Reading 11, 12 & 13- Controlled Substances Flashcards
When is agency NOT allowed when needing to change something on a prescription?
C-II medications!! you must talk to the provider directly!!!
What is NOT required on a controlled substance prescription:
- Date
-Address of the patient
-DOB of the patient
- Drug name
-Directions for use
-DEA # of prescriber
-Prescriber Signature
DOB of patient
On C-II - C-V prescriptions what can you NOT change whatsoever on the script?
Patient name
Controlled substance
Prescribers name (and signature)
** must covert to oral prescription or get a new script
When will an Amytal prescription expire?
1 year (C-II)
When does a Halcion prescription expire?
6 months, C-IV
What is the maximum quanity on C-II prescription?
NO MAXIUM Quantity but use clinical judgement
If a prescriber is authorizing multiple C-II scripts, what is the maximum days supply? What other requirements are needed?
90 days supply
must date it with earliest fill date
prescribe for legit med reason
prescriber has assessed abuse risk
has all other prescription requirements
How many max refills are allowed with a Librium prescription?
5 refills, C-IV (Chlordiazepoxide)
What are the only controlled substances that can be partially filled legally?
OPIOIDS
If the pharmacy cannot provide the full amount for a controlled substance, what should the pharmacist do?
DOCUMENT
give partial fill
Fill the remaining quantity within 72 hours
What are two situations where a pharmacist can partial fill a C-II medication for more than 30 days? How long is it?
Long Term Care Faculity patient OR terminal illness
Can wait 60 days after the written date
After writing an emergency C-II prescription over the phone, what does the provider need to do?
Sent you a covering prescription within 7 day, stating “Authorization for Emergency Dispensing”
What are the 3 criteria for emergency C-II prescriptions?
-immediate administration is necessary for treatment
- there is no alternative
- it is not possible for the prescriber to write a prescription
When a controlled substance prescription is sent to a central fill pharmacy, what should be changed about the prescription?
Write “Central Fill” along with the name, address, and DEA number of the pharmacy
How long should central fill pharmacies keep prescription CS copies?
2 years
What must always be on a C-II prescription label? (select all)
- date
-pharmacy address
-caution statements
-drug name
-prescriber name
date
pharmacy address
prescriber name
***cautionary statements should only be on the label if on the prescription AND drug name is not required
When can controlled substance faxed prescriptions be used as the original prescription?
- C-II Narcotics compounded as an injectable
- C-II for LTCF
- C-II Narcotics for hospice and paid for by Medicare or state program
- C-III-V always
What are the limitations for transfers of C-II - C-V prescriptions?
Transferred ONCE after it has been filled
EXCEPT: if the pharmacies share an online database, it can transfer equal to the amount of refills (max 5)
-ONLY transferred pharmacist to pharmacist
-record the name, address, and DEA number of pharmacy
How long must you maintain records for transfer prescriptions?
2 years after the date of the last refill
Detoxicification
giving the patient less and less of a narcotic to bring a patient to drug-free state
Narcotic
Opiium
Opiates
Poopy straw
Cacoa leaves
Cocaine
Ecgonine (C-II)
What are the 5 ways a patient can be given a narcotic for substance use disorder?
- physical is separately registered as Narcotic Treatment Program (methadone clinics)
- Maintenance in a hospital (must be hospitalized for another reason)
- Physicians administer their office supply (DO NOT PRESCRIBE) - max of 3 days
- Drug Addiction and Treatment Act 2000 (DATA) - must have DEA number with X - only treat 30 patients within 1st year - NO C-II SCRIPTS
-only approved drug is buprenorphine/naloxone - Pharmacist deliver CS to prescriber office for an individual patient injection or implant - administration no later than 14 days after receiving the product from pharmacy
4 ways to destroy/get rid of controlled substances legally:
- onsite = reqeuires 2 employees and substance must be nonretrievable
- reverse distributer
- Send to distributor === only returns or recalls
- Request to DEA office (DEA Form 41)
How DEA form should be used to report theft? How soon should you report?
DEA Form 106
Within 1 day
What DEA form should be used to request destruction of a CS?
DEA Form 41
When do you report theft?
When ANY theft happens and there is significant loss
