Utah MPJE Flashcards
What needs to be reported in writing to the division not later than ten business days before the date of (6 things)?
A permanent closure of the pharmacy facility,
A change of name or ownership of the pharmacy facility,
a change of location of the pharmacy facility, a sale or transfer of any controlled substance as a result of the permanent closing or change of ownership of the pharmacy facility,
a final administrative disciplinary order against the pharmacy license holder by the regulatory or licensing agency of the state in which the pharmacy is located if the pharmacy is a class D pharmacy,
or a final order against a pharmacist who is designated as the PIC of the pharmacy by the regulatory or licensing agency of the state.
How long shall a reporting pharmacy maintain a copy of any notification required by the permanent closure/10 business day notification?
2 years and make a copy available for inspection.
What is a class A vs B vs C vs D vs E pharmacy in Utah?
Class A - Pharmacy located in Utah that is authorized as a retail pharmacy to compound or dispense a drug or dispense a device to the public under a prescription order.
Class B - Pharmacy located in Utah that is authorized to provide pharmaceutical care for patient in an institutional setting (closed-door, hospital, clinic, nuclear, and branch pharmacies; and pharmaceutical administration and sterile product prep facilities.
Class C - Means a pharmacy that engages in the manufacture, production, wholesale, or distribution of drugs or devices in Utah
Class D - nonresident pharmacy
Class E - all other pharmacies
Closed-door - a pharmacy provides pharmaceutical care to a defined and exclusive group of patients because they are treated by or have an affiliation with a specific entity (including an HMO or infusion company) but not including a hospital pharmacy, retailer of goods to the general public, or the office of a practitioner.
What is defined as compounding in Utah (4 things)?
Prep, mixing, assembling, packaging, or labeling of a limited quantity drug, sterile product or device:
As the result of a practitioner’s prescription order or initiative based on the practitioner, patient, or pharmacist relationship in the course of a professional practice;
For the purpose of, or as an incident to , research, teaching , or chemical analysis and not for sale or dispensing; or
in anticipation of prescription drug orders based on routine, regularly observed prescribing patterns.
What is not compounding in Utah (3 things)?
The preparation of prescription drugs by a pharmacist or pharmacy intern for sale to another pharmacist or pharmaceutical facility;
The preparation by a pharmacist or pharmacy intern of any prescription drug in a dosage form which is regularly and commonly available from a manufacturer in quantities and strengths prescribed by a practitioner; or
the preparation of a prescription drug, sterile product, or device which has been withdrawn from the market for safety reasons.
How long shall a prescription record be kept on file for?
5 years from the date of last dispensing
Can you work as a pharmacy tech if your pharmacist license has been denied, revoke, etc.?
NO, while on probation with the division you can’t.
What is required for an animal prescription (2 things)?
Name of the owner and the species of the animal
How long shall all records required by federal and state laws or rules be maintained?
5 years
How long shall inventory records be maintained?
5 years
What 6 rules are there for inventory?
1) The PIC or DMPIC shall be responsible for taking all required inventories but can delegate to another person or persons.
2) The inventory records shall be maintained for a period of 5 years and be readily available for inspection
3) The inventory records shall be filed separately from all other records
4) The inventory records shall be in a written, typewritten, or printed form and include all stocks of controlled substances on hand on the date of inventory including any out of date drugs and drugs in an automated pharmacy systems. If using verbal recording it must be promptly transcribed.
5) The inventory may be taken either as the opening of the business or the close of business on the inventory date
6) The person taking the inventory and the PIC or DMPIC shall indicate the time the inventory was taken and shall sign and date the inventory with the date the inventory was taken. Signature of PIC or DMPIC and date of the inventory shall be documented within 72 hours or 3 working days of the completed initial, annual, change of ownership and closing inventory.
What 8 things does a pharmacist licensee have to do?
1) Submit an application
2) Pay a fee
3) Produce satisfactory evidence of good moral character as it relates to the applicant’s ability to practice pharmacy
4) complete a criminal background check and be free from criminal convictions
5) Have no physical or mental condition of a nature which prevents the applicant from engaging in the practice of pharmacy
6) have graduated from and received a professional degree from a school of COP that is accredited by the ACPE
7) Completed internship hours
8) Passed examinations (MPJE, NAPLEX)
How many hours of pharmacy practice are required for a reciprocity license?
