Oklahoma State Law Flashcards
Record Keeping in Oklahoma for Prescription records, immunization records, nightly reports is how long compared to Federal regulation?
5 yrs = Oklahoma
2 yrs = Federal
Record Keeping Oklahoma for Patient records, invoices, and inventory is the same as Federal regulation and how long is that?
2 yrs
Prescription Record Filing Requirements are what in Oklahoma?
- Non-Scheduled legend
- Schedule II
- Schedule III-V
MUST HAVE 3 Separate Files in Oklahoma
Prescription Record Filing Requirements are different how Federally?
Federal allows co-mingling of Legend with schedules III-V plus C stamp notation
Refill Record Keeping requires what?
- May be recorded on the back of the prescription
- May be kept using an automated data processing system
Inventories, records, invoices, purchase records of what must be kept separate from Schedule III-V?
Schedule I and II must be separated
In Oklahoma, CDS inventory MUST be taken between WHEN?
May 1- July 1 and then a copy included with pharmacy renewal license
If your pharmacy license expires in October can you perform CDS inventory in September in Oklahoma?
NO, Must complete CDS inventory and license renewal in between May 1 - July 1
Controlled substance inventory must be performed every 2 years OBNDD/Federal but what is it in Oklahoma?
ANNUAL
In Oklahoma ANNUAL CDC Inventory must include what?
EXACT COUNT of ALL SCHEDULES regardless of the size of the bottle
Nightly Reports are required for what?
ALL controlled dangerous substances
C-II reports separate from CIII-V reports and they shall be what by a PHARMACIST?
Verified, signed, and dated
Nightly reports represent prescription records, NOT what?
Inventory/Invoice records
How long do Nightly Reports have to be kept for?
5 yrs
What are the requirements for Patient Records?
- Full name of the patient
- Address and telephone number
- Age or DOB
- A list all prescription drug orders obtained by the patient at that pharmacy during the previous 6 months, showing the prescription number, the name of drug, strength, quantity, and date received, and the name of the prescriber
What are the parts of CDC Inventory that varies by State?
- Inventory at license renewal
- Change of ownership or pharmacy manager
- Board requested inventory
- Closing inventory
Inventory at License Renewal has to be done when in OK?
May 1-July 1
Change of Ownership/Pharmacy Manager has to be done when in OK?
- CDS Inventory taken and sent to the Board within 10 days
- Indicate NEW and FORMER manager names + registration numbers
Board Requested Inventory has to be done when in OK?
Due to loss/theft/etc the board will request the pharmacy to conduct an inventory and must be done within 10 days
Closing Inventory has to be done when in OK?
Taken and a copy sent to the board within 10 days of closing the pharmacy
What are the Prescription Requirements for Oklahoma CDS Prescriptions?
- Practitioner Name, Address, DEA#
- Date of Issuance
- Name of Medication/Dosage/Strength
- Name and Address of Patient
- Directions for Use
- Cautionary Statements
- Refills Allotted, if any
- For Veterinary, must include species, name, and address of owner
For ALL schedules regardless of category, a PHARMACIST may ADD what?
- Patients address or age
- Generic name, if used
- Prescriber DEA # IF CIII-V
A Pharmacist may ADD what AFTER confirmation with prescriber?
- Strength, dosage form, quantity, directions for use
- Must call prescriber and confirm to add DEA# for C-II
For C-II Prescriptions Pharmacists CANNOT ADD what?
- Prescriber Name
- Drug Name
- Date of Issuance
- Patient Name
For C-II prescriptions can you erase, white out, or mark out anything?
NO
EACH CDS prescription should be written on a SINGLE prescription form with NO other prescriptions on the same form. Mistakes happen most often with?
Dentists prescribing tramadol and phenergan on the same form
Schedule II prescriptions becomes INVALID when?
30 days from the day they are issued
A FAX sent from the prescriber may serve as the original for a C-II if what?
- Being filled by a home infusion pharmacy
- The patient is in a long-term care facility
- The patient is in a hospice program
Oklahoma House Bill 1446 applies to what?
