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Advanced Pediatric Pharmacology Exam 1 > Prescription Writing and Controlled Substances > Flashcards

Prescription Writing and Controlled Substances Flashcards

1
Q

Non-Controlled Substances

A

Not recognized by federal law as being an abused drug when used for non-medical purposes or used in excessive quantities

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2
Q

Schedule I (3)

A
  1. High potential for abuse
  2. No currently accepted medical use
  3. Lack of accepted safety adata

(ex: Heroin)

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3
Q

Schedule II (3)

A
  1. High potential for abuse
  2. Currently accepted medical uses
  3. Abuse of drug may lead to severe physical and/or psychological dependence

(ex: ADHD medications, opioids)

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4
Q

Schedule III (3)

A
  1. Less potential for abuse than schedule II
  2. Currently accepted medical uses
  3. Abuse may lead to moderate/low physical dependence or high psychological dependence

Ex: Fioricet vs. Firoinal

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5
Q

Schedule IV (3)

A
  1. Less abuse potential than Schedule I,II,III
  2. Currently accepted medical uses
  3. Abuse may lead to limited physical or psychological dependence
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6
Q

Schedule V (4)

A
  1. Less abuse potential than I-IV
  2. Currently accepted medical uses
  3. Abuse may lead to limited physical or psychological dependence
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7
Q

Schedule I examples (4)

A
  1. GHB (gamma hydroxybutyric acid) - sleep medication
  2. Diacetylmorphine (heroin)
  3. Mescaline
  4. Peyote
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8
Q

Schedule II examples (6)

A
  1. Diazepam
  2. Alprazolam
  3. Hydromorphone
  4. Lisdexamphetamine (stimulant to tx ADHD)
  5. Methylphenidate
  6. Morphine
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9
Q

Schedule III examples (5)

A
  1. Buprenorphine (narcotic for pain)
  2. Testosterone
  3. Dronabinol (Orexigenic - appetite stimulant and helps n/v)
  4. Ketamine (for anesthesia)
  5. Oxandrolone (anabolic steroid)
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10
Q

Schedule IV examples (5)

A
  1. Modafinil (tx narcalepsy and sleep apnea)
  2. Tramadol (pain med)
  3. Zolpidem (sedative)
  4. Butorphanol (narcotic)
  5. Phentermine (promotes weight loss)
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11
Q

Schedule V examples (4)

A
  1. Diphenoxylate (opiod)
  2. Pregabalin (nerve pain medication)
  3. Ezogabine (anticonvulsant)
  4. Lacosamide (anticonvulsant)
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12
Q

ONYSRx (5)

A
  1. Includes an authenticity area for RPh
  2. Test area on upper right corner
  3. NYS seal fades from blue to clear
  4. “Standard register” turns orange from yellow
  5. ONLY ONE MEDICATION per prescription blank is allowed in NYS regardless of the type of Rx blank
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13
Q

Requirements on all prescriptions (8)

A

Prescriber Information

  1. Name of prescriber or institution
  2. Address
  3. Telephone Number
  4. License number/state registration/certificate number
  5. Professional designation

Patient Information

  1. Name
  2. Complete Address
  3. Age or DOB
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14
Q

Non-Controlled Rx Rules (7)

A
  1. Valid for 1 year from date written (except Medicaid is valid for 6 months)
  2. Need inscription of drug name, strength, and dosage form
  3. Need subscription of directions for pharmacist and quantity to dispense
  4. Indicate number of refills
  5. All prescriptions are generically filled unless DAW is filled in appropriate box
  6. All medications must be signed handwritten in ink
  7. Some medications require a diagnosis on face of the Rx
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15
Q

Non-Controlled Rx Medicaid Rules (3)

A
  1. Valid for 6 months from date written
  2. Maximum of 5 refills w/i 6 months and can only be refilled when 10 day supply is left
  3. If it is not going to be generically filled there must be “brand medically necessary” written
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16
Q

Controlled Substance Prescriber Information (7)

A

Heading should contain:

  1. Name
  2. Address
  3. Telephone number
  4. DEA registration license number
  5. State registration number
  6. Profession
  7. Institution ONYSRX: institution name, address, DEA
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17
Q

