRUGS AND DANGEROUS DRUG RESEARCH

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7
Q

Q: Who is eligible to apply for a research license to conduct projects involving dangerous drugs?

A

A: Eligible applicants include public agencies, institutions of higher education, private organizations, and individuals for the purpose of conducting research, demonstration, or special projects using dangerous drugs.

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8
Q

Q: What must an applicant provide when applying for a research license for dangerous drugs?

A

A: The applicant must provide the following information:
1. Name, address, and date of birth of persons involved in handling dangerous drugs, and any felony convictions.
2. Drug protocol, including:
- Formulary of dangerous drugs for research.
- Utilization of the dangerous drug.
- Quantity used per dose or experiment.
- Annual drug purchase amount.
3. Policy and procedure manual, including:
- Drug security: storage area and list of individuals with access.
- Drug procurement: invoices, receipts, and sources.
- Drug usage: records or logs.
- Drug waste/destruction: memorandum report.
- Drug storage area.
- Research protocol: confidentiality of proprietary or trade secrets.
4. Qualifications of the applicant, which may include degrees, higher education, and specialized training.

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9
Q

PART 18 NUCLEAR PHARMACY

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10
Q

“Practice of Nuclear Pharmacy”

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means a patient-oriented service that embodies the scientific knowledge and professional judgement required to improve and promote health through the assurance of the same and efficacious use of radiopharmaceuticals and other drugs.

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11
Q

“Nuclear Pharmacy”

A

means a pharmacy which provides radiopharmaceutical services, and shall be licensed by the Board as a wholesaler or retail pharmacy.

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12
Q

Q: What defines a “Qualified Nuclear Pharmacist”?

A

A: A “Qualified Nuclear Pharmacist” is a pharmacist currently licensed by the Board who meets either of the following criteria:

  1. Certification:
    • Certified as a Nuclear Pharmacist by the Board of Pharmaceutical Specialties.
  2. Training and Instruction:
    • Experiential Training:
      • Attained a minimum of 500 contact hours of experiential training in nuclear pharmacy under the supervision of a qualified nuclear pharmacist. This training must include:
        • Procurement of radioactive materials.
        • Compounding of radiopharmaceuticals.
        • Maintenance of a quality assurance program.
        • Dispensing of radiopharmaceuticals.
        • Distribution of radiopharmaceuticals.
        • Implementation of basic health and safety practices and procedures.
        • Provision of information and consultation related to nuclear pharmacy and radiopharmaceuticals.
    • Didactic Instruction:
      • Completed 200 contact hours of didactic instruction in nuclear pharmacy and the safe handling and use of radioactive materials from a nationally-accredited college of pharmacy or an ACPE-accredited provider. This instruction must cover:
        • Radiation physics and instrumentation.
        • Radiation protection.
        • Mathematics pertaining to the use and measurement of radioactivity.
        • Radiation biology.
        • Radiopharmaceutical chemistry.
  3. Exemption:
    • Any pharmacist legally listed on a radioactive material license for a nuclear pharmacy in the State of New Mexico for at least six months prior to the 1994 effective date of these regulations is exempt from the above training and certification requirements.
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13
Q

“Radiopharmaceutical Services”

A

“Radiopharmaceutical Services” means the procurement, storage, handling, compounding, labeling, quality control testing, dispensing, distribution, transfer, record keeping and disposal of radiochemicals, radiopharmaceuticals and ancillary drugs, and also includes quality assurance procedures, radiological health activities, any consulting activities associated with the use of radiopharmaceuticals, and any other activities required for provision of pharmaceutical care.

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14
Q

“Quality Control Testing”

A

“Quality Control Testing” means the performance of appropriate chemical, biological and physical tests on compounded radiopharmaceuticals and the interpretation of the resulting data to determine their suitability for use in humans and animals.

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15
Q

“Quality Assurance Procedures”

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“Quality Assurance Procedures” means all activities necessary to assure the quality of the process used to provide radiopharmaceutical services, including authentication of product history and maintenance of all records as required by pertinent regulatory agencies.

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16
Q

“Authentication of Product History”

A

“Authentication of Product History” means identifying the purchasing source, the ultimate fate, and any intermediate handling of any component of a radiopharmaceutical or other drug.

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17
Q

“Radiopharmaceutical”

A

“Radiopharmaceutical” means any drug which exhibits spontaneous disintegration of unstable nuclei with the emission of nuclear particles or protons and includes any nonradioactive reagent kit or nuclide generator which is intended to be used in the preparation of any such substance but does not include drugs such as carbon-containing compounds or potassium-containing salts which contain trace quantities of naturally occurring radionuclides. The term ‘radiopharmaceutical’ also includes any biological product which is labeled with a radionuclide or intended solely to be labeled with a radionuclide.

