Pharmacy Practice Flashcards
1
Q
Refill transfers: the pharmacist at a registered pharmacy who transfers original Rx information shall:
A
(i) write void on the front of the original hard copy
(iii) Record:
• The fact that an authorized refill of the prescription has been transferred
• the name of the patient
• the name, address, phone # of the pharmacy to which it was transferred
• the name of the pharmacist receiving the Rx information
• the name of the pharmacist transferring the information
• the date of the transfer
2
Q
Refill transfers: the pharmacist at a registered pharmacy who accepts the original transferred Rx information shall record:
A
(i) Produce a hard copy of such info and ensure that the term “refill transfer” appears on the face of the hard copy. Must also record the following:
(ii) the name of the patient; that an authorized refill of the Rx has been transferred; the name, address, and phone # of the pharmacy from which is was transferred; the name of the pharmacist receiving the Rx info.; the name of the pharmacist transferring the info.; the date of the original Rx and most recent transfer; and the original Rx #
3
Q
CE Records: Must keep for 6 years after completion
A
Keep five items of info. on each course for 6 years from the date you completed it: (1) title of the course or program and any ID # assigned by the sponsor (2) # of hours completed (3) the sponsor’s name and any ID # (4) verification by the sponsor of your attendance (5) the date and location of the program or course.
4
Q
For oral control prescriptions, what information must be reduced to writing?
A
(1) Prescriber’s name, address, and DEA #. (2) Patient’s name and address. (3) Date ordered. (4) Name and quantity of controlled substance ordered. (5) Directions for use. (6) Notation indicating it is a “telephone order”
5
Q
Once you receive the official NY state Rx for an oral order (must be within 72 hours) (or electronic Rx), what do you have to write on it? Note: the words “authorization for emergency dispensing” must appear on the face of the Rx
A
On the front of Rx:: • The words “follow-up prescription to oral order” • Prescription # • Date the oral order was filled • Your signature
On the back of the Rx:
• Follow-up prescription to order # ___ (Rx#)
• Oral order filled on ___ (date)
• follow-up Rx received ___ (date)
6
Q
When a pharmacist administers an anaphylaxis treatment agent, what information must be documented?
Note: record and maintain this information in the patient’s medication profile or on a separate form
A
- Recipient’s name
- Date and address of administration
- Administering pharmacist’s name
- Name of the treatment, manufacturer, and lot #
7
Q
What must be done after administering the anaphylaxis treatment agent?
A
- Contact the local EMS system or ensure equivalent follow-up care is provided
- Inform the patient’s PCP (if applicable)
8
Q
Can you dispense an out-of-state prescription for a Schedule II, III, IV, or V controlled substance?
A
Yes, but only within the 30 days of the date the Rx was signed
9
Q
Facilities with an “institutional dispenser (limited)” license must maintain a daily running record of controlled substances received that logs what information?
A
- Date, name, and quantity of prescribed controlled substance
- Name of prescriber
- Name of patient
- Name of pharmacy
- Serial # (Rx #) of the prescription
10
Q
When a follow-up Rx for oral CII or benzo is not received within 72 hours, the pharmacist should record on the back of the oral order that “written Rx not received” with the date and name/signature of the pharmacist AND…
A
Notify the NYS Bureau of Controlled Substances in writing within 7 days. The DEA must also be notified, but the method and time frame are not specified in federal law.
11
Q
Each time a controlled substance refill (CIII-CV) is dispensed, the pharmacist must document on the back…
A
Sign the actual Rx form, date it, and indicate the quantity dispensed
12
Q
Each time an official New York State prescription or an out-of-state written prescription for a schedule III, IV or V controlled substance is refilled, the dispensing pharmacist shall document that the refill information entered into the computer has been reviewed and is correct by manually signing:
A
(i) A hard-copy printout of each day’s controlled substance prescription refill data; each pharmacist must sign and date the printout to indicate it is correct and include the refills for that day. Printouts can be long and may come from a central “computer room.” This more common in pharmacist that fill a large # of Rxs. The printout must be provided to the pharmacy within 72 hours of the date when the refills were dispensed.
(ii) a bound logbook containing a statement that the refill information entered into the computer that day has been reviewed and is correct as show.
(iii) When a prescription is received electronically, the prescription and all required annotations shall be retained electronically.
13
Q
Controlled substance inventory must be taken…
A
every 2 years on May 1st of ODD years. Must keep inventory record on-premises for 5 years. Keep CII records separate from all other controls.
14
Q
If the prescriber or employee of prescriber calls in an oral authorization to refill an RX on file, the pharmacist must write on the back of the original Rx:
A
The date, time, name of the prescriber authorizing refills, initials/signature as receiver of authorization. Controls may only be called in by the prescriber (not an employee).
