Reading 11 Flashcards
Covers the definition of prescription, prescription issuance red flags, corresponding responsibility, correcting prescriptions, prescription requirements, and persons entitled to fill prescriptions.
Define “prescription”.
“an order for medication which is dispensed to or for an ultimate user but does not include an order for medication which is dispensed for immediate administration to the ultimate user (e.g., an order to dispense a drug to a bed patient for immediate administration in a hospital is not a prescription).”
True or false: a medication order in a facility is considered a type of prescription.
false
Define “prescription issuance”.
“the decision-making process that goes into deciding what drug, strength, quantity, and directions the patient needs.”
Explain the corresponding responsibility doctrine (CRD).
the responsibility for the proper prescribing and dispensing of controlled substances is upon the prescribing practitioner, but a corresponding responsibility rests with the pharmacist who fills the prescription
Define “patient-prescriber relationship”.
one “where a prescriber has taken a patient history, conducted an assessment, developed a treatment plan, and documented these steps.”
Red flags may be ________-, ________- ________-, or ________-specific.
patient; prescriber; situation; prescription
What are the 13 red flags for prescription review?
- A prescriber writes more prescriptions compared to other prescribers in the area.
- A prescriber writes larger prescription quantities than other prescribers in the area.
- A patient comes into the pharmacy to fill their prescription too frequently.
- A prescriber writes prescriptions for antagonistic drugs (stimulants and depressants) at the same time.
- A patient presents prescriptions written in the names of other people.
- Multiple patients come into the pharmacy simultaneously or within a short time, with similar prescriptions from the same prescriber.
- Patients who are not regular patrons of your pharmacy or are not residents of your community present prescriptions from the same prescriber.
- The prescription looks “too good;” the prescriber’s handwriting is too legible.
- Quantities, directions, or dosages differ from usual medical usage.
- The prescription does not comply with the acceptable standard abbreviations or appears to be textbook presentations.
- The prescription appears to be photocopied.
- Directions are written in full with no abbreviations.
- Prescription is written in different color inks or written in different handwriting.
A pharmacist can only be penalized through CRD if they knowingly fill a fraudulent/unsafe prescription. What is the legal definition of “knowingly”?
“a pharmacist recognizing the possibility of wrongdoing but consciously refusing to conduct a proper investigation.”
What must be included on a controlled substance prescription?
- date of issuance
- full name and address of patient
- drug name, strength, and form
- quantity prescribed
- directions for use
- name, address, and DEA number of the prescriber/institutional DEA number and assigned suffix
- prescriber signature
What implements can be used to write paper prescriptions?
- ink
- indelible pencil
- typewriter
- computer printer
but MUST be manually signed by the practitioner
What must prescriptions issued under DATA 2000 include?
the physician’s DATA-waived DEA number and prescriptions issued for GHB must include the medical need of the patient
What can pharmacies correct on a CIII-V prescription?
- patient address (upon verification)
- dosage form*
- drug strength*
- drug quantity*
- directions for use*
- issue date*
*after speaking with prescriber and documenting on the face of the prescription
Although we cannot alter the patient name, controlled substance name (except in generic substitution), and prescriber’s name, we can still correct if there is an error. How do we do this?
call the prescriber and convert the written prescription to an oral, telephoned prescription and change the information
What is the general consensus on making changes to C-II prescriptions?
we can make changes as long as state laws/policies allow it
If there is an error with a C-II prescription relating to the patient name, substance, or prescriber’s name/signature, what must be done to change it?
patient must go back to the prescriber and have a new prescription written or new electronic prescription sent
