Pages 91-end DS book Flashcards
What one place can a technician work where they are not required to obtain registration?
Federal facility
When do registered pharmacy technician registrations expire? Even or odd years?
March 31st, even years
When do certified technician licenses expire? Even or odd years?
September 30th, even years
How long is a technician trainee license good for?
Valid for one year
How many CE hours do registered techs need to do?
Ten hours total, 2 in law and 2 in med safety
What 5 things can a certified tech do that a trainee/registered tech cannot?
1.) Accept new verbal Rx’s for non-controlled drugs
2.) Accept verbal refill authorizations as long as no change to OG script
3.) Send/receive transfers for non-controlled drugs
4.) Contact prescriber/agent for clarification as long as no professional judgement nec.
5.) Perform diagnostic lab testing
What two things can a pharmacy technician trainee not do that a registered tech can?
1.) Stock automated drug dispensing cabinets, crash carts, floor stock
2.) Request refill authorizations with no change from OG script
If a pharmacist/intern license is revoked, suspended or refused how soon shall they return their ID card/license to the Board?
Within 10 days
At what age can retailers sell dextromethorphan products to customers?
18 or older
What 3 criteria must be met that prohibits pharmacists from dispensing certain non-self injectable cancer drugs directly to a patient?
1.) Drug is indicated for treatment of cancer or cancer related illness
2.) Must be administered IV or subQ
3.) Cannot reasonably be self-administered by patient or caregiver
4 requirements associated with a request to BOP for off-site record keeping
1.) Terminal distributor number of the pharmacy
2.) License # of the requestor
3.) Name and address of the alternative location
4.) The time frame of the records to be moved off-site
Which 2 situations is it reasonable to dispense naloxone without a prescription?
1.) To an individual who there is reason to believe is experiencing or at risk of experiencing an overdose
2.) A family member, friend, or other person in a position to assist an individual who they believe is at risk of experiencing an overdose
There must be a physician approved protocol in place for dispensing naloxone without a prescription. What 6 items must this protocol include?
1.) Description of clinical pharmacology of naloxone
2.) Indications for use of naloxone as rescue therapy, including eligible candidates
3.) Precautions and CIs concerning dispensing naloxone
4.) Assessment/follow-up actions by the pharmacist or intern
5.) Naloxone products authorized to be dispensed including name of product, dose, route of admin, required delivery device and directions for use
6.) Any patient instructions in addition to counseling requirements
What counseling is required when dispensing naloxone without a prescription? (8 items)
1.) Risk factors for overdose
2.) Strategies to prevent overdose
3.) Signs of overdose
4.) Steps in responding to overdose
5.) Info on naloxone
6.) Procedures for administering naloxone
7.) Proper storage and exp. of naloxone product dispensed
8.) Info on where to obtain referral for substance abuse treatment
When dispensing naloxone occasionally to state/local law enforcement agencies, does the pharmacy making the occasional sales have to count these towards the 5% rule?
No, does not apply to these types of sales
What are the 5 types of injections that pharmacists can administer to patients as long as a physician approved protocol is in place?
1.) LAI opioid antagonist used for treatment of drug addiction/alcohol dependence (could be initial or subsequent doses)
2.) LAI antipsychotic drug
3.) Hydroxyprogesterone caproate for PREGNANT women
4.) Medroxyprogesterone acetate for NON-PREGNANT women
5.) Vit B12 injections
Must renew protocol every 2 years FYI
T/F: The pharmacist that administered a non-immunization injection to a patient has 5 days to notify the physician
False, 7 days
Record keeping required for all injections given by pharmacist (11 items). How long must these be kept?
1.) Full name/address of pt
2.) DOB or age
3.) Gender
4.) Allergies
5.) Date of admin.
6.) Name, strength, and dose of drug admin.
7.) Lot # and exp. date of drug
8.) Route
9.) location of injection site
10.) Positive ID of pharmacist administering drug
11.) ID of person who provided permission to administer the drug
Records must be kept for 3 years
How much time of live or home study coursework must be completed to administer one of the five injections a pharmacist could hypothetically give?
1.5 hours of live or home study (7.5 hrs for all 5) with 30 minutes including review of sterile technique in injectable dosage preparation and administration
MTM main objectives (5 things)
1.) Enhance appropriate medication use
2.) Improve medication adherence
3.) Increase detection of adverse drug events
4.) Improving collaboration between prescriber and pharmacist
5.) Improving outcomes
How soon must suspicious wholesaler orders be submitted to the BOP electronically?