15
Q
What information must be documented in the inventory record? Note: a separate entity is required for each type of substance and package size.
A
- Date of the inventory
- If the inventory was taken at the beginning or close of business
- Name, strength, quantity, or volume in each container, and dosage form of each controlled substance
- Package size and # of packages
- Total content of all packages of that size on the date of the inventory
16
Q
Inventory: For sealed, unopened containers of all controlled substances, an exact count is needed (just copy from package). For opened containers of controlled substances:
A
- All schedule I and II containers require an exact count
- Schedule III, IV, V containers holding ≤1,000 dosage units can be estimated
- Schedule III, IV, and V containers holding >1,000 dosage units require an exact count
17
Q
Scheduled III-V drugs can obtained from a supplier/wholesaler by using a purchase order or through CSOS. Invoices or packing slips must contain:
A
- Name of each controlled substance in order
- Drug formulation (e.g. oral solution)
- # of dosage units in each container
- # of packaged ordered and delivered
18
Q
A pharmacy can transfer controlled substances to another pharmacy, the original supplier or the manufacturer. A DEA form 222 or CSOS must be used to transfer schedule I and II drugs. An invoice or CSOS is used to transfer schedule III-V drugs and must contain the following information:
A
- Drug name, dosage form, strength, and quantity
- Date of controlled substance transfer
- Recipient’s name, address, address and DEA number
19
Q
The breakage, damage or spillage of controlled substances is not considered a “loss” of controlled substances. If the breakage or spillage is not recoverable, then…
A
the registrant must document the incident in the inventory records, and 2 witnesses to the breakage or spillage must sign the record
20
Q
Original Rxs, executed copies of Form 222, and inventory records must be kept…
A
on-site
21
Q
Shipping and financial records can be stored…
A
at a central location after submitting written notification to the local DEA field office. States may also required pharmacies to request permission to store records off-site
22
Q
Unless the DEA denies the request to keep records off-site, the registrant can begin storing the records at a central location…
A
14 days after the DEA receives this request
23
Q
Upon request, the pharmacy must provide the DEA with the central records within…
A
48 hours
24
Q
All schedule II drug records must be kept…
A
separate from all other records.
25
For in-transit losses, the pharmacy is only responsible for making the report if the registrant has already signed for the delivery and...
subsequently notices that some or all of the controlled substances are missing
26
Before dispensing a new Rx, or if there are changes made to an existing Rx, a pharmacist or intern providing prescription services shall be required to personally counsel on:
* the name and description of the medication and • known indications
* dosage form, dosage, route of administration, duration of drug therapy
* special directions and precautions for preparation, administration, and use by the patient
* common severe side or adverse effects or interactions and therapeutic contraindications that may be encountered, including their avoidance, and the action required if they occur
* techniques for self-monitoring drug therapy
* proper storage
* prescription refill information
* the action to be taken in the event of a missed dose
27
If a patient requests access to their Rx records, how many days does the pharmacist have to comply with HIPAA?
If asked to provide a copy of an individual's prescription records, the pharmacy must provide access to the PHI no later than 30 calendar days from receiving the request. This is an outer limit; pharmacies should respond to requests for prescription records ASAP
28
The pharmacy may impose a reasonable cost-based fee to provide the Rx records to the patient. The fee may only include the cost of:
* labor for copying the protected health information requested by the individual, whether in paper or electronic form
* supplies for creating the paper copy or electronic media if the individual requests that the electronic copy be provided on portable media
* postage when the individual has requested the copy, summary, or explanation be mailed
* preparing an explanation or summary of the protected health information, if agreed to by the individual
29
Can a pharmacy provide HIPAA information for marketing?
No, only if the patient signs an authorization form first.
30
How many days does the pharmacy have to comply with amending a patient’s pharmacy records if the patient asks?
60 days
31
When can a pharmacist release an individual's Rx records for court cases?
* If they have received a signed court order from a judge
* if they received a subpoena issued, often from an attorney's office. However, only if certain conditions are met. Before responding to the subpoena, the pharmacy should receive evidence that there were reasonable efforts to notify the person whose records are being sought so the person has a chance to object to the disclosure or seek a qualified protective order for the information from the court. A qualified protective order would be a stipulation by both parties that the records being sought would be used for the sole purpose of the litigation, and then either be destroyed or returned at the end of the proceedings.
32
What conditions must be met before responding to a subpoena requesting access to an individual's Rx records?
The pharmacy should first receive evidence that there were reasonable efforts to notify the person whose records are being sought so the person has a chance to object to the disclosure or seek a qualified protective order for the information from the court. A qualified protective order would be a stipulation by both parties that the records being sought would be used for the sole purpose of the litigation, and then either be destroyed or returned at the end of the proceedings.
33
Which prescriptions require pharmacists to use child-resistant packaging?
