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Fl 2* > RXPREP chapter 8: controlled substances part 3 > Flashcards

RXPREP chapter 8: controlled substances part 3 Flashcards

1
Q

Who can prescribe CS?

A

physician

dentist

podiatrist

veterinarian

midlevel practitioner

or other practitioner who is authorized to prescribe, registered with the DEA or exempt from DEA registration, an under the hospital’s registraiton

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2
Q

What are common mid-level practitioners?

A

certified nurse midwives

certified registered nurse anesthetists

NP

Optometrists

PA

Rph

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3
Q

The DEA number starts with two…

A

two letters

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4
Q

The first letter of the DEA identifies…

A

the type of practitioner or institution

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5
Q

the second letter of the DEA identifies the…

A

prescribers last name

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6
Q

the two letters of a dea number are followed by

A

7 numbers (the last number is the check digit)

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7
Q

if a practitioner is authorized to prescribe narcotics for opioid addition treatment, the practitioner will receive what number

A

DATA 2000 waiver unique identification number (UIN)

same as the DEA number but the first letter is X (replaces the FIRST letter)

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8
Q

For a DEA number, A/B/F/G represents…

A

Hospital, clinic, practitioner, teaching institution, pharmacy

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9
Q

for a DEA number, M represents

A

mid level practitioner

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10
Q

P/R represents in a DEA number

A

manufacturer, distributor, researcher, analytical lab, importer, exporter, reverse distributor, narcotic treatment program

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11
Q

Step 1 of determining a DEA number is valid

A

add the 1st, 3rd, and 5th digits together

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12
Q

Step 2 of determining a DEA number is valid

A

add the 2nd, 4th, 6th digits tgoether

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13
Q

Step 3 of determining a DEA number is valid

A

multiply the result of step 2 by 2

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14
Q

Step 4 of determining a DEA number is valid

A

add the results of step one and step three together. the last digit of this sum should match the last digit of the prescriber’s DEA number. (this is the check digit)

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15
Q

the PDMP is regulated by

A

specified state-wide administrative, regulatory or law enforcement agency. NOT THE DEA

most commonly collected in real time, daily or every 72 hours or weekly

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16
Q

CS prescriptions must include

A

patient full name and address
prescriber full name and address
drug name, strength, dosage form, quantity, and directions for use
# of refills authorized

signed and dated by the prescriber the date it is issued to patient

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17
Q

if an MLP is prescribing under a physician directed protocol who signs?

A

the MLP

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18
Q

orders written for direct administration to patients in facilities such as clinics and hospitals are not considered prescription, they are referent o as

A

medication orders or chart orders

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19
Q

pharmacists can receive prescriptions for what schedule drugs verbally?

A

III-V

the pharmacist must immediately reduce the prescription to writing
don’t need prescriber’s signature

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20
Q

oral prescriptions for schedule II drugs are not valid except in what type of situations

A

emergent

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21
Q

faxed prescriptions are acceptable for schedule what drugs

A

III-V

as long as they contain all required elements and the prescriber has SGINED

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22
Q

generally, faxed prescriptions for schedule II drugs CANNOT serve as the original prescription

t/f

A

true

the schedule II drug cannot be dispensed to the patient until the pharmacy receive the written prescription

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23
Q

a faxed prescription can serve as the original copy for a schedule II drug in what three scenarios?

A
  • a drug compounded for administration to pa tint by parenteral, IV, IM, subQ, or intraspinal route
  • a prescription for a resident of a LTCF
  • a prescription for a patient enrolled in a hospice program
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24
Q

in 2010, the DEA released final rules that permit electronic prescription for controlled substances for schedule…

A

II-V drugs

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25
Q

prescribers and pharmacies must use what type of software for electronic prescriptions for CS?

A

DEA-approved software

two factor authentication method to sign and transmit EPCS

26
Q

The credentials that are permitted for DEA-sanctioned validation include two of the following:

A

something you know (password or response to a question)

something you have (hard token)

something you are (iris, fingerprint scan)

OR

can use a digital certificate

27
Q

when a prescription is received electronically, federal law requries that the prescription and all required annotations must be stored electronically for at least __ years

A

2

28
Q

for all CS, there are three items that cannot be changed:

A

patient name

drug

dr signature

29
Q

despite schedule II drugs having the highest abuse potential of all drugs, there is no expiration date or quantity limit set by federal law for schedule II presriptions

t/f?

A

true

but no refills

30
Q

what are the three circumstances in which a schedule II prescription may be partially filled

A

1) if the pharmacy cannot supply full quantity (remaining portion must be filled in 72 hours; after this time, a new prescription is required - rph notifies dr)
2) under the 2016 CARA, pharmacists can partially fill schedule II drugs at the request of the PATIENT or prescriber, can only be dispensed up to 30 days from the date the prescription was issued
3) patients residing in a LTCH or patients with a terminal illness/hospice (must document this on prescription, partial fills can be dispsended up to 60 days from the date the rx was issued

31
Q

the pharmacy does not have sufficient stock fo the drug.. deadline to fill remaining balance

A

72 hours after first partial filling

32
Q

partial fills - request by the patient or the practitioner who wrote the CII rx; deadline to fill remaining balance

A

within 30 days after issue date

33
Q

partial fills- terminally ill or LTCF residents; deadline to fill remaining balance

A

within 60 days after issue date

34
Q

for each partial fill, the pharmacist must document what on the back of the prescription?