Within 5 days of the order being identified as suspicious
If there are no suspicious orders found during a month of review, when does a zero report have to be filed by?
The 15th of the next month
When dispensing naltrexone without a prescription how soon must you notify the prescriber and is there a limit to the number of times a pharmacist can dispense it without a prescription?
Within 5 days of dispensing; Unlimited amount (up to RPH discretion)
How long must records of naltrexone dispenses be kept?
At least one year
T/F: Naltrexone when dispensed without a prescription must be reported to OARRS
True; Write new prescription document for each dispense and assign a number as well
Define an “elder adult”
60 years or older and handicapped by age-related conditions or mental impairments
When starting to use an automated pharmacy system, how long must a pharmacist verify the accuracy of all drugs dispensed by the system for and what must the accuracy be?
A continuous 45-day period; Accuracy must be 99.985%
What % of all dispensed Rx’s need reviewed by a quality assurance program to make sure the automated dispensing system is working appropriately?
5%
What is the license called when an outpatient remote pharmacy does no dispensing, but enters orders, etc.?
Limited Category II terminal distributor; No dispensing, but sole purpose is to enter, review, and/or verify prescriptions
What two smoking cessation medications do not fall under the dispensing nicotine replacement therapy by pharmacists without a prescription law?
Zyban and Chantix
What 6 requirements must be in a physician-signed protocol in order to dispense NRT without a prescription?
1.) Treatment guidelines and location where this will occur
2.) Types of NRT to be dispensed
3.) Screening procedure to determine if patient is good candidate
4.) Provision for pharmacists to refer high-risk individuals or individuals with complications to a PCP
5.) Requirement that pharmacists must provide a follow-up care plan
6.) Proper documentation of all care
How soon after identifying a potential NRT candidate should the RPH notify the PCP?
Within 72 hours
What is the max days supply a pharmacist can dispense of an opioid analgesic?
90 days; NOTE: does not stop prescriber from writing for >90 days, falls on pharmacist to ensure this is followed
T/F: Opioid analgesics that are CIII-CV must follow the within 14 days of date written law to be refilled
False, does not apply to refills of these medications
How long does a pharmacy have to fill a “do not fill until ____” prescription?
Up to 14 days from the do not fill until date written
In regards to partial filling of C-II prescriptions, as long as an initial fill was dispensed within 14 days of written, how long does the patient have to pick up the remaining amount of the script?
Within 30 days of the date the RX was issued NOT when the first fill was
T/F: The issue date of a prescription for an opioid can be adjusted after pharmacist/prescriber consultation
True
Days supply limit for opioids in acute pain situations; adults then minors
7 days for adults
5 days for minors with parent consent
What is the average daily MME that cannot be exceeded for acute pain opioid prescriptions?
No more than 30 MME/MED per day
T/F: Medicare Part D/Advantage Plan patients must get their controlled substance prescriptions sent electronically.
True as of 1/1/23
How soon does a pharmacy have to fulfill a C-ii prescription they did not have enough in stock for?
72 hours
What are the three things that a pharmacist cannot change or clarify on a C-ii script?
1.) Patient name
2.) Prescriber signature
3.) Drug prescribed
If a patient brought in a script for Adderall 10mg BID written on 3/12/23 and they came in 8/12/23 to fill it would you be able to do so? Why or why not?
Yes, non-opioid C-II scripts have same rules on 1st fill timing as non-controlled substances, so patient has 6 months from written date.
If a pharmacist takes an emergency verbal C-II order, how long does the prescriber have to send in a written prescription?
Within 7 days; Written script has to be attached to the oral script that was transcribed on the phone call with the prescriber by the RPH (This can be sent electronically as well and must be marked by RPH for “Emergency Dispensing”)
How long can a prescriber indicate a “Do not fill until” for C-II scripts?
Up to 90 days
T/F: Controlled substances are eligible for simultaneous refills
False, only non-controlled maintenance medication can be filled this way.
Ex: Ativan 1mg #30 QHS x 5 RF
Pt would need to do #30 at a time
Ativan 1mg #90 QHS x 1 RF
Pt could do #90 at a time and would only be allowed 1 RF of 90