In general, it is not required for hospital patients or patients of long-term care facilities; in these settings, the medication is not in the possession of the patient. Where the medication is to be taken in a home setting, including a personal care home, then the normal child-resistant requirements apply.
34
Which insulins require a Rx?
Analog insulins. Rapid-acting analog insulins include Humalog (Lispro), Novolog (Aspart), and Apidra (Glulisine). Long-acting analog insulins include Lantus (Glargine), Tresiba (Degludec), Ryzodeg (Degludec/Aspart), and Levemir (Detemir).
35
Which insulins are available OTC, "behind the counter"? (less costly than Rx)
Human insulin including regular and NPH insulin. Ex. Novolin R, Humulin R, Novolin N, Humulin N, Humulin 70/30, Novolin 70/30
36
In New York, a pharmacist should not dispense any non-controlled drug or device if the prescription is presented:
More than 1 year (365 days) after the date of issuance.
37
Unless an earlier refilling is authorized by the prescriber, no prescription for controlled substances shall be refilled earlier than:
7 days prior to the date the previously dispensed supply would be exhausted if used in conformity with the directions for use.
38
A registered pharmacist who is certified by the New York State Education Department (SED) to administer immunizations is authorized to administer immunizing agents to prevent seasonal influenza to patients:
2 years of age or older
39
A pharmacist shall complete a training course in the administration of immunizations within...
the 3 years immediately preceding application for a certificate of administration
40
What topics must be covered in a program that trains pharmacists to administer immunizations?
a. techniques for screening patients and for obtaining informed consents
b. techniques in the administration of immunizing agents
c. indications, precautions and contraindications in the use of immunizing agents
d. handling of emergencies, including the use of medications required for emergency treatment of anaphylaxis
e. cardio-pulmonary resuscitation techniques
f. recordkeeping and reporting of immunizations and information
41
A patient comes to a pharmacy with a prescription for Oxycontin. After processing the claim, the pharmacist finds out that he does not have enough quantity to dispense the full supply. Under this circumstance, the pharmacist may:
Reverse the claim and return the prescription back to the patient; The other option would be to supply partial quantities of the written prescription. The remaining portion of the prescription may be filled within 72 hours of the first partial filling; however, if the remaining portion is not or cannot be filled within the 72-hour period, the pharmacist shall so notify the prescribing individual practitioner.
42
A confidential record is privileged and a pharmacist may release a confidential record only to:
(1) . The patient or the patient's authorized representative;
(2) . A practitioner or another pharmacist if, in the pharmacist’s professional judgment, the release is necessary to protect the patient’s health and well-being;
(3) . The board or to a person or another state or federal agency authorized by law to receive the confidential record;
(4) . A law enforcement agency engaged in investigation of a suspected violation;
(5) . A person employed by a state agency that licenses a practitioner, if the person is performing the person’s official duties; or
(6) . An insurance carrier or other third party payer authorized by the patient to receive the information
43
The prescription information for controlled substances shall be filed electronically with the Bureau of Narcotic Enforcement, utilizing a transmission format acceptable to the Department, not later than:
24 hours after the substance was delivered.
44
What information from controlled substance prescriptions must be electronically transmitted to the NYDOH/BNE, (Prescription Monitoring Program)?
(i) . pharmacy Rx #;
(ii) . pharmacy's NPI #;
(iii) . patient name;
(iv) . patient address, including street, city, state, zip code;
(v) . patient date of birth;
(vi) . patient's sex;
(vii) . date prescription filled;
(viii) . metric quantity;
(ix) . national drug code number of the drug;
(x) . number of days’ supply;
(xi) . prescriber's Drug Enforcement Administration (DEA) number;
(xii) . date prescription written;
(xiii) . serial # of official prescription form or an identifier designated by the department; and
(xiv) . payment method
45
What are the prerequisites to obtaining a Certificate of Administration?
* Possess current NY pharmacist license
* Complete an approved immunization training program with the past 3 years (APhA or ACPE certified immunization course)
* Possess current CPR or BLS certification
46
In the event that such licensed pharmacist shall no longer have personal supervision of the pharmacy, the owner shall notify the department of such fact:
and of the name of the licensed pharmacist replacing the pharmacist named on the license and shall apply for an amended registration showing the change. The amended registration must be attached to the original registration and displayed in the same manner.
47
Within how many days shall the New York State Pharmacy Board be notified of any change in the identity of the SP of a registered establishment?
7 days
48
An oral prescription or an oral authorization for the refill of a prescription for the drug, other than a controlled substance, may be communicated by an employee of the prescribing practitioner.
True. The pharmacist receiving such oral authorization for the refill of a prescription shall write on the reverse side of the original prescription the date, time, and name of the practitioner authorizing the refill of the prescription.