2000 hours in a 4 years window immediately preceding the date of application
Can a pharmacist or pharmacist intern dispense an oral prescription for a C2 of a practitioner if it’s immediately reduced to writing?
NO, can do any other (including other controls) but not C2
How soon does a prescriber have to personally sign the order for a C2 drug if the patient is in a facility and was verbally requested by a licensed medical practitioner?
72 hours if C2, 30 days if another prescription drug.
Can a physician’s verbal order be copied and forwarded to a pharmacy for dispensing and serve as the pharmacy’s record of the prescription order?
YES
When and how often do pharmacy permits expire?
September 30th of odd-numbered year (so every 2 years)
When and how often does a pharmacists and technicians license expire?
September 30th of odd-numbered year (so every 2 years)
What is true about renewal of intern licenses (3 things)?
1) The duration of the intern license may be no longer than 5 years if the applicant is a current pharmacy student, resident, or fellow in a program approved by division in collaboration with the board.
2) The duration of a pharmacy intern license may be no longer than one year for a license issues if the applicant is a foreign grad from a foreign school and received a certification of equivalency from a credentialing agency approved by the board
3) A pharmacy intern license issued may not be renewed by may be extended by the vision in collaboration with the board
How long are non-controlled drug or device prescriptions valid?
365 days after the date of issuance
What 3 things to know about opioid antagonist dispensing?
1) A person licensed under the Utah chapter who dispenses an opiate antagonist to an individual with a prescription is not liable for any civil damages resulting from the outcomes that result from the eventual administration of the drug to a person who another believes is suffering from an opioid related overdose
2) The provision of the section do not establish a duty or standard of care in the prescribing, dispensing, or administration of an opiate antagonist.
3) It is not unprofessional conduct or unlawful conduct for a licensee under this chapter to dispense an opiate antagonist to a person on behalf of another person it he person obtaining the antagonist has a prescription for the drug from a licensed prescriber
If a prescriber specifically indicated the name of the prescription product should not appear on the label, should the pharmacist still put the name on the label?
NO. If requested by the prescriber, don’t put it on.
What are the rules for dispensing a limited supply of a prescription drug to an individual who is no longer a patient in the hospital setting?
Can do if:
1) the person is discharged from the hospital on the same day that the hospital pharmacy dispenses the prescription to the individual
2) the prescription drug relates to the reason the person was hospitalized
3) The class A pharmacy the patient usually goes to is not open at the time of discharge
4) The hospital pharmacy dispenses a quantity of the prescription drug that is the lesser of:
A 72 hour supply or an adequate amount to threat the discharged patient through the 1st day on which the patient’s class A pharmacy is open after the discharge and dispensing the prescription drug complies with protocols established by the hospital pharmacy.
What are the rules around dispensing 1 or more refills of a legend drug at the time the drug is dispensed (4 rules)?
Can do so if:
1) The drug is not a controlled substance’
2) The prescription does not include the dispense quantity written or some other notation having similar meaning
3) The total dosage units dispensed including the units for both the prescription and refills, do not exceed a 100-day supply; and
4) in the professional judgment of the pharmacist or pharmacy intern, the refill should not be dispensed at the time the prescription is dispensed.
When are emergency refills allowed for non-controlled maintenance meds?
30 days as of May 2020 (72 hours before).
Drug is currently using the drug, the drug is not controlled, and it’s in the patient’s health best interest
Prescriber is not available to promptly authorize refill and it’s in the professional judgment of the pharmacist or intern to dispense
The pharmacist or pharmacy intern or another pharmacist or pharmacy intern at the same pharmacy has not previously dispensed a refill for the prescription under this section
Dispense no more than the amount necessary to address the emergency
Notify practitioner of the emergency refill ASAP
What are the partial filling of C2 rules in Utah?
Allowed if:
1) Insufficient supply on had, make notation of the quantity supplied on the prescription record. Remaining portion must be filled within the 1st 72 hours of partial filling, if the remaining portion can not or will not be filled within the 72 hour the pharmacist shall so notify the prescriber. No more filled beyond 72 hours without a new prescription. No longer than 30 days after prescription is written.