ONLY to Immediate Release Opioids prescribed for acute pain
Oklahoma House Bill 1446 requires written diagnosis for acute or chronic pain be included on prescription is excluded in what populations?
- Active cancer treatment
- Hospice
- LTCFs
- Treatment of substance abuse/dependence
Buprenorphine Cough Syrups with Codeine or Hydrocodone are excluded from Oklahoma House Bill 1446?
YES, when prescribed for cough
Initial prescription for ACUTE Pain for patients that what?
- Never been issued prescription for the drug/equivalent in the past YEAR or
- NEW surgical procedure within the past YEAR
- LIMITED to MAX of a 7-day supply (CAN PARTIAL FILL)
If a SECOND ACUTE pain prescription is needed, what is the max?
MAX quantity of a 7-day supply after prescriber has consulted with patient
If a THIRD ACUTE pain prescription is needed, what is required?
- Prescriber must have in place with patient a written agreement
- No quantity/days supply noted
- Pharmacies are NOT required to ensure the written contract is in place
What is Chronic Pain?
Beyond acute healing of injury
Prescriber must evaluate patient therapy, if chronic pain treated for 3 months or greater but what happens if the patient has an acute pain during chronic therapy?
Prescriber is no longer limited to THREE 7-day periods, can do 4 prescriptions or more
What is the Oklahoma House Bill 2931?
Prescribers registered with OBNDD must electronically submit all CII-V prescriptions
CII prescriptions MUST be electronically prescribed except may accept NON-Compounded FAXED prescription on OBNDD PAD ONLY if what?
- Pain management by home infusion pharmacy
- LTCF patient
- Hospice patient
What are the electronic prescribing exceptions of Oklahoma House Bill 2931?
- OK Veterinarians (must use OBNDD pad)
- Out of state prescribers
- Prescribers practicing in federal facilites
- Prescription filled at a pharmacy on federal property
- On-site hospital pharmacy order for on-site admin
What is Oklahoma House Bill 2676?
Prescribing exceptions for Copounded Rxs
What are the exceptions included in Oklahoma House Bill 2676?
- Do NOT have to be e-prescribed or issued on OBNDD prescription pad
- CIII-V can be written, phone in, or faxed
- CII van be WRITTEN (NOT PHONED)
According to Oklahoma House Bill 2676, Electronic Prescriptions MAY BE used for what?
- Compounded prescriptions
- Compounded infusion prescriptions
- Prescriptions issued under approved research protocols
For Multiple CII Rxs same drug, patient, and day what is permitted?
- Each prescription issued on a SEPARATE blank
- Up to 3 prescriptions of same medication on same date
- Total quantity prescribed does not exceed 90 day supply
- 2nd/3rd Rx have a Do Not fill UNTIL DATE
Can the pharmacy alter written date on multiple CIIs on same day?
NO, must include both written and fill dates
According to Oklahoma HB 1446 Emergency Rules: Major Surgery/Confided to Home, after issuing initial Rx, practitioner can issue 1 subsequent rx for immediate release opioid in CII in a quantity to NOT exceed 7 days IF what?
- Patient had a major surgery and confined to home
- Subsequent Rx provided on same day as initial Rx
- Written instructions on subsequent Rx indicate earliest date on which it may be filled
For Oklahoma HB 1446 Emergency Rules: Subsequent Rx must be filled within 5 days of the do not fill date indicated on the Rx or what?
VOIDED
In Oklahoma, for an emergency situation with ORAL authorization of CII, the prescriber must deliver a written prescription to pharmacy when?
72 hrs Oklahoma
1. Must have authorization for emergency dispensing on Rx and DATE of ORAL order
2. May be directly delivered or mailed
3. If not completed pharmacist must contact OBNDD
For PARTIAL filling of CIIs, federal partial fill rules do NOT apply to what 2 situations in Oklahoma?
- Does NOT apply to emergency oral Rx
- Does NOT apply if pharmacy does not have enough medication in stock, must fill the remainder within 72 hrs
Refills for CIII-IV has what rules?