49
An oral prescription or an oral authorization for the refill of a prescription for the drug, other than a controlled substance, may be communicated by an employee of the prescribing practitioner; provided however the pharmacist shall:
i. contemporaneously reduce such prescription to writing;
ii. dispense the substance in conformity with the labeling requirements applicable to a written prescription; and
iii. make a good faith effort to verify the employee's identity if the employee is unknown to the pharmacist.
50
A pharmacist receives a new prescription for Tylenol No.3. The prescription reads: 1 tablet PO QD. Qty:60
Refill: 5
According to New York State Pharmacy Law, what will be the maximum quantity of the drug may a pharmacist dispense to a patient during the life of the prescription?
When the initial prescription is written for a quantity of substance in excess of a 30-day supply, the prescription may only be refilled once.
The Rx is written for a quantity 60 (more than 30 day supply based on direction 1 tab po qd). Since the Rx may only be refilled once; the maximum dispense quantity during the life of the prescription shall be 120 tablets.
51
When there is a class I recall of a Rx drug, pharmacies shall make a reasonable attempt to notify all patients that have been prescribed and who are currently taking such recalled drug dispensed from such pharmacy by...
phone or mail within 72 hours of the pharmacy being notified by the FDA, manufacturer, a wholesaler, or by other notice of such recall.
52
If upon presentation of the prescription, the pharmacist or pharmacy intern determines that the prescription is a prescriber-approved alternative drug, the pharmacist or pharmacy intern shall meet include with each Rx...
a written notification that clearly advises the patient that a prescriber-approved alternative drug has been dispensed, the directions for the use of such drug, and the availability of counseling on the drug.
53
The pharmacist or pharmacy intern shall make a reasonable effort to contact the patient or person authorized to act on behalf of the patient by telephone in order to personally offer counseling to that person about the prescriber-approved alternative drug. A reasonable effort shall mean...
at least 2 attempts to reach the patient or person authorized to act on behalf of the patient through telephone calls placed to such person by 48 hours after mailing or delivering the prescription. Must document such efforts, or if the patient doesn't have a phone, or does not wish to be contacted by phone.
54
A pharmacist may fill a generic drug for a prescribed brand name unless the prescriber has...
written by hand or electronically, "DAW" in the box provided on a prescription. *No stamp or impression or preprint letter DAW is allowed.
55
Pharmacists or pharmacy interns shall conduct a prospective drug review before each Rx...
is dispensed or delivered to a patient or person authorized to act on behalf of the patient. Such review shall include screening for potential drug therapy problems due to therapeutic duplication, drug-drug interactions, including serious interactions with over-the-counter drugs, incorrect drug dosage or duration of drug treatment, drug-allergy interactions, and clinical abuse or misuse.
56
A pharmacist shall not be required to counsel a patient or caregiver when the patient or caregiver...
refuses such consultation and such refusal is documented in the records of the pharmacy.
57
For a prescription that is delivered to a patient by a mail or carrier, which of the following is/are true?
I. Must include a written offer to counsel the patient with each Rx.
II. The written offer to counsel shall provide a telephone # at which a licensed pharmacist or pharmacy intern may be readily reached.
III. For pharmacies engaged primarily in the mail order delivery of prescriptions, that telephone number shall be toll-free for long-distance calls.
58
In NY, patient-specific medication labels must contain the following information:
(i) the pharmacy name and address
(ii) the date prepared
(iii) the Rx serial number
(iv) the name of the prescriber
(v) the name and address of the patient
(vi) the drug name, manufacturer, and strength
(vii) the directions for use
59
Who may orally prescribe or authorize a refill for one or more hypodermic syringes or hypodermic needles?
a practitioner, a health care professional in an RHCF, or an employee of the prescribing practitioner.
The pharmacist shall make a good faith effort to verify the identity of such a person.
60
In an emergency, a practitioner may orally prescribe and a pharmacist may dispense, to an ultimate user, syringes and hypodermic needles, provided, however, the pharmacist shall...
(i). contemporaneously reduce such oral prescription to a written memorandum indicating the name, address and phone number of the prescriber, name and address of the ultimate user, date on which the hypodermic needles and/or syringe was ordered, quantity prescribed, directions for use, and the fact that it is a telephone order;
61
In an emergency, a practitioner may orally prescribe and a pharmacist may dispense, to an ultimate user, syringes and hypodermic needles, provided, however, the pharmacist filling such oral Rx shall indicate on the memo the...
the date filled, and the number of the Rx under which it is recorded in the Rx file, and sign the memorandum.
62
Unlicensed persons shall not be authorized to...
