Reading 16, 17, 18 - Prescriptions and BoP Flashcards
If a prescription does not have the number of refills on it, you can it assume it has ____ refills?
ZERO
A drug order does NOT need which of the following (choose all):
-bed number
-directions for use
-name of the patient
-name of the pharmacist
-name of the prescriber
-name of the drug and strength
-drug expiration
Name of the pharmacist
Drug expiration
A prescription does NOT always need which of the following (choose all):
-patient address
-patient DOB
-name and strength of drug
-amount dispensed
-practitioner signature
-adequate directions
-precautions
Patient DOB
Precautions
A prescription is required to have the number of refills on it by Indiana law?
NO, refills do not need to be on the prescription but are highly recommended
A prescription label does NOT always need which of the following (choose all):
-address of pharmacy
-prescriber
-the date
-patient name
-drug name
-directions for use
-precautions for use
drug name and precautions for use
What can you NOT prescribe anabolic steroid for?
Exercise performance in sport
Hormonal manipulation intended to increase muscle mass
Mechanical storage devices must be under the direct supervision of ____?
Pharmacist or Practitioner
What Act talks about drug samples?
Prescription Drug Marketing Act
Drug samples are great for patients. What are some restrictions put on practitioners and pharmacies?
-CANNOT sell samples
-CANNOT knowingly remove from original packaging
-CANNOT knowingly give expired drug samples
Drug samples are great for patients. What are some restrictions put on practitioners and pharmacies?
-CANNOT sell samples
-CANNOT knowingly remove from original packaging
-CANNOT knowingly give expired drug samples
What type of practitioner can we NOT substitute generics?
Veternian prescriptions MUST be verified
On a prescription what side should the prescriber sign if he/she wants to dispense as written?
LEFT
For a Indiana Medicaid patient prescribed Lipitor. What must you check before dispensing Lipitor to this patient?
If the generic, atorvastatin is lower cost, then you MUST substitute for generic
If a Medicare patient was prescribed Lasix 80 mg PO daily. What must the prescriber do if they would the prescription to be filled as written?
They MUST write in their OWN hand writting “Brand Medically Necessary”
You substituted Z pack for azithromycin pack. What must you write on the label?
Identify both products: “Azithromycin generic for Z pack”
What MUST you do when dispensing naloxone?
Educate on administration and tell patient to call 911 either befor or after administration
What is NOT necessary when substituting a biosimilar biological product:
-verifying in the Orange book it is interchangeable
- prescribing practitioner has signed “may substitute”
-informing the patient of the substitution
Verification is required but from the PURPLE BOOK
What is an Electronic Data Intermediary (EDI)?
The entity that allows computer systems of practitioners and pharmacies to relay information to one another (electronic prescriptions, refills, patient care info)
Pharmacist intern includes all of the following except:
- permitted by the board to engage in the practice of pharmacy
- graduate of an approved college of pharmacy
- a qualified applicant awaiting examination for licensure
-individual participating in a residency or fellowship
permitted by the board to engage in practice of pharmacy
*** this is partially true but it needs to be under the supervision of a pharmacist!!!
What is required on a prescription under Indiana law?
-Name of patient
-Address of patient
-Date of issue
-Drug name and Strength
-Amount issued
-Directions of use
-Prescriber
-Prescriber signature
The board of pharmacy has 7 members. What should those members include?
-5 pharmacists (1 from hospital)
-1 technician
-1 public member
How often must the BoP meet?
at least 8 times per year
What is an Indiana BoP term?
4 years
What is considered an approval by the majority?
Quorum is required for approval and the majority of the quorum (3 out of 4) is considered approval
The different between POWER and DUTY?
Power == they may do this (example: issue temporay variance)
Duty == they must do this (example: establish standards for counseling patients)
What are the duties of the Indiana BoP?
-establish standards for pharmacy practice
-establish standards for counseling patients
- establish procedures for returning expired drugs
-adopt rules and procedures for electronic prescriptions
-adopt rules regarding OTC saled of ephedrine and pseudoephedrine
What is the Indiana BoP jobs when there is an impaired pharmacist?
