Prescription Writing and Controlled Substances

Question 1

Non-Controlled Substances

Answer 1

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

Question 2

Schedule I (3)

Answer 2

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

(ex: Heroin)

Question 3

Schedule II (3)

Answer 3

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)

Question 4

Schedule III (3)

Answer 4

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

Question 5

Schedule IV (3)

Answer 5

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

Question 6

Schedule V (4)

Answer 6

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

Question 7

Schedule I examples (4)

Answer 7

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

Question 8

Schedule II examples (6)

Answer 8

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

Question 9

Schedule III examples (5)

Answer 9

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

Question 10

Schedule IV examples (5)

Answer 10

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

Question 11

Schedule V examples (4)

Answer 11

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

Question 12

ONYSRx (5)

Answer 12

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

Question 13

Requirements on all prescriptions (8)

Answer 13

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

Question 14

Non-Controlled Rx Rules (7)

Answer 14

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

Question 15

Non-Controlled Rx Medicaid Rules (3)

Answer 15

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

Question 16

Controlled Substance Prescriber Information (7)

Answer 16

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

Question 17

Controlled Substance Patient information (5)

Answer 17

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

Question 18

Condition Code A

Answer 18

3 month supply indicated for panic disorders

Question 19

Condition Code B

Answer 19

3 month supply indicated for ADD or ADHD

Question 20

Condition Code C

Answer 20

3 month supply indicated for convulsive disorders

Question 21

Condition Code D

Answer 21

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

Question 22

Condition Code E

Answer 22

3 month supply indicated for narcolepsy

Question 23

Condition Code F

Answer 23

6 month supply indicated for hormone deficiency status

Question 24

Controlled Substance Rx Rules (8)

Answer 24

1. Date Rx is signed

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

3. 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)

6. All Rx’s will be filled generically unless DAW is written; medicaid requires “brand medically necessary”
7. Diagnosis required for certain meds
8. Signature signed in ink

Question 25

Controlled Substance Refill Rules (5)

Answer 25

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

Question 26

Controlled Substance Signa (5)

Answer 26

Specific Directions for Patients 1. Dosage 2. Route 3. Frequency 4. Duration 5. Maximum Daily Dosage (MDD) **

Question 27

Max Daily Dosages (2)

Answer 27

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

Question 28

Fax Rules of Controlled Substances (3)

Answer 28

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

Question 29

Telephone Prescription Rules (2)

Answer 29

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

Question 30

Definition of Emergency Situation Rx (3)

Answer 30

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

Question 31

Emergency Situation Rx Rules (2)

Answer 31

1. Verbal orders good for 5 days supply | 2. Written/typed Rx must be mailed within 72 hours

Question 32

QD or OD

Answer 32

Every day

Question 33

QOD

Answer 33

Every other day

Question 34

BID

Answer 34

Two times daily

Question 35

TID

Answer 35

Three times daily

Question 36

QID

Answer 36

Four times daily

Question 37

AC

Answer 37

Before meals

Question 38

PC

Answer 38

After meals

Question 39

HS or QHS

Answer 39

Bedtime

Question 40

Disp

Answer 40

Dispense

Question 41

Sig

Answer 41

Directions

Question 42

Safe Rx Writing (3)

Answer 42

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

Question 43

DEA Numbers (3)

Answer 43

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

Question 44

Calculating DEA Numbers

Answer 44

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