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MPJE > VA Requirements for a Prescription Drug Order > Flashcards

VA Requirements for a Prescription Drug Order Flashcards

1
Q

What is required to be on a written prescription?

A
  1. Prescriber’s name, address, and telephone number
  2. Prescriber’s DEA number if the med is not Schedule VI
  3. The patients first and last name
  4. the date of the prescription
  5. the prescribers signature, which must be added on the day it is issued
  6. if must be individually typed or printed in ink
  7. if must have the patient’s address which can be added by the pharmacy or maintained in the electronic dispensing record
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2
Q

How many medications can be on a prescription?

A

Only one; unless it is a chart order for hospital or long term care, home infusion, hospice, etc

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3
Q

When can chart orders or prescriptions for Schedule II-V meds be transmitted from a remote location to the pharmacy?

A
  1. For patients of long-term care facilities
  2. For patients receiving parenteral, IV, IM, SQ, or intraspinal infusion therapy being served by a home infusion pharmacy.
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4
Q

Who appoints the members of the Board of Pharmacy? How long is the terms of members of the Board of Pharmacy?

A

the governor of VA; four years

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5
Q

What is a covered substance for purposes of the Prescription Monitoring Program (PMP)?

A
  1. All schedule II-V drugs for which a prescription is required
  2. Naloxone
  3. Other drugs of concern as noted by the Board
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6
Q

Is Cannabidiol oil or THC considered a controlled substance?

A

Yes

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7
Q

What information has to be reported to the Prescription Monitoring Program (PMP) upon dispensing?

A
  1. the recipient’s name and address
  2. the recipients date of birth
  3. the drug dispensed
  4. the quantity of drug dispensed
  5. date of dispensing
  6. prescribers ID number
  7. dispensers ID number
  8. method of payment for the prescription
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8
Q

When does the information have to be provided to the PMP?

A

within 24 hours or the dispensers next business day, whichever is later

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9
Q

Are there exemptions to the reporting requirements for the PMP?

A

Yes, most cases of administration of drugs as well as dispensing to patients in hospitals or hospice settings.

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10
Q

Are pharmacies and dispensers required to be registered with the PMP?

A

Yes

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11
Q

Who does a pharmacist register with for the Prescription Monitoring Program?

A

The Department of Health Professions

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12
Q

Can a pharmacist authorize or delegate authority to another individual to access the PMP database?

A

Yes if the other person is licensed, registered, or certified by a Health Regulatory Board or has routine access to confidential patient data and has signed a patient data confidentiality agreement.

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13
Q

When can a licensed physician assistant prescribe controlled substances?

A

When the PA has entered into a practice agreement with a licensed physician or podiatrist.

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14
Q

Can physicians or podiatrists limit the prescribing of the physician assistant?

A

Yes, the agreement must include the controlled substances the physician assistant is allowed to prescribe.

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15
Q

Are licensed nurse practitioners allowed to write prescriptions in VA?

A

Yes when the NP has completed the equivalent of at least 5 yrs of full time clinical experience as a licensed NP and has received certain written attestations from the patient care team physician.

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16
Q

Are physicians allowed to prescribe higher doses of a pain relieving medication then is recommended?

A

Yes, for intractable pain. The physician must certify the medical necessity of the excess dosage in the patients medical record and it must be prescribed in good faith for accepted medicinal or therapeutic purposes.

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17
Q

Is a supervising pharmacist required to be physically present?

A

Yes, the pharmacist must be in the facility where the pharmacy is located and where the duties are being performed. The pharmacist must also be available for immediate oral communication.

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18
Q

Who can a pharmacist and his designated alternate pharmacist enter into a collaborative agreement with?

A
  1. any physician, osteopath, or podiatrist
  2. a physician’s office
  3. a physician assistant
  4. a licensed NP
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19
Q

What cooperative procedures can be authorized under a collaborative agreement?

A
  1. drug therapy
  2. lab tests
  3. medical devices
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20
Q

Are patients required to participate in a collaborative procedure without their consent?

A

No. A prescriber may also elect to not have a patient participate. He does this by contacting the pharmacist or documenting it on the patient’s prescription.

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21
Q

Can collaborative agreements include the implementation, modification, continuation or discontinuation of drug therapy pursuant to protocols?

A

Yes

22
Q

Who can write a valid prescription in VA?

A
  1. Doctors
  2. Osteopathic Physicians
  3. Podiatrists
  4. Dentists
  5. Veterinarians
  6. Licensed NP
  7. Licensed PA
  8. TPA certified optometrists
23
Q

What if one person or company owns multiple pharmacies? Can a prescription be filled at one location and delivered to the other for pick up?

A

Yes. The pharmacies must have a written agreement that specifies the services to be provided by each pharmacy and how they will comply with the law.

24
Q

Are central fill pharmacies allowed in VA? Does a VA pharmacist have to perform a check for accuracy on activities done by the remote processor? If the remote processor is using electronic files, does the VA pharmacist need to have access to these files also?

A

Yes, Yes and Yes they need to both have access to it.

25
Q

What prescriptions can be faxed in VA?