A

date of partial filling
amount dispensed
amount remaining
name of dispensing rph

35
Q

if an electronic record keeping system is used, the following information must be maintained and be updated in real time when a partial fill is dispensed

A 
original rx number
date of issue
drug name, dose, formulation, strength and quantity
quantity authorized
patients name
prescriber name
address of LTCF, hospital, or patients home
list of partial fills dispensed
36
Q

what type of pharmacy are prohibited from preparing emergency fills for schedule II Drugs under any circumstance

A

central fills

37
Q

what is the criteria for dispensing pursuant to an oral schedule II prescription

A

dispense the minimum necessary amount

prescriber must provide the original prescription within SEVEN DAYS of oral authorization (original can be written or electronic; can be mailed; authorization for emergency dispensing and date of oral prescription must be on the front of the rx)

pharmacist must attach the written prescription to the emergency oral prescription

if the original prescription is not received within 7 days, the pharmacist must report the breach to the local DEA office

38
Q

according to federal law, prescriptions for non-scheduled and schedule V drugs do not expire; when do schedule III-IV drugs expire?

A

6 months from the issue date

39
Q

what is the refill limit for schedule III and IV

A

5 refills (6 months expiration)

schedule V and non-scheduled drugs never expire, and have no refill limit; schedule II drugs never expire

40
Q

what is the emergency fill day supply

A

only 72 hours

41
Q

record keeping requirements for schedule III-V refills - pharmacist must write what on the back the rx

A

dispensing rph intials

date dispensed

quantity dispensed

42
Q

schedule III-V prescriptions are only allowed ___ transfer(s) that must be communicated directly between two licensed pharmacists

A

1

some states allow interns or CPHT
the only exception is if the pharmacies share a rel time online database of the prescription record keeping system

records kept for 2 years

43
Q

The transferring pharmacy must do what steps when transferring CS

A

void on front of original hard copy

write the receding pharmacy’s information on the back

pharmacy name
business address
DEA#
name of transferring rph
name of receiving pharmacist
date of transfer
44
Q

the receiving pharmacy must do what steps when receiving CS

A

reduce the prescription to writing and write transfer on the face of the rx

date the original prescription was issued
original number of refills
date it was first dispensed
number of refills remaining
transferring pharmacy name, address, DEA# and prescription#
name of transferring rph
pharmacy’s name, address, DEA#, and prescription number from which the prescription was originally filled if different

45
Q

can you transfer a CII?

A

only if its electronic

46
Q

federal law requires this caution statement on all schedules except for

“CAUTION: federal law prohibits the transfer of this drug to any person other than the person for whom it was prescribed”

A

V

47
Q

each controlled substance prescription disposed must include what items on the container

A 
date of initial fill
date of current fill (if it is a refill)
pharmacy name and address
prescription serial #
name of patient
name of prescriber
directions for use
cautionary statements
48
Q

the federal limit on the amount of drug that can be dispensed every TWO days:

240mL (8oz) or 48 units of any CS containing _____

120mL (4oz) or 24 units of any other CS…

A

opium

  • only the pharmacist can dispense a non-prescription CS to patient who must be at least 18
49
Q

what must the rph record after dis-sending a non-prescription CS

A

patient name and address
drug name and quantity
date of purchase
pharmacist name or initials

50
Q

what methadone tablet is only FDA approved for treating opiod addition

A

40mg soluble tablet

the lower doses are indicated for the treatment of pain and opioid dependence

51
Q

to operate as an opioid treatment program, clinics must register with the DEA using what form

A

363

additionally, practitioner must obtain approval and certification by the center for substance abuse treatment (CSAT)

52
Q

for the first 90 days (days 1-90), the patient can receive up to ___ take home dose per week

A

one

53
Q

second 90 days (91-180) the patient can receive up to ___ take home doses per week

A

2

54
Q

third 90 days (181-270) the patient can receive up to ___ take home doses per week

A

3

55
Q

treatment beyond 270 days and less than one year can receive a maximum of how many day supply of take home medication

A

6 dat supply

56
Q

after one year, can receive a max of ___ supply

A

2 week

57
Q

after two years, can receive a max of ___ supply of take home medication; but monthly visits

A

1 month

58
Q

DATA 2000 waiver; physicians can treat up to how many patients in the first year and then the potential eligibility to treat how many after the first year

A

30; 100

59
Q

CARA expanded DATA 2000 and allowed who to prescribe buprenorphine for a 5 year period

A

NP and PAs

60
Q

SUPPORT granted NPs and PAs permanent prescribing authority of buprenorphine for opioid addition.

A

true

also inlaced qualified clinical nurse specialists, CNAs and certified nurse midwives; eligible to treat up to 100 patients at a time in the first year; 275 patients after the first year

61
Q

What is the indication of Butrans

A

pain management

62
Q

what is the indication of probuphine, sublocade, Suboxone

A

opioid addition

Fl 2* (9 decks)

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