1. Receive oral prescriptions from prescribers;
2. Interpret and evaluate a Rx for conformance with legal requirements, authenticity, accuracy and interaction of the prescribed drug with other known prescribed and over-the-counter drugs;
3. Make determinations of the therapeutic equivalency as such determinations apply to generic substitution;
4. Measure, weigh, compound or mix ingredients;
5. Sign or initial any record of dispensing required to be maintained by law;
6. Counsel patients; or
7. Perform any other function involving the exercise of professional judgment.
63
What information must be on a non-CS Rx (pharmacist cannot change it)?
Patient's name, Prescriber's name and signature, drug's name, date the Rx was signed
64
What information may the pharmacist add on a non-CS Rx with permission from the prescriber?
Drug's strength, dosage form, quantity, and directions for use. Also, may add the prescriber's address, telephone number, and profession. The pharmacist shall also indicate the change on the Rx and initial the change.
The pharmacist shall write the date he or she received the oral authorization on the Rx, the reason for the change, and his or her signature.
65
The pharmacist is not required to obtain authorization from the practitioner to enter...
the patient's address, sex, or age if the pharmacist obtains this information through a good-faith effort.
66
Who is eligible for a Limited (Intern) Permit?
(i) Individuals who have successfully completed the first professional year of study in an Accreditation Council for Pharmacy Education (ACPE) program OR
(ii) a graduate from a non-accredited program that has passed NAPLEX (Part I) and has been approved by the board
67
A limited permit issued to a pharmacy intern shall have an expiration date of...
5 years from the date of issue
68
Limited permits may be renewed once for a period not to exceed...
2 years
69
If the information is otherwise readily available in the records of the pharmacy, the pharmacist does not need to add the following to an Rx:
(i) patient's address and age
| (ii) the prescriber's address, telephone number, and profession
70
A pharmacist may dispense insulin and related supplies, or other life-sustaining maintenance prescription drug identified by the commissioner, through a non-patient-specific prescription, to an individual who has had a valid Rx for the drug during the prior 12-month period which has since expired, on an emergency basis provided the pharmacist:
(a) first attempts to obtain an authorization from the prescriber of the patient-specific prescription and cannot obtain the authorization, and the prescriber does not object to dispensing to the patient under the non-patient-specific prescription;
(b) believes that, in the pharmacist's professional judgment, the interruption of the therapy reasonably might produce an undesirable health consequence detrimental to the patient's welfare or cause physical or mental discomfort;
(c) provides refill of the prescription and the quantity of that refill is in conformity with the directions for use under the patient-specific prescription, but limited to an amount not to exceed a 30-day emergency supply; and
(d) notifies, within 72 hours of dispensing the refill or refills, the original prescriber that an emergency prescription has been dispensed
71
Where any pharmacy registered by the department is damaged by fire the board shall be notified within a period of...
48 hours. The board shall have the power to impound all drugs for analysis and condemnation if found unfit for use.
72
Where a pharmacy is discontinued, the owner of its prescription records shall notify the department as to the disposition of said prescription records, and in no case shall records be...
sold or given away to a person who does not currently possess a registration to operate a pharmacy.
73
Certified pharmacy interns may administer immunizations in New York State.
True, but only under the immediate personal supervision of the certified pharmacist.
74
In the case of oral prescriptions, the prescriber must expressly state whether substitution is to be permitted or prohibited.
True, any oral Rx that does not include such an express statement shall not be filled.
75
In the case of oral Rxs, the pharmacist shall indicate on the label affixed to the immediate container in which the drug is sold or dispensed the...
the name and strength of the drug product and its manufacturer unless the prescriber specifically states otherwise. Also, the pharmacist shall record on the prescription form the brand name or the name of the manufacturer of the drug product dispensed.
76
Graduates of registered or accredited programs leading to the bachelor's degree in pharmacy shall have completed at least...
6 months of full-time experience, or the equivalent thereof, as a pharmacy intern in an internship program.
77
A patient brings a new prescription that is electronically generated and contains an electronic signature of the prescriber. Can the pharmacist fill this Rx?
No. Once a Rx is handed to the patient, it is no longer an e-Rx and must contain the handwritten, pen-to-paper signature of the prescriber.
78
Is a pharmacy required to print and maintain a hard copy of an electronically transmitted prescription?
No. A hard copy is not required to be maintained as long as the electronic message is securely maintained. The same applies to refills. Similar to other records, the electronic records must be maintained for five (5) years and must be reproducible and provided to the Department upon demand. Likewise, facsimile copies must be maintained in a readable fashion for five (5) years.
79
No practitioner shall issue any prescription in this state, unless such prescription is made by electronic prescription from the practitioner to a pharmacy, except for prescriptions:
(a) issued by veterinarians;
(b) where electronic prescribing is not available due to temporary technological or electrical failure;
(c) issued by practitioners who have received a waiver or a renewal thereof for a specified period determined by the commissioner of health, not to exceed one year, from the requirement to use electronic prescribing, due to economic hardship, technological limitations that are not reasonably within the control of the practitioner, or other exceptional circumstance demonstrated by the practitioner;
(d) issued by a practitioner under circumstances where such practitioner reasonably determines that it would be impractical for the patient to obtain substances prescribed by electronic prescription in a timely manner, and such delay would adversely impact the patient's medical condition, provided that if such prescription is for a controlled substance, the quantity that does not exceed a five day supply if the controlled substance were used in accordance with the directions for use;
(e) issued by a practitioner to be dispensed by a pharmacy located outside the state.