A

Schedule III through VI meds

26
Q

What information must be on a faxed prescription?

A

All the information that is required on a written prescription including the prescriber’s signature. It also much include:

    • the date the prescription was faxed
    • printed name, address, phone number, and fax number of the prescriber
    • the institution it was faxed from (including address, phone number and fax number if applicable)
27
Q

Can you fax a schedule II prescription?

A

Only if for a long-term care facility, home infusion, and hospice patient.

28
Q

What if the prescriber doesn’t want the patient to have to wait for the schedule II prescription can they fax it?

A

For information purposes only so that it can be prepared. It cannot be dispensed until the patient delivers the actual written prescription.

29
Q

How will the pharmacy know if a fax is for a hospice patient?

A

The prescriber must note it on the prescription

30
Q

Can refill authorizations be faxed?

A

Yes they must contain:

  1. the patient’s name and address
  2. drug name and strength
  3. quantity and directions for use
  4. prescribers name, date of authorization, and the prescribers signature or agents name
31
Q

Are electronic prescriptions allowed in VA?

A

Yes, including Schedule II

32
Q

How long is a Schedule II prescription valid?

A

6 months

33
Q

Can a Schedule II be refilled in VA?

A

No

34
Q

When can a pharmacist do a partial fill of a Schedule II?

A
  1. When the pharmacist doesn’t have the full quantity to fill the prescription
  2. When the prescription is for a long-term care facility patient
  3. When the patient has a documented terminal illness
  4. When requested by the prescriber or patient
35
Q

A pharmacist only had enough of a Schedule II drug to do a partial fill. How long does he have to fill the rest?

A

This must be done within 72 hours of the first partial dispensing. If the pharmacist cannot supply the remainder within 72 hours they must notify the prescriber that they cannot supply anymore without first receiving a new prescription.

36
Q

How long after the initial partial dispensing can a pharmacist continue to partially dispense a Schedule II prescription for long-term care facility and terminally ill patients?

A

60 days

37
Q

What information must be recorded for each partial filling of a Schedule II?

A
  1. the date of the partial dispensing
  2. quantity dispensed
  3. remaining quantity authorized to be dispensed
  4. identification of the dispensing pharmacist
38
Q

If the patient or prescriber requests a Schedule II prescription to be partially filled, how long can the pharmacist do partial fills?

A

No more than 30 days after the prescription was written. Partial fills can’t exceed the total quantity prescribed.

39
Q

When can a pharmacist take an oral prescription for a Schedule II medication?

A

Only in the case of an emergency; the pharmacist can only dispense enough med to last during the period of the emergency and they must receive a hard copy within 7 days

40
Q

Does the hard copy of an emergency Schedule II prescription have to have any additional information on it?

A

Yes, in addition to meeting all the requirements for a regular Schedule II prescription, the prescription must have “authorization for emergency dispensing” written on it. And the date of the oral order.

41
Q

What if the prescriber does not get the pharmacist the required hard copy for an emergency prescription in time (CII)?

A

The pharmacist is required to notify the nearest office of the DEA and the BOP

42
Q

How long are prescriptions for Schedule III-V drugs valid?

A

six months

43
Q

What is the max number of refills for a CIII-V prescription?

A

max of five times as authorized by prescriber

44
Q

What information has to be recorded when a prescription is filled or refilled?

A

The pharmacist initials and the date must be recorded either on the back of the prescription or in an electronic record on the date of dispensing

45
Q

Are partial fills of Schedule III-V prescriptions allowed?

A

Yes, as long as each partial dispensing is recorded the same as a refill; the total quantity dispensed does not exceed that prescribed; and no dispensing occurs after 6 months from the date the prescription was issued.

46
Q

How long is a Schedule VI prescription valid?

A

one year; unless the prescriber specifically indicates on the prescription that it can be refilled for up to two years

47
Q

Is the pharmacist allowed to dispense the entire amount prescribed including refills to a patient if requested?

A

Yes, unless the drug is classified as a psychotherapeutic agent, axiomatic, sedative, hypnotic, or drug of concern.

48
Q

What standards apply to the compounding of sterile and non-sterile products by the pharmacy that does not share the same physical space with an outsourcing facility? What if the pharmacy shares its physical space with an outsourcing facility?

A

The USP-NF standards; its compounding must be done in accordance with current good manufacturing practices (CGMP)

49
Q

What information must go on a prescription label?

A
  1. the drug name and strength
  2. the generic name of any single ingredient
  3. the number of dosage units or if liquid the number of ML dispensed
50
Q

What if a generic drug is dispensed when the prescription was written for brand? what must be on the label?

A

The label must contain the generic drug name followed by “generic for” and the brand name of the drug along with either the generic’s brand name or the manufacturer or distributor of the drug.

51
Q

What are the requirements for compliance packaging?

A

the labels for each individual container must list all the drugs it contains and the main packaging label must contain all the required elements for an outpatient prescription label along with a physical description to identify each solid dosage form

52
Q

What documentation is required if non-child resistant packaging is requested?

A

A notation must be made on the dispensing or other retrievable record.

MPJE (11 decks)

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