Controlled Substance Patient information (5)

A
  1. Full name
  2. Complete address
  3. Age or DOB
  4. Gender (ONYSRx)
  5. Condition code (for over 30 day supply)
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18
Q

Condition Code A

A

3 month supply indicated for panic disorders

19
Q

Condition Code B

A

3 month supply indicated for ADD or ADHD

20
Q

Condition Code C

A

3 month supply indicated for convulsive disorders

21
Q

Condition Code D

A

3 month supply indicated for relief of pain suffering from chronic and incurable diseases

22
Q

Condition Code E

A

3 month supply indicated for narcolepsy

23
Q

Condition Code F

A

6 month supply indicated for hormone deficiency status

24
Q

Controlled Substance Rx Rules (8)

A
  1. Date Rx is signed

2. Rx is only valid for 30 days from date written

  1. Inscription includes drug name, strength, dosage form

4. Subscription includes directions for pharmacists and maximum of 30 day supply UNLESS condition code is stated

5. Only 7 day supply for acute pain (since 8/2016)

  1. All Rx’s will be filled generically unless DAW is written; medicaid requires “brand medically necessary”
  2. Diagnosis required for certain meds
  3. Signature signed in ink
25
Q

Controlled Substance Refill Rules (5)

A
  1. ONYSRx says no refills on controlled substances
  2. Non-ONYSRx says less than or equal to 5 refills w/i 6 months of issue and not until 7 day supply is left
  3. No refills of schedule II drugs
  4. Schedule III and IV may be refilled (maximum of 5 refills, not effective after 6 months from signed date and may only be refilled once if there is over a 30 day supply)
  5. Schedule V drugs may only be refilled as authorized on the rx by the prescriber
26
Q

Controlled Substance Signa (5)

A

Specific Directions for Patients

  1. Dosage
  2. Route
  3. Frequency
  4. Duration
  5. Maximum Daily Dosage (MDD) **
27
Q

Max Daily Dosages (2)

A
  1. Schedule II medications require MDD
    - Anabolic steroids
    - Opiates
    - Amphetamines
    - Narcotics
  2. Benzodiazepines are schedule II in NYS and Schedule IV in federal law; would require MDD with NY Rx
28
Q

Fax Rules of Controlled Substances (3)

A
  1. Schedules III-V may be faxed
  2. The fax is considered to be equivalent to an original prescription
  3. Schedule II may not be faxed
29
Q

Telephone Prescription Rules (2)

A
  1. Prescriptions may be telephoned in by the prescriber or the prescriber’s designated representative
  2. Only the practitioner can prescribe controlled substances via telephone
30
Q

Definition of Emergency Situation Rx (3)

A
  1. Needing immediate administration for treatment
  2. Lacking alternative treatment
  3. Not reasonably possible for practitioner to provide a written prescription for the drug at the time
31
Q

Emergency Situation Rx Rules (2)

A
  1. Verbal orders good for 5 days supply

2. Written/typed Rx must be mailed within 72 hours

32
Q

QD or OD

A

Every day

33
Q

QOD

A

Every other day

34
Q

BID

A

Two times daily

35
Q

TID

A

Three times daily

36
Q

QID

A

Four times daily

37
Q

AC

A

Before meals

38
Q

PC

A

After meals

39
Q

HS or QHS

A

Bedtime

40
Q

Disp

A

Dispense

41
Q

Sig

A

Directions

42
Q

Safe Rx Writing (3)

A
  1. Avoid writing doses in volume; write mg or mcg
  2. Avoid decimal errors/check calculations
  3. Use correct prescription blank
43
Q

DEA Numbers (3)

A
  1. Consists of 2 letters and 7 numbers
  2. First letter is A or B
  3. Second letter is first letter of last name
44
Q

Calculating DEA Numbers

A
  1. Add 1st, 3rd, 5th number (=x)
  2. Add 2nd, 4th, 6th number (=y)
  3. Add x+2y = the 7th number in the DEA number

Advanced Pediatric Pharmacology Exam 1 (8 decks)

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