Reading 11, 12 & 13- Controlled Substances

Question 1

When is agency NOT allowed when needing to change something on a prescription?

Answer 1

C-II medications!! you must talk to the provider directly!!!

Question 2

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

Answer 2

DOB of patient

Question 3

On C-II - C-V prescriptions what can you NOT change whatsoever on the script?

Answer 3

Patient name
Controlled substance
Prescribers name (and signature)

** must covert to oral prescription or get a new script

Question 4

When will an Amytal prescription expire?

Answer 4

1 year (C-II)

Question 5

When does a Halcion prescription expire?

Answer 5

6 months, C-IV

Question 6

What is the maximum quanity on C-II prescription?

Answer 6

NO MAXIUM Quantity but use clinical judgement

Question 7

If a prescriber is authorizing multiple C-II scripts, what is the maximum days supply? What other requirements are needed?

Answer 7

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

Question 8

How many max refills are allowed with a Librium prescription?

Answer 8

5 refills, C-IV (Chlordiazepoxide)

Question 9

What are the only controlled substances that can be partially filled legally?

Answer 9

OPIOIDS

Question 10

If the pharmacy cannot provide the full amount for a controlled substance, what should the pharmacist do?

Answer 10

DOCUMENT
give partial fill
Fill the remaining quantity within 72 hours

Question 11

What are two situations where a pharmacist can partial fill a C-II medication for more than 30 days? How long is it?

Answer 11

Long Term Care Faculity patient OR terminal illness
Can wait 60 days after the written date

Question 12

After writing an emergency C-II prescription over the phone, what does the provider need to do?

Answer 12

Sent you a covering prescription within 7 day, stating “Authorization for Emergency Dispensing”

Question 13

What are the 3 criteria for emergency C-II prescriptions?

Answer 13

-immediate administration is necessary for treatment
- there is no alternative
- it is not possible for the prescriber to write a prescription

Question 14

When a controlled substance prescription is sent to a central fill pharmacy, what should be changed about the prescription?

Answer 14

Write “Central Fill” along with the name, address, and DEA number of the pharmacy

Question 15

How long should central fill pharmacies keep prescription CS copies?

Answer 15

2 years

Question 16

What must always be on a C-II prescription label? (select all)
- date
-pharmacy address
-caution statements
-drug name
-prescriber name

Answer 16

date
pharmacy address
prescriber name

***cautionary statements should only be on the label if on the prescription AND drug name is not required

Question 17

When can controlled substance faxed prescriptions be used as the original prescription?

Answer 17

• 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

Question 18

What are the limitations for transfers of C-II - C-V prescriptions?

Answer 18

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

Question 19

How long must you maintain records for transfer prescriptions?

Answer 19

2 years after the date of the last refill

Question 20

Detoxicification

Answer 20

giving the patient less and less of a narcotic to bring a patient to drug-free state

Question 21

Narcotic

Answer 21

Opiium
Opiates
Poopy straw
Cacoa leaves
Cocaine
Ecgonine (C-II)

Question 22

What are the 5 ways a patient can be given a narcotic for substance use disorder?

Answer 22

1. physical is separately registered as Narcotic Treatment Program (methadone clinics)
2. Maintenance in a hospital (must be hospitalized for another reason)
3. Physicians administer their office supply (DO NOT PRESCRIBE) - max of 3 days
4. 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
5. 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

Question 23

4 ways to destroy/get rid of controlled substances legally:

Answer 23

1. onsite = reqeuires 2 employees and substance must be nonretrievable
2. reverse distributer
3. Send to distributor === only returns or recalls
4. Request to DEA office (DEA Form 41)

Question 24

How DEA form should be used to report theft? How soon should you report?

Answer 24

DEA Form 106
Within 1 day

Question 25

What DEA form should be used to request destruction of a CS?

Answer 25

DEA Form 41

Question 26

When do you report theft?

Answer 26

When ANY theft happens and there is significant loss