- Expire 6 months from date of issuance
- May not be refilled more than 5 times
- May not get refills at the same time as initial fill or more than one refill at a time
A new prescription for a specific CDS VOIDS any existing refills or other prescriptions for the same drug meaning?
New prescription = the refills for the existing prescription immediately are voided
A practitioner may authorize additional refills for CIII-IV if the original prescription was what?
Written for less than 5 refills
Partial Fill Regulations for CIII-V are what?
- Total quantity dispensed cannot exceed total prescribed
- No dispensing 6 months after date issued
Transfer Regulations for CIII-V are what?
- If on hold or never filled = cannot be transferred
- Refills can be transferred according to State Law
- ONLY between 2 Licensed PHARMACISTS = NO interns
Exempt narcotics only apply to what?
Schedule V
Logbook for C-V dispensing by a pharmacist must contain what?
- Name and Address of Purchaser
- Date of EACH purchase
- Name or Initials of Pharmacist
What are the 48 hr limits for C-V Codeine/Salts?
160 mg (<80 mg/30mL or oz)
1. Codeine Oral Solution 0.2% allowable
2. Codeine Oral Syrup 5mg/mL allowable
What is the max amount of mLs that you can dispense or codeine oral solution 0.2%?
80 mL
Reporting to OBNDD must be done within 5 MINUTES of CDS Dispensing and must submit what?
- Recipient’s name
- Recipient’s identification number (drivers license)
- NDC
- Date of Dispensing
- Quantity
- Prescribers DEA Registration #
- Dispensers DEA Registration # and Location
What is acceptable identification for CDS prescriptions per OBNDD?
- Valid Passport
- Military Identification Card
- Driver’s License
- State Issued Identification
House Bill 1246 says if state issued identification is expired <1 yr what can be used?
SSN
OBNDD requires the ID of both the ultimate user and who?
The person who picks up the prescription be reported to the PMP
What are the sale limits of PSE in Oklahoma?
- 3.6g per day
- 7.2g per 30 days
- 60g per year (250 days at max labeled dosing)
For Mid-Level Practitioners in Oklahoma what are the prescribing limits?
- OUT of state mid level may prescribe noncontrolled substances
- ONLY mid level licensed IN OKLAHOMA may prescribed controlled substances (supervising physician must also be licensed in OK)
PA’s can prescribe what?
CII: drug formulary per medial board/pharmacy board
CIII-V: 30 day supply, no refills
Legend/Non CDS: new diagnosis 30 day supply 2 refills or established diagnosis 90 day supply with 3 refills
APN can prescribe what?
CII: NO
CIII-V: 30 day supply, no refills – may be less than 30 day supply w/refills but not to exceed 30 days total
CRNA can prescribe what?
CII-V
ONLY in perioperative, NO outpatient
Optometrists can prescribe what?
Hydrocodone-Containing products up to 5 days
CIII-V: up to 7 day supply, no refills without follow up exam
Must be within scope of the eye
Oklahoma House Bill 3862 allows for what?
Optometrists to DISPENSE medications
Legal to fill CDS from MD/DO/DDS/Vets licensed from out-of state but NOT legal for who unless licensed in Oklahoma?
NP, PA, Optometrists
Veterinarians are NOT eligible to obtain an NPI # and prescriptions should NOT be denied and for NON-CDS prescriptions pharmacies should what?
NOT request DEA number
Laws on electronic prescriptions and use of OBNDD prescription pad do NOT apply to who?
Prescriber’s practicing in a FEDERAL facility
Practitioners may NOT prescribe a CDS for patient within the 1st or 2nd degree whether by blood or marriage
But they MAY prescribe a CDS for patient within the 3rd degree or BELOW, must have a VALID doctor patient relationship
What counts as a 1st degree relationship?
Spouse, parent, children
What counts as a 2nd degree relationship?
Sibling, grandchildren, grandparents
What counts as a 3rd degree relationship?
Niece/Nephew, Great Grandchildren, Aunt/Uncle, Great Grandparents
Naloxone can be prescribed/dispensed by a pharmacist without protocol to who?
- Any person at risk of experiencing an opioid related drug overdose
- Family or friend of an at risk person
- First responder
