sonata and ambien
sublimaze ( Fentanyl) ?
Panic Disorder; great for the Exception
ADD; great for the Exception
Chronic debilitiating neurological conditions characterized as movement disorders/seizures
Relief of chronic and incurable pain
Hormon deficiency in males; use anabolic steroids
ALL drugs can have up to 90 days RX under what condition?
If they have a CODE so all drugs can have up to 90 day supply with a CODE!!!
These drugs are NEVER refillable?
CII anabolic steroids, CII and CIV( BENZO)
These drugs are refilliable 5x within 6 months of date written?
CII, CIV( NOT BENZO) and CV
This drugs can have up to 180 day exception?
CII Anabolic Steroids!
CII and CII anabolic steroid explain how the oral rx ( emergency)goes down?
emergency for 5 day supply, follow up must in 72 hours, if not inform BNE; file in CII
CIV explain how the oral RX (Emergency)and filing goes? e.g. Ambien or Sonata
Up to 30 day supply or 100 units; whatever is less; follow up must received within 72 days, but if not received still w/in 7 days write on RX " Written Follow Up NOT Received"; File in CIII-CIV-CV file; same as ONYS but no sex needed
CIII oral rx ( emergency)explain and filing?
UP to to 5 day supply, must receive 72h, still not after 7 days write on back. FIle in CIII-CV file; same as ONYS but no sex needed
CIV Benzodiazpines? oral RX ( Emergency)?
Maximum 5 days for ER; Must receive follow up in 72 hours if not after 7 days inform BNE. File in CIII-CV.
CV oral RX emergency?
Up to 5 day supply, just like CII; File in CIII-CV; same as ONYS but no sex needed.
Written Follow up RX for CII, anabolic steroids and CIV BENZO?
Must be received in 72 hours, must have " Authorization for Emergency Dispensing" on face; must be attached to phone RX, if not received after 7 days, pharmacist must notify BNE!
ONYX RX form has to have? on original and both copies of the RX form?
A)name, address, age, sex of user and X FOR PT SEX. B)name, address, dea #, tele, and handwritten signature of prescriber C) name, strength of drug, quantity, sig, including but not limited to dosage form, frequency of dosage, and MDD. D) date RX was signed by dispensing practitioner E) DEA of instituion and prescriber F) profession and reg. # of prescriber
ONYX RX form is used for?
BENZO, CII, and anabolic steroids
Does an RX have to be countersigned?
NO ONLY ORDER has to be COUNTERSIGNED
DEA copy 1, 2, and 3?
1-supplier, 2-DEA, 3-purchaser!
in house pharmacy, dea#, bulk stock in CS, sub stock-dispersed
In House or RX filled by outside pharmacy, may have bulk CS
Limited to prescriptions ( NO BULK CS) e.g. mental health clinics, NO BULK CS
Inpatient orders-NO ONYSRx used RPA orders must be countersigned?
24 hours by MD
Inpatient orders-NO ONYSRx Oral orders for CS OK but signed?
within 48 hours
Inpatient orders-NO ONYSRx routing orders?
Inpatient orders-NO ONYSRx PRN CS orders valid for?
72 hours, renewed every 72hours
Inpatient orders-NO ONYSRx specified time orders for CS are good for?
7 days-7day period extended for convulsive disorder to 30 days
Inpatient orders-NO ONYSRx Transfer orders?
SINGLE dose in transfer, not exceeding 3 hours travel time
Inpatient orders-NO ONYSRx ER orders good for?
NMT 24 hour supply
Acquisition invoices ( CIII,CIV, CV) and DEA 222 (CII).
CII-CIV dispersed, less than 72 hours supply store with patients other medications, and more than 72 hour supply stored in double lock cabinets.
NO CII!!! CIII-CV- with double locks, locked drawer system, anchored, limited access.
CII in valut, and CIII-CV in secured lock cabinet!
The only pharmacist that can immunize is?
the one that has the certification, and they can only immunize for a nonspecific pt for pneumoccocal diseases!
products containing less than 15 mg of hydrocodone per dosage unit?