2) LTCF or terminally ill patient may have them filled in partial quantities.
a) If there is any questions whether the patient may be classified as having a terminal illness, contact the prescriber.
b) the pharmacist shall record on the prescription either
terminally ill” or “LTCF”, dispensing date(s), quantity filled, remaining quantity, and identification of the dispensing pharmacist.
What are the schedule I drugs in Utah?
Difenoxin (Lyspafen), Dihydromorphine, Heroin (Diacetylmorphine, diamorphine), LSD, Marijuana, Mescaline, Peyote
How do you order schedule I drugs?
DEA form 222
Who can you release or discuss patient info with (6 exceptions)?
1) Pharmacy patient in person or the pharmacy patient’s legal guardian or designee
2) a lawfully authorized officer
3) 3rd party administrator
4) those providing pharmacy services
5) those who are getting a prescription transfer
6) pharmacy patient’s attorney after the presentation of a written authorization signed by (patient before a notary public, parent or lawful guardian, if the patient is a minor, lawful guardian if patient is incompetent, or personal rep if patient deceased).
What does unprofessional conduct NOT include (3 things)?
1) Giving or receiving a price discount based on purchase volume
2) passing along a pharmaceutical manufacturer’s rebate; or
3) providing compensation for services to a veterinarian.
What is an exhausted prescription for insulin?
1) Expired no earlier than 6 months before the patient requests the pharmacist for a refill; or
2) is not expired and has no refills remaining.
Can a pharmacist dispense a insulin supply if presented with an exhausted prescription?
YES
1) If 1 or more refills on prescription, can combine to dispense a supply for 90 days but can not exceed total supply authorized by the refills.
2) Dispense based on the prescribing practitioner’s instructions for the exhausted prescription in any amount up to a 60 day supply.
a) can not do more than 1 time per exhausted prescription
b) pharmacist shall attempt to contact the prescribing practitioner to inform it has expired and notify patient of the attempt
c) notify prescriber of amount of insulin dispensed and type of insulin dispensed
d) may dispense an interchangeable biological product except that the pharmacist may not dispense an interchangeable biological product if a prescribing practitioner prohibits the substitution
e) Pharmacist may dispense the therapeutic equivalent when filling a prescription for : a glucometer, diabetes test strips, lancets, or syringes.
What are the rules on a prescriber dispensing a medication (5 rules)?
1) the hospital pharmacy is closed
2) patient needs it in their professional judgement
3) dispensing meets protocols established by the hospital pharmacy
4) practitioner dispenses only a sufficient amount of the prescription drug as necessary to last until a pharmacy can fill the prescription
5) May not dispense more than a 2 day supply of a controlled substance
Who may appoint the members of the Utah State Pharmacy Board?
Executive director of the department of commerce, governor must approve
How many member are on the board?
5 pharmacists, 1 tech, 1 general public member (must be Utah resident, 21 or older, never licensed to practice pharmacy, never held financial interest, no activity directly related to pharmacy
Pharmacists and tech must have at least 5 years experience in the practice of pharmacy in good standing with the division in Utah after licensure and maintain licensure in good standing to engage in the practice of pharmacy or practice as a pharmacy tech in Utah for the duration of the appointment. Must also be residents in Utah for 3 years.
How long can Schedule V substances be dispensed after initiation?
1 year
How often can a pharmacist report to the CSD regarding controlled subtances dispensed by the pharmacist?
1) Real time
2) 24 hour daily or next business day, whichever is later, batch submission.
This does not apply to a patient at a healthcare facility and patients can access their records upon submission of a written request to the division
May a prescriber or one of his employees check the CSD before giving a 1st time C2 or C3 prescription to a patient?
YES, must also periodically review in the data base or other records the patient has filled. Can have someone else do it if not in violation of subsections, necessary due to emergency, cause by a suspension or disruption of the database, failure in operation or availability of internet.
What guidelines are followed for reviewing prescribers who have a pattern of prescribing opioids not in accordance?
1) CDC guideline for prescribing opioids for chronic pain
2) Utah clinical guidelines on prescribing opioids for the treatment of pain
3) other publications describing best practices related to prescribing opioids
How many members and who is on the CS advisory committee?
15, director of the department of health or directors designee, state medical examiner or the examiners designee, commissioner of public safety or designee, a bunch of other people. Shall serve 4 year terms.