80
The following are examples of situations in which a pharmacist or pharmacy-intern might substitute a written offer:
(1) The patient or caregiver is hearing impaired.
| (2) The patient or caregiver is not an English speaker.
81
According to New York State Pharmacy Law, no drug shall be dispensed by a pharmacist when such Rx form includes more than one drug per prescription form.
True. In practice, the pharmacist can call the prescriber to convert the Rx into an oral order for each drug prescribed.
82
Any pharmacist selling or furnishing a hypodermic syringe or hypodermic needle pursuant to a prescription shall record upon the prescription...
his or her signature (not initial) or, as applicable, electronic signature, and the date of the sale
83
A prescription for hypodermic needles/syringes may be refilled not more than the number of times specifically authorized by the prescriber upon the prescription; provided, however, no such authorization shall be effective for...
a period longer than two years from the date the Rx is signed
84
A pharmacist receiving an oral authorization for the refill of a prescription for one or more hypodermic syringes or hypodermic needles shall enter on the original prescription or electronic record:
the date, time, name of the authorizing practitioner and the name of the practitioner's employee or RHCF professional, if applicable, and shall sign or electronically sign such record.
85
A prescription for one or more hypodermic syringes or hypodermic needles shall include:
(1) the name, address and age of the ultimate user;
(2) the name, address, telephone number of the prescriber
(3) signature or electronic signature of the prescriber
(3) the date on which it was issued
(4) the name, and strength of the drug, if applicable
(5) the directions for use
(6) the quantity of the hypodermic syringes or hypodermic needles prescribed
(7) the number of authorized refills.
86
Drugs repacked in a pharmacy for in-house use only shall have an expiration date of:
12 months, or 50% of the time remaining to the manufacturer's expiration date, whichever is less, from the date of repacking
87
When a practitioner is notified that an electronic prescription was not successfully delivered, what shall the practitioner do?
The practitioner shall indicate on any written or oral Rx issued as a replacement of the original electronic prescription that the prescription was originally transmitted electronically, to which pharmacy the prescription was originally transmitted, and that the original transmission failed.
88
The NY State Board of Pharmacy must be notified when the % of stockholders at a pharmacy corporation changes by:
10% (must be done within 30 days)
89
Prescriptions may be written using the following:
Typewriter, computer, ink, non-erasable ballpoint pen, or indelible pencil
90
Interns can perform all the same tasks as pharmacists except interns cannot...
sell self-defense sprays, sign the Official New York State Rx Form, or initial/sign a Rx without a pharmacist doing the same.
91
Who may review and electronically sign a prescription prior to transmission from a doctor’s office?
Only prescribers. Once signed, an agent or employee of the practitioner may transmit the Rx on behalf of the practitioner. The act of transmission must be independent of the review and signature process.
92
A pharmacy must contain the following utensils:
Mortar and pestle, balance device sensitive to 6 mg, graduate devices to measure from 0.1-500 mL. If needed, a pharmacy should also contain metric (apothecary) weights.
93
The pharmacy which dispenses radioactive drugs shall be equipped with at least the following:
a) laminar flow hood
b) dose calibrator
c) exhaust hood and filter system
d) chromatography apparatus
e) apparatus or materials for the determination of pH
f) single-channel and/or multichannel scintillation
detection system
g) microscope
94
A pharmacy must keep which references?
Copies of laws, rules, and regulations governing the practice of pharmacy in New York, and other reference resources as necessary
95
All electronic prescriptions must have a(n):
NPI number. All electronic prescriptions must have the same required information as written prescriptions, but must also have an NPI number.
96
Chains that have more than how many pharmacy locations must provide written prescription related-information in foreign languages for non-English speaking patients?
8 locations
97
What is the allowed ratio of full-time pharmacy interns to preceptors?
1:1 (2:1 if part-time intern)
98
Patients have the following options for sharing their prescriptions through shared databases among pharmacies:
i) The patient can select which pharmacies can share information to have prescriptions dispensed
(ii) The patient can allow Rx information to be shared through a database to be dispensed at any pharmacy (iii) The patient can request Rxs not be shared in a database and a firewall will need to be placed to protect the information
99
A person must be how many years of age to be eligible for licensure as a pharmacist?
