Pharmacy Practice Act

Question 1

What are the minimum standards of a pharmacy?
Hint - 11 things

Answer 1

1) Library
2) Equipment
3) Stock of drugs
4) Prescription containers
5) Space and fixtures
6) Pharmacy hours posted
7) Personnel and staffing
8) “Additional standards required for specialized practice”
9) Internet access
10) Name tags for employees w/ title
11) For institutional pharmacies: must have quality assurance program

Question 2

Pharmacist care/practice includes …?
Hint - 10 things

Answer 2

1) Interpreting prescriptions
2) Dispensing drugs and drug therapy related devices
3) Compounding drugs
4) Counseling pts, recommending drug therapy related devices, and assisting in drug/appliance selection for treatment of common diseases
5) Performing drug regimen reviews w/ pts (med rec) and reviewing interactions
6) Performing drug utilization reviews w/ prescribers when needed
7) Advising pt and health care providers about drug therapy
8) Acting pursuant to a consult agreement
9) Vaccine administration
10) Long-acting injectable drug administration

Question 3

When can a pharmacy return a drug to stock?

Answer 3

If the drugs have never left the prescription department, were dispensed but never picked up, or never left control of the delivery agent (in addition to other conditions) - this does not apply to inpatient

Question 4

What other 7 conditions must be met to return a drug to stock?

Answer 4

1) Must have an exp date (1 year from dispense or manufacturer’s date)
2) Must be kept in the bottle it was dispensed in. Must maintain the same label unless it is a stock bottle or a new/modified label still contains the same drug name, dose, and exp date
3) Must use a different bottle when dispensing an RTS to another pt
4) Must be stored properly
5) Must be removed in the event of a drug recall, unless lot # can be verified
6) Cannot show signs of tampering or adulteration
7) Can be transferred intracompany (additional rules)

Question 5

Who can Ohio pharmacists enter a consult agreement with?

Answer 5

Ohio licensed physicians, PAs (authorized by supervising physician), and CNPs/CNSs/CNMW (authorized by collaborating physician)

Question 6

What 3 conditions must be met for a pharmacist to enter a consult agreement w/ a provider?

Answer 6

1) Provider must have an ongoing provider-pt relationship with each pt whose drug therapy is being managed
2) The diagnosis being managed is within the provider’s scope of practice
3) Each pharmacist has training and experience related to the particular diagnosis being managed

Question 7

What can pharmacists do under a consult agreement?
Hint - 6 things

Answer 7

Manage drug therapy for a specific diagnosis/disease state including:
1) changing duration of treatment
2) adjusting strength, dose, dosage form, frequency, administration, or route
3) discontinuing drugs
4) administering drugs
5) add a drug to a pts regimen
6) order labs related to management of drug therapy and, if specified in the CA, evaluate the results - DOES NOT ALLOW PHARMACIST TO DIAGNOSE BASED ON LAB RESULTS

Question 8

Who can terminate a consult agreement?

Answer 8

The pharmacist, provider, patient, or individual who gave consent for the patient

Question 9

Who must be notified if a patient terminates a consult agreement?

Answer 9

Every pharmacist and provider who participates in the agreement

Question 10

Who must be notified if a provider/pharmacist terminates a consult agreement?

Answer 10

The person who terminates the agreement must notify (written) to all other pharmacists, providers, and patients terminated

Question 11

What must be included in a consult agreement?
Hint - 9 things

Answer 11

1) The diagnoses/disease states being managed and if they are primary or comorbid
2) A description of the drugs or drug categories the agreement involves
3) A description of the procedures, decision criteria, and plan the pharmacist is to follow
4) A description of how the pharmacist is to comply with the records of each action taken and at what regular intervals this will take place
5) Identification of the pharmacists and providers authorized to enter the agreement
6) A provision that allows the physician to override a decision made by the managing pharmacist when needed
7) Quality assurance mechanism
8) Effective and exp date
9) Training/experience criteria for the pharmacist

Question 12

How long is a consult agreement effective for?

Answer 12

2 years

Question 13

In the event of any issues regarding a change in medications, who is liable in a consult agreement?

Answer 13

The pharmacist or provider that made the change is the one liable. Ex. if a pharmacist made a medication change that led to patient harm, the provider in the agreement would not be held liable.

Question 14

What 4 things must be included in the consent for a patient entering a consult agreement?

Answer 14

Must tell the patient:
1) a pharmacist may be utilized in management of pt care
2) pt has a right to participate or withdraw from the agreement
3) This consent may be part of patients initial consent for treatment
4) Managing Pharmacist means a pharmacist managing a pt’s drug therapy under a CA

Question 15

Pharmacists must maintain a record of each action taken for a pt under a CA using positive identification. How long must these records be kept for?

Answer 15

3 years from the date of last action taken

Question 16

If issuing a prescription as an agent of a prescriber through a CA, what must the pharmacist include on the prescription?

Answer 16

1) Info for the consulting prescriber (name, address, etc.)
2) Telephone number where the pharmacist can be reached
3) All positive identification shall be of the pharmacist on behalf of the prescriber

Question 17

A pharmacist authorized to prescribe controlled substances under a CA must:
Hint - 5 things

Answer 17

1) Have a valid controlled substance prescriber registration (Ohio)
2) Be in good standing with the Ohio Board of Pharmacy
3) Notify the board within 5 business days if the pharmacist is no longer able to prescribe controlled substances via the CA
4) Must obtain and keep current and valid DEA registration
5) Must submit DEA registration to the board within 30 days

Question 18

What is the minimum a pharmacist must meet with a patient being managed under a CA?

Answer 18

Once annually

Question 19

What is the definition of a practitioner?

Answer 19

A licensed health care professional authorized to prescribe drugs

Question 20

What conditions must be met for a pharmacist to be able to dispense an emergency fill (without a prescription)?
Hint - 5 things

Answer 20

1) Cannot be for a CII
2) Pharmacy has a record of an Rx for the drug in the name of the patient that is requesting it and the Rx has no refills or is expired
3) Pharmacist is unable to contact the prescriber for refill authorization
4) Can only be done once per Rx
5) Days supply can either not exceed 72 hour supply OR is the patient has been on consistent, non-controlled drug therapy determined by pharmacy records, a 30 day supply can be dispensed

Question 21

If a patient is out of refills, receives an emergency 30 day supply of a non-controlled substance, then runs out again, what emergency days supply can the pharmacist dispense for the patient?

Answer 21

7 day supply, can be dispensed a second and third time within a 12 month period

Question 22

When must the pharmacist inform a prescriber of an emergency fill?

Answer 22

Must notify the prescriber within 72 hours of the dispense

Question 23

How long after an emergency fill do records of the fill have to be maintained for?

Answer 23

1 year

Question 24

What records must be kept after dispensing an emergency fill?

Answer 24

1) Pt name and address
2) Name and address of person receiving the drug (if not the pt)
3) Amount dispensed
4) original Rx number

Question 25

T/F: Pharmacists must create a new Rx document for an emergency refill

Answer 25

True