Can a pharmacist or pharmacy intern dispense an epinephrine auto-injector and stock albuterol without any prescription drug order?
YES! Can to :
1) Qualified adult for use in Emergency Response for Life-threateninig conditions or qualified entity for epinephrine auto-injector entity.
2) pursuant to a standing prescription drug order
3) without any other prescription drug order
Do you have to report the dispensing and sale transaction of gabapentin to the CSD?
YES
What drugs can a pharmacist administer to a patient?
Any long acting injectables.
Aripiprazole, paliperidone, risperidone, olanzapine, naltrexone, naloxone, and drugs approved by the FDA for the treatment of HIV.
Must train, have BLS certification and LAI certification, maintain documentation of any prior administration and successfully complete a minimum of 2 hours CE related to LAIs.
When is codeine a C3 drug in Utah?
If final mixture has less than 1.8 gms per 100 cc
Can you dispense a legend drug written by a licensed prescribing practitioner in another state?
YES if the pharmacist or pharmacy intern verifies the prescription is valid
Can you stamp brand medically necessary on a prescription?
NO. Must be WRITTEN. If orally given pharmacist or intern can write down and must say “orally by” with the name of the practitioner.
Is phenergan with codeine a CV?
YES
For anti seizure meds what are the rules on substitution of meds?
Must consult the prescriber, prescriber may prohibit the substitution, notification to prescriber is not required if the drug equivalent is paid for in whole or in part by Medicaid
How soon must you notify a provider of a biosimilar substitution?
5 business days. Not required when there is no FDA-approved interchangeable biological product for the prescribed, a refill prescription is not changed from the product dispensed on the prior filling of the prescription or the product is paid for using cash or cash equivalent
When can you dispense a refill of a liquid legend drug administered to the eye?
After time sufficient to allow 70% of the dosage units to be dispensed
What are the intern rules for hours?
1) 1740 hours of practice
2) if suspended or dismissed from a college of pharmacy must notify the division within 15 days of the suspension or dismissal
3) If can’t meet all requirements for intern licensure must surrender license within 60 days unless an extension is requested and granted by the Division in collaboration with the board.
4) Foreign schools must have at least 1,440 hours of supervised practice in the US
5) Up to 500 hours may be granted for other experience substantially related to the practice of pharmacy
What are the drug sample rules?
1) Are not C2 drugs, opioids, or benzos (other controlled drugs are allowed.
2) Are prepackaged by the manufacturer
3) Are provided to the prescribing practitioner free of charge and provided to the patient free of any direct or indirect charge
4) Do not exceed a 30 day supply for (controls or non controls unless a prescriber documents that providing more than 30 days is necessary (legend drugs only))
5) Marked on the immediate container to indicate the drug is a sample or are recorded in the patient’s chart with the name and number of samples provided
Can a C2 (excluding opioids) being filled exceed a 30 day supply quantity?
NO
What are the CE requirements?
1) 30 hours for a pharmacist, 20 for a tech
2) Pharmacists shall include 12 hours of live or technology enabled participation in lectures, seminars, or workshops
3) 15 hours of disease state management/drug therapy, AIDS/HIV therapy, or patient safety
4) 1 hour of pharmacy law or ethics
5) 2 hours of immunization if providing immunizations
6) 2 hours of LAI if providing LAIs
7) 2 hours of hormonal contraceptives if dispensing
8) techs must have 8 hours of live or tech enabled, 1 hour of law, current PTCB or ExCPT shall fulfill all CE requirements for a tech
9) Must maintain competent records for a period of 4 years after the close of the 2 year period to which the records pertain
What can a tech not do?
1) perform a DUR, clarify an order from a prescriberm final review, dispense or counsel on a PRESCRIPTION drug (can on OTC or dietary)
2) final review of a prescribed drug prepared for dispensing except as permitted by rules made by the division in consultation of the board
3) receive new prescription drug orders when communicated telephonically or electronically unless the original info is recorded so the pharmacist may review the prescription drug order as transmitted
What are the rules for a PIC pharmacist to not be in the pharmacy?
1) Remote rural hospital
2) clinical located in a remote rural county with less than 20 people per square mile
3) Supervising pharmacist is not available and tele pharmacy system maintains records and files quarterly reports as required by the division rule to assure that patient safety is not compromised
