! Prescription Writing Flashcards
What are the 2 groups of medication
OTC don’t need prescription
Legend need prescription andd erived from valid patient-prescriber relationship
2 groups of legend drugs
Non schedules/non controlled which are not addictive and have no abuse potential
Scheduled/controlled which have addiction/abuse potential and/or dose
Designation fo non scheduled vs scheduled designations impact what
Dispense quantity, refills allowed and prescriptions life span
C-1 schedule
NO
Example of scheduled drugs
Morphine, codeine, amphetamine, diazepam
Examples of non scheduled drugs
Amoxicillin, propranolol, furosemide
What are the 9 legal requirements of prescriptions
- Name and address of prescriber
- name address patient
- date prescription was written with year
- name, strength, dose
- direction for use
- Quantity to be dispensed
- Number of refills allowed
- Prescribers signiture
- prescriber DEA number (for controlled drugs)
What is the DEA number
A 2 letter and 7 digit number (personally identifies physician)
-required by law if scheduled/controlled compound
What is quantity
30
Wt/vol/number and spelling
Non controlled legend lifespan
12 months or number or refills-whichever ccomes first
Limit to refills
7 day for opoid
No legal limit on # of refills or quantity dispensed during 12 month life span (limits set by insurance)
Partial filling non controlled legend
Possible until full quantity of prescription and all refills dispensed or expiration date 1 year
Controlled prescription lifespan
6 months or # or refills whichever occur first
Exception -C-V which has a lifespan of 12 months
Wnumber of refills
C-II=none (0 refills)
CIII-CIV=5 refills over 6 months
C-V=no limit on refills (prescribable )
Legal limit on quantity dispensed
90 days for C-III through CV
30 days for CII up to 90 days with documentation of medical reason
Partial filling controlled
Possible only for CIII/IV/V until full quantity of prescription and all refills dispensed or expiration
Partial filling for CII is not possible , UNLESS
Pharmacist doesn’t have full quantity (72 hours) or long term care/hospice
Schedule II controlled substances:prescription validity, quantity limits, refills
6 months
30/90 days with documentation medical reason
May not be refilled
Schedule III-IV controlled substances
Six month
90 days
Up to five times within six months
Schedule V controlled
One year
90 days
As prescribed
Non controlled substances
One year
As prescribed
As prescribed
How send in prescriptions
Call/fax original prescription or refills for all legends except CII
Patients cant fac
Prescriptions for legends can be electronically submitted with what
Board approved software, scan or fax with valid electronic signicatied or confidential digital key/identifier
Faxed prescriptions must be signed ___
Manually
Security paper required by Missouri state and strongly recommended by BNDD
CII prescription transfers not allowed
Except in emergency a physician can telephone only
Prescription transfers allowed if for not CII in what case
Still in date and with refills (pt request or by pharmacy on request of patient; only pharmacy to pharmacy)
CIII through CV can be transferred __
Once
When can CIII-CV be transfers more than once
If pharmacies share a real time online database0federal law still requires involvement of 2 pharmacists in transfer
___ __ orders are not transferable outside of the facility (need to be converted to a new order/prescription)
Nursing home
What can be changed on a controlled substance prescription
Date written Patients address Drug form Drug strength Quantity to be dispensed Prescribers DEA number Directions for use Substitutions permitted Refill information Reasons for extended supplies for schedule II prescriptions
What can never be changed/added
Patients name
Drug name
Prescribers signature
What constitutes an emergency for controlled substances
Immediate administration is necessary for roper treatment of the intended ultimate use
No appropriate alternative tratment is available including a non CII
It is not reasonably possible for prescriber to provide written prescription to the pharmacist prior to dispensing
In the case of emergency __ hours is allowed for delivery of Rx to dispensing pharmacy and how is the quantity limited
72
Limited to amount needed during emergency time
Collaborative practice (APRN/RPh) or supervisory (PA) agreements
These professionals may write for any legend drug if documented in a signed agreement
- need name and contact information of physician and personal writing prescription
- physician and personnel writing prescription must be registered with the BNDD and DEA to prescribe controlled substances
- legend prescriptions by these proverbs have different limits
Self prescribing of controlled substances
Illegal in MO
Self prescribing of non controlled substances is not illegal but discouraged by board of healing arts
Prescribing for family
Sure as long as the same records are maintained as for any other patient
Can you return dispensed medications for credit or Reid spending
No
How can you give drugs back
Medication disposal events
Drug take back events sponsored by DEA
Proper disposal
__ also carry liability, and are bound by moral/ethical principles similar to a physician
Pharmacists
What happens is pharmacist deliberately ignores a questionable prescription
May lose license
Felony