-Assist in rehab like Indiana Professionals Recovery Program (IPRP)
Active Pharmacist vs Inactive Phamacist
Active: fees are current along with all required CE
Inactive: CANNOT PRACTICE pharmacy, must complete all CE before applying to become active again
Invalid license happens when…
when you do not renew your license your license becomes invalid and you MUST apply to reinstate your license
The date and year when a pharmacy license MUST be renewed
June 30th of EVEN numbered years (June 30, 2024)
renewed every 2 years
When are pharmacists CE requirements due? What are the CE requirements?
Due December 31st on odd numbered years
30 CE hours are required every 2 years
1/5 - can be management related
4/5 - must be pharmacy related
1/2 must be accredited
When can a technician share patient confidential information?
ONLY when there is a criminal prosecution
The different Classes of pharmacy permits:
Class 1 = dispense drugs to the public (retail)
Class 2 = institutional pharmacies
Class 3 = provide “closed door” central fills or mail order
What do you NEED to provide to the board to aquire a pharmacy permit?
Name
Occupation
Location address
What is the ratio of technicians to pharmacists allowed?
1:8
3 max can be techs in training
What other physical requirements for a pharmacy MUST be obtained?
-sufficient stock of drugs
-security
-well lit and ventilated
-sink with hot and cold water
-refridgerator
-Large enough area for everything
Pharmacy permits are non-transferable. When should a pharmacy obtain a new permit?
-change in location
-change in ownership
A patient wants to refill her Dexedrine prescription. The prescription expires on 12/1/23 and has 3 refills. Can you legally refill the prescription?
NO this is a C-II medication. You cannot refill C-II medications
A patient wants to refill his Vimpat prescription. The prescription was written on 10/2/22 with 4 refills remaining. The prescription was filled at your pharmacy prior. Can you refill this prescription legally?
NO the prescription is a C-V and expired 6 months after written (4/2/23)
A patient is needing their Levodopa prescription on a friday evening for his Parkinson’s. Their provider’s office is no longer open. The original Levodopa prescription had 6 refills on it, but it is now out. Can this pharmacist legally allow an emergency refill? If the prescription is written for #90 tablets, what is the max amount you can give?
YES, this drug is NOT a controlled substance. The original prescription had refills and it was prescribed for continuous use for PD.
The MAX amount in an emergency refill is 30 days supply.
*NOTE: the pharmacist MUST notify the doctor within the NEXT business day that they have authorized an emergency refill
A patient was newly prescribed metformin 500 ER 2 tabs PO BID for 30 days. To make it easier on the patient, the pharmacist changed the quantity to match a 90 days supply. What this done legally?
NO, you cannot change the quantity to a 90 days supply until after the patient has been on the medication for at least 30 days
What pharmacy type can accept returned controlled substances?
Category II
What are the requirements for accepting a returned drug in a retail pharmacy setting?
- must be a patient in an residing in an institution, hospice, or jail
- properly stored
- unopened in original packaging or unit dose packaging
- returned to the dispensing pharmacy
- NOT expired
- NOT a controlled substance
A pharmacy may accept and resale a medical device if:
-patient is in jail
-not expired
-returned unopened
What can pharmacists change on the prescription without calling the provider?
Quantity
Dosage form (equivalent amount)
Complete missing information with sufficient evidence to support
must document
What can pharmacists prescribe to patients through their NPI number?
Spacers
Nebulizers
medical devices (CPAP)
Glucose testing supplies
pen needles
syringes
What time frame do you have after administering a vaccine to notify the patient’s prescriber?
14 days
What are the requirements to dispense epinephrine and glucagon in a pharmacy?
-expiration must be 12 months unless you get the patient’s consent
-must provide administration instructions and educated to call 911
Who can supervise a pharmacy intern when it comes to immunizations?
pharmacists
physicians
physicians assistant
APRN
RN