Vicodin, schedule III narcotic
products containing not more than 90 mg of codeine per unit ?
Tylenol III w. codeine; schedule III
suboxone and subutex?
Federally how is partial dispensing done?
for Schedule II you can partially dispense if the pharmacist cannot supply the full amount of a written or Emergency oral RX. The rph has to note the quantity supplied on the FRONT of the Rx on a written or electronic record. Remaining may be dispensed w. in 72 hours of the first partial, however if you cannot within 72 hours must tell the prescribing practictioner. NO further quantity may be supplied beyond 72 hours without a new RX!!
Federally partial filling of Schedule II how is this done?
pharmacist must record on the RX whether the pt is terminally ill or a LTCF patient. if it doesn't have it its a violation of the CSA. For each partial filling, write on back and do not give more than prescribed amount. for LTCF or terminally ill the RX valid for 60 days from date of issue.
Emergency dispensing explain what must be done?
5 days of medication, the RPH has to write it down, the rph has to make sure that this is coming from the doctor by caller id or some secret confirmation, within 7 days you must have a hard copy and staple it to the original and on its face it must say " Authorization for Emergency Dispensing" and the date of the ORAL order!!
The pharmacist receives a paper or oral prescription that indicates that it was electronically transmitted what do you do?
make sure that you don't have both just mark VOID on one!
BIG M stands for mid level practitioners! and then followed by the first letter of the registrants last name J for Jones! and then 1+3+5 and 2+4+6=(2X) and then add, the last number should be the same as the 1 and it is !!
A prescription is an order for a medication which is dispensed to or for an ?
A prescription for CS must include?
date and signed on the date issued, the pt full name address, and the practitioners full name address and DEA number. Also the drug name, strength, dosage form, quantity, sig, and refills if any
Can someone else other than the practitioner write out the RX?
yes an individual may be designated by the practitioner to prepare RX for the practitioners signature.
Intern, resident, staff physicial, Mid level practitioner in the hospital can use the hospitals DEA registration #?
yes they can! the dispensing, admin, prescribing has to be in the usual course of professional practice. they have to be authorized in the state that they practice. hospital has verified and its within the scope, and the hospital has to give them an internal code number for each practitioner! (-012) example!
For a schedule II CS an oral order is only permitted?
in an emergency situation, and refills are NOT allowed
Federally their is no time limit within which ?
a schedule II RX must be filled
Their are no express federal limits with respect to the ?
quantities of drugs dispensed via a prescription.
Federally the DEA has granted 3 exceptions in which the fax is considered the RX and you dont need a follow up
1. infusion sites 2. LTC 3. hospice program that has a contract!
Federally what can you do and you cannot in NYS?
1) electronic recording of RX info 2) faxes are considered equivalent to the original, in nyc you need a follow up. 3) transfer drugs ( 3-5), in nys you can NEVER transfer RX and no transfer of refills!
CS cannot be more than?
30 days old be4 you fill it; federal law has no limit could be 1000 years old and quantity doesnt matter
Not a controlled substance
Federally ordering and filing for benzo's and anabolic steroids?
you would use a duplicate INVOICE to order federally for benzos and anabolic steroids and you would file benzos in CIV
Filing anabolic steroids and CII NYS law?
ONYSRx and file in C-II files
Filing CIII,CIV(exclude benzo) and CV?
Regular controlled RX, file in CIII,CIV,CV file
Filing CIV BENZO?
ONYSRx and file in CIII,CIV,CV file
Emergency is considered what three things?
Immediate admin of drug is necessary, no alternative TX available, and theirs no way to write RX now!
When adjusting a RX what cannot be adjusted by RPH?
practitioners signature, date, CS name, name of pt! may not be changed by the Rph
The label for the controlled substance for an animal must include all the of following except?
the name of the animal!
Fiornal vs Fiorcet?
Fiorcet is not a schedule III ( CIII) drug!!!
premeditated and impromptu
dea needs a 2 weeks notice that your going to destroy something! impromptu-you need 2 licence folks!!