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18
Q

Q: Are the licensing requirements for a nuclear pharmacy separate from general pharmacy licensing requirements in New Mexico?

A

A: No, the licensing provisions for a nuclear pharmacy are in addition to, and not a substitute for, the general licensing requirements for all pharmacies in New Mexico.

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19
Q

Q: What must a pharmacy do to provide radiopharmaceutical services?

A

A: A pharmacy that will provide radiopharmaceutical services must obtain a nuclear pharmacy license from the Board.

20
Q

Q: What is required regarding personnel in a nuclear pharmacy?

A

A: A nuclear pharmacy must employ one or more qualified nuclear pharmacists. The application for a nuclear pharmacy license must include documentation that all pharmacists providing radiopharmaceutical services meet the criteria specified for a qualified nuclear pharmacist.

21
Q

Q: What general requirements must a nuclear pharmacy meet?

A

A: A nuclear pharmacy shall meet the requirements of 16.19.6 NMAC of the Board, except as specifically provided for in the nuclear pharmacy regulations.

22
Q

Q: What is required regarding personnel attendance at a nuclear pharmacy?

A

A: A qualified nuclear pharmacist must be in personal attendance when the nuclear pharmacy is open for business.

23
Q

Q: What records must a nuclear pharmacy maintain?

A

A: A nuclear pharmacy must maintain records of procurement, inventory, and disposition of all radioactive drugs and other radioactive materials.

24
Q

Q: What regulatory documents must a nuclear pharmacy have?

A

A: A nuclear pharmacy must have a current copy (paper or electronic) of city, state, and federal regulations governing the safe storage, handling, use, dispensing, transport, and disposal of radiopharmaceuticals.

25
Q

Q: What are the minimum equipment requirements for a nuclear pharmacy?

A

A: The minimum equipment requirements for a nuclear pharmacy, in addition to those in 16.19.6.11 NMAC, include:

  1. Radionuclide Dose Calibrator
  2. Refrigerator
  3. Single or multiple channel scintillation counter with well-type NaI(T1) or Ge(Li) detector
  4. Radiochemical fume hood and filter system
  5. Area rate meter
  6. At least two (2) GM survey meters
  7. Microscope and hemacytometer
  8. Laminar air flow hood and/or biologic safety cabinet
  9. Syringe and vial radiation shields
  10. Lead-shielded drawing station
  11. Decontamination supplies
  12. Other equipment as needed for radiation safety and quality control/quality assurance.
26
Q

Q: What standards must a nuclear pharmacy operate in accordance with?

A

A: A nuclear pharmacy must operate in conformance with the United States Pharmacopeia General Chapters: <825> Radiopharmaceuticals – Preparation, Compounding, Dispensing, and Repackaging, and all other applicable chapters numbered 1000 or less.

27
Q

Q: How must medications be dispensed from a nuclear pharmacy?

A

A: Medications shall be dispensed from a nuclear pharmacy in accordance with the requirements contained in 16.19.6 NMAC, except as specifically provided for in the radiopharmaceutical regulations.

28
Q

Q: To whom can a radiopharmaceutical be dispensed?

A

A: A radiopharmaceutical shall be dispensed only to a licensed practitioner authorized by the Nuclear Regulatory Commission or an equivalent agreement state agency to possess, use, and administer such drug. It can be dispensed only upon receipt of a prescription from such a licensed practitioner. Alternatively, it may be transferred to a person authorized to possess and use the drug for non-clinical applications.

29
Q

Q: What additional labeling information is required on the outer container shield of a radiopharmaceutical?

A

A: The outer container shield of a radiopharmaceutical must be labeled with the following information:

  1. The standard radiation symbol
  2. The words “Caution – Radioactive Materials”
  3. The radionuclide
  4. The chemical form
  5. The amount of radioactivity and the calibration date and time
  6. The expiration date and time
  7. If a liquid, the volume
  8. If a solid, the number of dosage units or weight
  9. If a gas, the number of ampules or vials
  10. The name of the patient (required only for radiolabeled blood components and all radiopharmaceuticals intended for therapeutic use)
30
Q

Q: What labeling information is required on the inner container of a radiopharmaceutical?

A

A: The inner container (e.g., syringe, vial, etc.) used to dispense or transfer a radiopharmaceutical must be labeled with:

  1. The standard radiation symbol
  2. The prescription or lot number
  3. The name of the radiopharmaceutical
  4. The name of the patient (required only for radiolabeled blood components and all radiopharmaceuticals intended for therapeutic use)
31
Q

Q: What must a licensed nuclear pharmacy do upon receiving a verbal prescription for a radiopharmaceutical?