21 years and older
100
Prescriber information required to be on a prescription issued on an official NY state prescription form includes:
(i) Prescriber name
(ii) Prescriber's profession
(ii) Office address and zip code
(iv) Office telephone #
(v) NY license number.
(vi) The DEA # is also required for controlled substance prescriptions
101
Which of the following requirements applies to pharmacist name badges?
Must be legible and must be worn while working
102
Which of the following must be electronically prescribed in the state of NY?
Prescription medical devices, controlled substances, non-controlled substances, hypodermic needles/ syringes
103
Similar to OBRA’ 90 requirements, patient profiles at the pharmacy must contain all of the following:
* Patient name, address, phone number
* DOB or age
* Gender
* Chronic diseases
* Comprehensive list of medications and relevant devices
* Known allergies and drug interactions
* Any other relevant information for counseling
104
Patient records must be kept in a retrievable form for:
5 years following the date of the most recent entry
105
What is the Elderly Pharmaceutical Insurance Coverage (EPIC) program?
It assists those 65 years and older with supplementing drug costs from out-of-pocket Medicare Part D.
106
Which type of formulary requires that substitution of medication be allowed for all medications except those specifically prohibited?
Negative formulary
107
Is the transfer of drugs between pharmacies allowed?
Yes, non-controlled substances, needles, and syringes may be transferred from one pharmacy to another in the appropriate quantity to cover the amount needed for a Rx. The Rx must be waiting to be filled in order for items to be transferred.
108
The active ingredient in self-defense sprays must be:
Oleoresin of Capsicum
109
Which of the following references is/are required to be possessed by a pharmacy in order to operate?
Pharmacy Guide to Practice (Pharmacy Handbook), controlled substances statue (Article 33 of Public Health Law), and Rules and Regulations on Controlled Substances (Chapter II, Subchapter K, Part 80)
110
A patient package insert (PPI) must be provided upon each dispensing of:
oral contraceptives, estrogenic drug products, progestational drug products. **In acute-care hospitals or long-term care facilities, the PPI must be provided to the patient before administration of the first estrogen and every 30 days thereafter, as long as the therapy continues.
111
Which drug characteristics authorize the FDA to require a medication guide?
1) the drug is one for which patient labeling could help prevent serious adverse effects
2) the drug has serious risks relative to benefits that patients should be made aware of because it could affect their decision to use or continue to use the product
3) the drug is important to health and patient adherence to directions for use is crucial to the drug's effectiveness
112
Drug product information required to be on a Rx issued on an official NY state prescription form includes all of the following:
Drug name, drug strength, dosage form, quantity, and directions for use. **The max daily dose is also required on the prescription for controlled substances.
113
Medicaid prescriptions for non-controlled substances are valid for fill for how many days after issue date?
60 days
114
The Board of Pharmacy must be notified within how many days of a change of location and mailing address?
30 days
115
Which of the following situations is an exception to required electronic prescribing?
(i) the prescriber having a waiver of electronic prescribing from the proper authority
(ii) sending a Rx to another state
(iii) electronic or technical difficulties/failure that impair the ability to send prescriptions
(iv) and when the prescriber feels it would not be practical for the patient to receive a prescribed product in a timely manner
116
Which of the following is considered an electronic prescription?
Encrypted prescriptions transmitted by regulated computer technology (not email and fax)
117
Pharmacies used for training pharmacy interns may have one intern per how many prescriptions or drug orders dispensed annually?
5000
118
A waiver of electronic prescribing can be granted for up to:
1 year
119
Who has the responsibility to inform the patient or patient’s caregiver whether the brand name or generic of a medication is prescribed?
The prescriber
120
Pharmacists must report vaccine administration to a patient’s primary care provider or to the statewide immunization registry or citywide immunization registry. If the pharmacist is reporting a vaccination to the registry, this must be done within how many days of the immunization taking place?
14 days
121
Written prescriptions issued in a foreign country for non-controlled medications and hypodermic needles may be filled. (The U.S. Territories of Puerto Rico, Guam, and American Samoa are not considered foreign countries). However:
A physician and patient relationship must exist for a Rx from a foreign country to be valid. Also, the prescribed product must be FDA-approved for sale in the U.S., and the Rx may not be shipped to a foreign country.
122
Mr. Bates is a patient that comes in for a prescription written for a generic medication. The pharmacy does not have the generic medication in stock, but Mr. Bates is in severe pain. Which of the following responses is appropriate?
Dispense the brand name of the medication to the patient since the patient requires alleviation of severe pain.
123
A medical emergency constitutes situations where:
the patient is in severe pain that needs to be alleviated, situations where disability may be caused by not receiving the medication, or where a patient may take their life if not promptly treated.
124
Which information that is not required on a written prescription must be included on an oral prescription?
Date received, time received, signature/initials of receiver
125
What is the allowed ratio of registered pharmacy technicians to pharmacists?