In an institutional setting class 3 specified time orders are good for how many days? extended?
7 days, and extended for 30 days for pt that have convulsive disorder!
In an institutional setting PRN orders for a patient are not valid after?
In NY state the time period for a prescriber of an emergency oral RX for schedule II shall provide the written RX within how many hours?
72 hours; by 7th day contact department BNE.
In NY state the duplicate of the triplicate has to be filed by the ?
In NY state a " WRITTEN" rx for a schedule II drugs should not exceed more than ?
In NY law an oral RX for a schedule IV drug( not including benzo) is limited to?
100 units or a 30 days supply whichever is less!
IN NY which drug cannot be placed in a hopistal medication cart?
DEA 222 form? Amphetamine?
IS FEDERALLY TO order schedule I and II drugs!!! ; if you see amphetamine or anything close to it probably Schedule II!
Each DEA 222 form must be signed and dated by a person authorized to sign a registration application or a person granted ?
power of attorney
Voiding DEA 222 forms, the purchaser wants to cancel an order by notifying the supplier in WRITING, the supplier must then do what?
indicate the cancellation on copies 1 and 2 of the DEA form 222 by drawing a line through the cancelled items and printing cancelled on the space next to the shipped items.
the supplier may void part or all of an order on a DEA 222 form by telling the purchaser, the supplier must indicate the voiding in?
copies 1 and 2 of the DEA form 22 by drawing a line through the cancelled items and printing void in the space provided for the # of items shipped. note only the supplier can CROSS OUT!
ordering BENZO and anabolic steroids you need ?
a duplicate invoice, you dont use a DEA 222 form you only use that for schedule I and II drugs!
If a practitioner would like to obtain a stock of
controlled substances for office administration he/she can write a prescription labeled "For Office Use" and have the prescription filled at a pharmacy.
False: Controlled substance prescriptions must be patient-specific. Prescriptions for office use are prohibited. Practitioners must order controlled substances intended for office administration directly from a licensed distributor or manufacturer.
Controlled substances may only be prescribed in a maximum thirty-day supply.
False: A practitioner may issue a prescription for up to a threemonth supply of a controlled substance if they have a CODE!!
If a practitioner makes a mistake on an official prescription form, he/she can cross out and initial the error.
True: The practitioner is not required to issue a new official prescription form if he/she makes an error when writing the prescription. The practitioner should be aware that, in most situations, the pharmacist will call the practitioner to verify the alteration. Should the situation arise, a practitioner can authorize the pharmacist to change all prescription information EXCEPT for practitioner signature, date written, patient name, drug name and strength. A practitioner may authorize a pharmacist to change the prescribed quantity, but may not authorize a pharmacist to add a quantity if it is missing from the prescription.
Physician assistants are authorized to prescribe Schedule II controlled substances in an outpatient setting.
TRUE!! PA can now prescribe CII substances they have to get their lisence amended by the DEA to include this!
Phoning in a controlled substance?
Nurses or other office personnel are not authorized to phone in a controlled substance prescription to a pharmacist. only the prescribing practitioner can phone in stuff thats why you need a secret code of some type to verify this!
Practitioners must date controlled substance prescriptions on the day that they sign the prescription?
True theirs NO posted dating or predating in New york law!
Treating someone with methadone you can, but for maintenance?
YOU cannot unless the practitioner is required to be registered with the DEA as a Narcotic Treatment Program ( NTP), and if you had to it cannot be for more than 3 days which goes means you TX them not maintenanced.
Theft in my pharmacy what form should i file?
Breakage and damage of CS goods and its RECOVERABLE and must be disposed what form?
partial refills are good for which drugs?
schedule III, IV and V drugs can be partially refilled
Refills for Schedule III, IV, and V right if you wanted to get 31 pills can you get 5X in 6 months?
NO you have ended that and you can only get on extra refill after that ok!!
pharmacist can alter a RX except for SDDN?
signature of practitoner, date of RX, drug name, or name of ultimate user!