Reading 14 & 15 - Indiana Prescribers and Professional Standards Flashcards
Definition of Sale includes:
-manufacturing, processing, transporting, handling, packing, preparation or repackaging
-exposure or offer
-holding, storing, or possession
-dispensing, delivering, or other supplying
-applying, administering, or other using
Examples of unexpected sales
-setting out a drug for a patient to pick it up andpotentially buy it
-administering a B-12 injection
Who has prescribing authority in Indiana?
Physicians (MD/DO)
Dentists (DDS/DMD)
Podiatrists (DPM)
Veterinarians (DVM)
Advanced Practice Registered Nurses (APRN)
Physician Assistant (PA)
Optometrists (OD)
**prescribers still must prescribe within their scope of practice
**the prescriptions must be valid as written based on the laws in the state they are working in
APRNs must work under a protocol with a supervising practitioner, excluding which practitioners with prescribing rights:
-veterinarian
-physician assistant
-another APRN
they CAN work under:
-podiatrists
-physicians
-dentists
What is the Indiana CSR?
Indiana Controlled Substance Registration
What are the requirements for a PA and their collaborating physician?
-MUST be directly supervised in person or via an electronic method (meaning ready available)
-MUST have a protocol on file
-only allowed to prescribe within the physician’s scope of practice
-NEVER prescribe ophthalmic devices (glasses, contacts, low-vision devices)
-NEVER interact with CS I drugs
Can we accept prescriptions from APRNs and PAs from other states?
YES, as long as they are licensed to prescribe legally within that state
*** they have to sign the prescription with their name, credentials, and license number
Optometrists Formulary to Prescribe in Indiana
- Independently prescribe === does not have to notify a PCP
- Dependently prescribe by notification of the PCP (write it on prescription)
-Dependently prescribe by consulting the PCP (write it on prescription)
What controlled substance can an OD prescribe if a DEA number and Indiana CSR is present?
Tramadol
What prescriber can we fill prescriptions ONLY from Indiana and nothing from out of state?
Optometrists (OD)
What midlevel providers are NOT able to prescribe in Indiana?
-Naturopaths
-Pharmacists
-Dieticians
-Chiropractors
Standards of Practice applies to which practitioners?
ANYONE with a license including pharmacy interns and technicians
Santions can be given to who?
ANYONE with a license
The sanction involving a written recorn of what you did wrong sent to you and put on your permanent file:
Letter of Reprimand
The sanction involving you license being taken away permanently
Revocation
After a revocation of a license what are the requirements to reapply, if possible?
-Wait 7 years
-You need to retake all exams
-Reapply with the board and they do NOT have to accept your application
The sanction involving maintaining licensure with restrictions or mandatory actions (including community servise, CE, reporting to the board, etc)
Probation
The sanction involving inability to practice but ability to apply for reinstatement after a certain point
Suspension
If a pharmacist is a imminent danger to the public, the BoP can issue:
Emergency Suspension for 90 days
The sanction involvinng verbal expression of disapproval and on your official record
Censure
What are the two ways a practitioner can avoid a hearing?
-Request a settlement
-Apply to surrender their license
What practitioners are NOT covered under the new electronic prescription law for controlled substances?
Medical residents
Veterinarians
What instances can we NOT accept a written prescription for controlled substances?
-electronic failure
-research protocol
-patient request
-prescriber outside indiana
-prescriber with a waiver from the board
-drug orders
patient requests and drug orders
What medications CANNOT be prescribed over telehealth?
Opioids and abortion inducing drugs
Which of the following is NOT a requirement when prescribing controlled substances through telehealth?
- conducted with audiovisual and two way interactive, real time communication
- issued medication for legitimate purpose
- patient must be 18 years or older
- complies with INSPECT
patient must be 18
If a patient is receiving an opioid for the 1st time, what should the days supply NOT exceed?
7 days
If an animal is receiving an opioid for the first time what should the days supply not exceed?
7 days
If a patient is a minor (<18 years old) and received a prescription for opioids, what should the max days supply be?
7 days
What are some exceptions to the 7 days supply rule for opioids?
- if patient is an adult who has already received an opioid prescription
- Cancer or Palliative care
- Substance use disorder
- conditions stated by licensing board
- Prescriber’s professional judgement
If a precriber wrote a prescription for a 16 year old for Demerol x 15 days for pain after surgery. What would you need to do in order to fill this legally?
Reach out to the doctor and document WHY thte prescriber wrote for over 7 days
Who can request partial fills for opioids?
Patient, legal representative, or guardian
DOCUMENT THIS
A patient wants a partial fill of her Tylenol #3 written for 30 tablets 2 months ago. The patient is requesting 5 tablet now and will fill the remaining quantity later. Is this allowed?
Yes, Tylenol #3 is a C-III OPIOID substance that can be partially filled as many times within the 6 months of active prescription as long as it does not exceed the written quantity
A patient requests for a partial refill of Dilaudid prescription written for #14 tablets 2 months ago. The patient is requesting 7 tablets nowand 7 tablets later. Can you partially fill both times?
NO, Dilaudid is a opioid C-II substance can cannot fulfill a remaining partial fill after 30 days the prescription was written