2:1 (this does not include other staff members that are helping with other non-prescription filling duties)
126
What is the allowed number of unlicensed persons (ex. pharmacy technicians) who can perform activities that do not require licensure?
As of April 2021, it has increased from 2:1 to 4:1. No more than 2 pharmacy technicians may be registered.
127
Who can grant a waiver of electronic prescribing to a practitioner?
The New York State Health Department
128
A medical facility has an approved waiver from electronic prescribing and has sent a prescription by fax. Which of the following are requirements for a fax prescription?
Must be manually signed, must be on an official NY State prescription form if issued in NY, must be an original hard copy prescription
129
Under what program are hypodermic needles and syringes allowed to be sold without a Rx?
Expanded Syringe Access Demonstration Program (ESAP)
130
Mr. Douglas comes into the pharmacy wanting to purchase hypodermic needles and syringes without a prescription. In order for him to be able to do this, all of the following must apply:
1) The pharmacy must have a special permit to sell them without a prescription
2) the patient only purchases 10 or fewer hypodermic needles/syringes
3) the patient must be at least 18 years of age or older
131
When a brand-name medication is dispensed in place of a generic product in cases of an emergency situation, what must be recorded on the back of the prescription?
The date, hour, and nature of the emergency situation
132
Unlicensed persons assisting in the pharmacy may not...
receive oral prescriptions, compound medications, counsel patients, or make decisions that require professional judgment
133
Official NY State Rx forms may be canceled by the commissioner by notifying the prescriber how long before such cancellation date?
6 months
134
How do you register a pharmacy?
1) Ensure that the pharmacy contains the necessary equipment, utensils, and stocks of drugs sufficient to allow the prompt and efficient compounding and dispensing of Rxs.
2) Pay the $345 fee.
135
Renewal of pharmacy registration is required:
Triennially (once every 3 years) Must be conspicuously placed in the pharmacy at all times.
Note: at the time of renewal, the owner of each pharmacy shall report under oath to the department any facts required by the Board
136
What is the pharmacy registration renewal fee?
$260 or a pro-rated portion thereof as determined by the department
137
Whose name must be included on the pharmacy registration in cases where the owner is not a licensed pharmacist?
The name of the supervising pharmacist (SP)
138
What must be done when the pharmacist that personally supervises the pharmacy is replaced with another SP?
The owner must notify the Board of the change within 7 days and apply for an amended registration.
139
To fulfill the experience requirement for license by endorsement (reciprocity), you must present evidence of at least one year of satisfactory pharmacy practice experience...
following licensure during the 5-year period preceding the date of the application.
140
A supervising pharmacist (i.e. pharmacist manager or pharmacist-in-charge) must be a full-time employee or work at least...
30 hours or more per week
141
If the pharmacy is open less than 30 hours per week, then the SP must...
be employed for a majority of the time the pharmacy is open.
142
Every pharmacy shall be under the immediate supervision and management of a...
a licensed pharmacist (not necessarily the SP) at all hours when open.
143
How many pharmacies can a pharmacist supervise at one time?
One
144
Who is responsible for notifying the Board of Pharmacy when there is a change in the identity of the SP?
the pharmacy owner
145
What information must be included on a Rx for a non-controlled substance medication?
* Prescriber’s name, address, phone #, profession, registration #, and signature (electronic signature for e-Rx)
* Date written
* Patient’s name, address, and age
* Name, strength, and quantity of the prescribed drug or device
* Directions for use
146
When a pharmacist reduces an oral Rx to writing, he/she must...
sign or initial the Rx. (can be done electronically). For refills, also include date, time, and name of prescriber on the back.
147
What does it mean when a prescriber indicates “PRN refills” on a non-controlled substance Rx?
limited to one refill
148
The date on the label of a refilled Rx bottle must be the...
date of the refill
149
Pharmacies must maintain a readily retrievable...
daily record of all prescriptions filled and refilled.
150
What information must be recorded in the daily record? (can be maintained by a manual system or by an electronic data processing system)
the prescriber, the patient, the signature or initials of the dispensing pharmacist, and the Rx #
151
As of March 2016, NY law requires all Rxs to be issued electronically*. Exceptions to electronic prescribing include:
* Rxs written by veterinarians
* Temporary technological failure
* Prescribers who have a wavier or renewal of a wavier (waivers valid for 1 year)
* No more than a 5-day supply of medications in situations where the prescriber determines e-prescribing is impractical and would adversely impact the patient’s medical condition (controlled substances)
* The Rx will be dispensed by an out-of-state pharmacy
* Prescribers who certify to the NYDOH that they will not issue more than 25 prescriptions per 12 months (includes controls and non-controls)
152
When refiling a Rx, what information must be documented on the Rx?
* Amount dispensed
* Date dispensed
* Signature of dispensing pharmacist
