Prescriptions Flashcards
Required elements for a valid prescription in NYS: prescriber info
Prescriber name, address, phone number, profession, signature, date the script was written by the prescriber
Required elements for a valid prescription in NYS: patient info
Patient name, age, address
Required elements for a valid prescription in NYS: drug info
Drug name, strength, directions, quantity, dosage form
Required elements for a valid prescription in NYS: additional drug info for CONTROLLED SUBSTANCES
gender of patient (CIIs and BZDs)
quantity in both number and written format
MDD
DEA number of the prescriber
Refills in numerical and written format (CIIIs-CVs)
What can a pharmacist correct/change/add to a legend/controlled substance script WITHOUT PRESCRIBER CONSENT in NYS?
Patient’s address, age, sex, and phone number
What can a pharmacist ADD to a legend/controlled substance WITH PRESCRIBER CONSENT in NYS? (6 things)
DEA # of the practitioner, institutional DEA #/suffix, directions, code, MDD, strength
What can a pharmacist CHANGE to a legend/controlled substance script WITH PRESCRIBER CONSENT in NYS? (8 things)
DEA # of practitioner
Institutional DEA #/suffix
Directions
Code
Quantity
MDD
Strength
Dosage form
What should pharmacists NEVER add or change on a prescription?
Patient name
Practitioner signature
Name of drug
Date script was written
Don’t ADD a quantity, but you can CHANGE it with prescriber permission!
What types of med substitutions are allowed?
Dispense the generic formulation of the drug UNLESS DAW is written in the box- then you MUST dispense the brand name!
“PRN” refills in NYS
1 refill
How many refills do CIIs get?
NONE (duh)
How many refills do CIIIs-CVs get?
5 refills (up to a 6-month supply)
Requirements for writing scripts: how many drugs can be on one prescription blank?
ONE!
Exception to the drug limit on a prescription blank
Noncontrolled drugs for certain facilities
Drug with the hypodermic syringe and needle
Out-of-state scripts with multiple noncontrolled drugs on the same label
Scripts written in NYS have to be written on what?
ONYSRx
What do scripts that are written but faxed in NYS have to be done on?
ONYSRx
Is a fax an electronic prescription?
NO
What does a faxed prescription need?
A handwritten signature!
Where do scripts have to come from?
The prescriber or an authorized person
Electronic scripts in NY: is it required?
YES!
Exceptions to electronic scripts in NYS: NO waiver needed (4 things)
Vets don’t need electronic scripts
Temporary electronic/technological failure
Practitioner determines it’s impractical for the patient to obtain substances prescribed by electronic prescription in a timely manner and a delay would impact the patient’s medical condition
Dispensing by a pharmacy out of state
Quantity of a controlled substance won’t exceed a 5-day supply
Exception to electronic scripts: WAIVER IS NEEDED (7 things)
Patient is in a nursing home or LTCF
Prescription containing 2 or more products for a compound
Drug to be administered parenterally
Scripts that have long and complicated directions
EPT, CDTM
Non-patient specific prescription for an opioid antagonist
Drugs prescribed under a research protocol
Prescribers who issue <25 scripts in a 12-month period
Electronic prescriptions need what kind of signature?
An electronic one (lol duh)
Can you electronically send controlled scripts?
Yes
Can electronic scripts be sent across state lines?
Yes
Verbals: who can call in a non-controlled script?
The prescriber or the prescriber’s agent (like a nurse)
What should a verbal be written on?
A prescription blank
What else needs to go on a prescription blank for a verbal?
RPG’s initials and the date of the Rx
All information needed for the script from the prescriber
Verbals: who can call in a CONTROLLED script?
Must be phoned in DIRECTLY BY THE PRESCRIBER
What else also needs to be done with a controlled substance verbal in NYS?
The prescriber has to submit the cover script within 72 hours for ALL schedules of controls
In nursing homes, all order should be what?
in writing, unless a verbal is warranted
A verbal order in a nursing home can only be accepted by who?
Licensed nurse or RPh
Verbal order in a nursing home: does it have to be countersigned? If so, when does it have to be?
Yes, it has to be countersigned by a prescriber within 48 hours or the order has to be D/C’ed
Can interns take verbals?