A

A: Upon receiving a verbal prescription for a radiopharmaceutical, the nuclear pharmacy must immediately reduce the prescription to writing or record it in a data processing system. The writing or record must contain:

  1. The name of the institution represented
  2. The date of the prescription
  3. The name and dose of the radiopharmaceutical
  4. The name of the procedure
  5. The requested date/time of calibration (tentative date/time of administration) of the prescribed radiopharmaceutical
  6. The name of the patient (required for radiolabeled blood components and all radiopharmaceuticals intended for therapeutic use)
  7. Any specific instructions, if required
32
Q

Q: What records must a nuclear pharmacy maintain for radiopharmaceuticals dispensed under an Investigational New Drug Application (INDA)?

A

A: For radiopharmaceuticals dispensed under an Investigational New Drug Application (INDA), the nuclear pharmacy must maintain:

  1. An investigator’s protocol for the preparation of the radiopharmaceutical
  2. A copy of the Institutional Review Board approval form (or letter)
  3. A letter from the manufacturer (sponsor) indicating that the physician requesting the radiopharmaceutical is a qualified investigator
33
Q

PART 19 HOME CARE SERVICES

A
34
Q

“Home care services”

A

means any organization licensed by the New Mexico Department of Health and the Board of Pharmacy to provide skilled nursing services and at least one other therapeutic or supportive service to patients/clients in their place of residence.

35
Q

Q: What does the New Mexico Board of Pharmacy acknowledge about home care services?

A

A: The New Mexico Board of Pharmacy acknowledges the establishment of home care services outside the institutional setting. To protect people who utilize such services, laws, regulations, and safeguards pertaining to drugs must be observed.

36
Q

Q: What must be listed in the policy and procedure manual of Home Care Services regarding dangerous drugs?

A

A: The dangerous drugs acquired, maintained, and administered by Home Care Services must be listed in the agency policy and procedure manual and approved by the Board of Pharmacy.

37
Q

Q: What dangerous drugs are approved for Home Care Services?

A

A: The following is an approved list of dangerous drugs for Home Care Services:

  1. Sterile Normal Saline and water - injectable
  2. Sterile Normal Saline and water - irrigation
  3. Acetic Acid – irrigation
  4. Heparin flush solution
  5. Tuberculin testing solution
  6. Hepatitis B vaccine
  7. Flu vaccine
  8. Topical anesthetic
  9. Diphenhydramine injectable
  10. Epinephrine injectable
38
Q

Q: How should additional dangerous drugs be handled by Home Care Services?

A

A: Any additional dangerous drugs must be defined and listed in the policy and procedure manual and must be approved by the Board of Pharmacy.

39
Q

Q: What are the general requirements for drug storage in Home Care Services?

A

A: There must be adequate space for the proper storage of drugs, which includes proper ventilation, lighting, temperature controls, and refrigeration.

40
Q

Q: How must dangerous drugs be stored in Home Care Services?

A

A: Dangerous drugs must be stored in a special locked space that provides adequate security.

41
Q

Q: What measures should be taken to prevent issues with drug storage?

A

A: The purchase, storage, and control of drugs must be designed to prevent having outdated, deteriorated, or impure drugs in the facility.

42
Q

Q: Where should dangerous drugs be stored and what is allowed regarding their transportation?

A

A: Dangerous drugs must be stored at the Home Care Service’s licensed location. However, small quantities of dangerous drugs, not exceeding the quantity necessary to meet the needs for a 96-hour period, may be possessed and transported to other locations by authorized employees.

43
Q

Q: What should be included in the Home Care Service’s policy and procedure manual regarding dangerous drugs?

A

A: The policy and procedure manual should include:

  1. Quantities of dangerous drugs allowed to be in the possession of authorized employees for administration.
  2. Requests for changes in these quantities must be approved by the Board.
44
Q

Q: What records must be kept regarding dangerous drugs issued to authorized employees?

A

A: A record of all dangerous drugs issued to authorized employees must be kept for a period of three years and must include:

  1. Date issued
  2. Name of authorized employee
  3. Name and strength of dangerous drugs issued
  4. Quantity of dangerous drug issued
45
Q

Q: What information must be recorded to account for the administration of all dangerous drugs?

A

A: Records must include:

  1. Date of administration
  2. Name of patient
  3. Name of dangerous drug
  4. Dose or amount administered
  5. Name of practitioner ordering administration
  6. Name of licensed person administering the dangerous drug
46
Q

Q: How often must a consultant pharmacist visit Home Care Services?

A

A: A consultant pharmacist is required to visit the Home Care Service on no less than a quarterly basis.

47
Q

Q: What registrations are required to purchase and store controlled substances in Home Care Services?

A

A: To purchase and store controlled substances, Home Care Services must obtain:

  1. A separate state controlled substance registration
  2. A DEA controlled substance registration