Yes (duhhhhhhhh)
Phone transfer: what the RPh GIVING the transfer has to record
Name of the patient
1 refill is going to be transferred
Name, address, and phone number of the pharmacy that it’s getting transferred to
Name of the RPh RECEIVING the transfer
Date of the transfer
Name of the pharmacist transferring the script (so record your name)
Phone transfer: what the RPh ACCEPTING the transfer has to record
Produces a hard copy or electronically of the transfer
Marks that it’s a refill transfer somewhere on it
Dates of the original and most recent filling or transfer of the original Rx
Transferring pharmacy’s name, address, script number
Name of transferring RPh
Name of pharmacist receiving the transfer
Copies of prescriptions: can patients get them?
Yes, if it’s for a non-controlled substance
Can an insurance company copy records?
No
Can Medicare/Medicaid copy records?
Yes
Who “owns” the script?
Patients have a right to have an order refilled if authorized and according to law
Patients have a right to a copy
RPhs have a duty not to disclose info and maintain confidentiality
What can you do with out-of-state prescriptions?
NYS law doesn’t really say anything about them. Exception is for controls; you can fill them if you find out of the practitioner who wrote it is licensed/registered in the state it was written in
What can you do with foreign prescriptions?
If the patient presents you a script for the same drug, strength, and formulation in the US, you can fill it
What about mailing a script to a foreign country? What can you do with that?
It means you’re exporting the drug, so you have to be registered with the SED as a manufacturer/wholesaler, receive FDA approval, AND permission from the other country to send it
(basically: it ain’t worth it)
What about patients obtaining scripts from foreign countries?
It has to be for personal use only and the drug can’t be available in the US
Can only have ≤3 months supply
How long do HIPAA and Medicaid say you have to keep prescription records for?
6 years (NYS law is 5, go with the stricter rule!)
Who can inspect your pharmacy records?
OPD
DOH
BNE
DEA
Medicare/Medicaid
FDA
Local police
How to store prescription files
Store all the CIIs together
Store the CIIIs-CVs together
Store the non-controls together
Prescription labeling: what has to be on it?
Patient name, directions, drug name, strength
Name, address, phone of pharmacy
Patient’s address
Name of prescriber
Date of filling/refilling Rx
Prescription number or other identifying number
Prescriptions: child safety cap requirements
All drugs have to be in child-resistant containers unless the patient requests otherwise
Can script containers be reused?
No
Use-by date for in-house repackaged drugs
The expiration date is 12 months out or 50% of the time remaining to the manufacturer’s expiration date, whichever is less, from the date of repacking
Counseling: who can do it?
Pharmacists and interns (duh)
When do you have to provide counseling?
Dispensing a script for the first time to a new patient of the pharmacy
New script for existing patient
Change in dose/strength/route/directions for already existing script
Can a patient refuse counseling? If so, what do you do?
They can refuse, you just have to document
Do you have to counsel on refills?
No, but you can offer the option to
Counseling: what if a patient gets their meds delivered to them?
Has to have a written offer to counsel with each script
What to cover in counseling
Name and description of the med and what it’s used for
How to take it, along with any special instructions and/or precautions for for preparation, administration, and use by the patient
Storage conditions
What to do in a missed dose
Side effects and how to manage them
Monitoring parameters and when to follow up with a provider on progress
(duh)
Disposal/donation of old drugs
State Drug Take-Back Day
Can also drop off at any medication drop off box at a local pharmacy, police station, etc.
Controlled substance scripts: how many refills is allowed on a CI?
None
Controlled substance scripts: how long is a C1 script valid for?
It’s not- it’s all illegal drugs lol
Controlled substance scripts: how many refills are allowed on a CII?
0
Controlled substance scripts: how long is a CII script valid for?
30 days
Controlled substance scripts: how many refills are allowed on a CIII?
5
Controlled substance scripts: how long is a CIII script valid for?
6 months
Controlled substance scripts: how many refills are allowed on a CIV?
5
Controlled substance scripts: how long is a CIV script valid for?
6 months
Controlled substance scripts: how many refills are allowed on a CV?
5
Controlled substance scripts: how long is a CV script valid for?
6 months
How many refills are allowed on a legend/OTC drug?
Not specified in the law, but it’s just however many the prescriber allows in 1 year
How long is a legend/OTC script valid for?
1 year
How many refills are allowed on a methadone script?
0
How long is a methadone script valid for?
30 days
