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Controlled substances part 3

Terms in this set (53)

Who can prescribe controlled substances?
physician, dentist, podiatrist, vet, mid level practitioner or any other practitioner under the hospitals registration
What do the first 2 letters of a DEA number represent?
first letter identifies the type of practitioner and the second is the first letter of their last name
How can you verify if a DEA number is valid?
add 1,3,5 then add 2,4,6 and double 2,4,6 then add to 1,2,3 and the last number of the sum should be the 7th digit
What does a DATA 2000 waiver represent?
allows a prescriber to write narcotics for opioid addiction treatment
What DEA letter indicates a DATA 2000 waived prescriber?
X
How can interns and residents prescribe controlled prescriptions?
under the hospitals DEA number with a unique internal code number
What registrant has a DEA number starting with A/B/F/G?
hospital, clinic, practitioner, teaching institution, pharmacy
What registrant has a DEA number starting with M?
mid level practitioner such as NP, PA, optometrist
What registrant has a DEA number starting with P/R?
manufacturer, distributor, researcher, narcotic treatment program
What is the last digit of the DEA number referred to as?
check digit
What is a prescription drug monitoring program?
PDMP is a service that prevents drug abuse and diversion that collects prescription information
Who regulates a PDMP?
state
Can a prescriber pre sign prescription blanks for non controlled or controlled drugs?
no it is illegal
What controlled drugs can a pharmacist receive over the phone?
C3-5
What controlled substances are able to be faxed and what are the additional requirements?
C3-5 and require the prescribers signature
Can C2 prescriptions be faxed to a retail pharmacy?
yes but require the written hardcopy before dispensing
When can a fax serve as the hard copy for a C2?
drug compounded for administration by non oral route, prescription for LTCF, patient enrolled in hospice
What are the requirements for prescribers to use DEA approved software to prescribe?
they need 2 of the following, something they know such as password, something they have such as a token key, something they are such as iris or fingerprint scan or alternatively they can use a digital certificate
What controlled substances can be submitted electronically?
C2-5
How long do electronic prescriptions need to be stored?
2 years
When can prescribers use a single digital signature?
to sign multiple prescriptions for the same patient
What should a provider do if they are unable to transmit a C2 electronically?
they must provide a handwritten prescription
What 3 items cannot be changed for controlled substances?
patient name, drug, prescriber signature
What is the federal expiration date for C2 prescriptions?
none
What controlled prescriptions do not expire per federal law?
C2 and C5
What are the federal laws for writing multiple C2 prescriptions at one time?
they cannot exceed a 90 day supply and cannot be post dated but instead write the date of issue and earliest acceptable fill date
What are the three cases in which a C2 may be partially filled?
the pharmacy cannot supply the full quantity, the patient or prescriber requests, or for patients in a LTCF or patients with a terminal illness
If a C2 is partially filled because the pharmacy cannot supply the quantity what are the requirements for the remaining quantity?
the quantity supplied must be documented on the hard copy and the remaining portion must be filled within 72 hours and if it cannot then the pharmacy must notify the prescriber
If a C2 is partially filled, the remaining quantity must be filled within ____
30 days
If a C2 is partially filled for a LTCF facility or a patient with a terminal illness, the remaining quantity must be filled within ____
60 days
What should be recorded for each partial fill of C2's for LTCF or terminally ill patients?
on the back of the rx the date of partial fill, amount dispensed, amount remaining, name of dispensing pharmacist
What are the emergency filling laws for C2 drugs?
a prescriber can call an oral prescription in if immediate administration is needed to avoid patient harm
What pharmacies are not allowed to receive emergency fills for C2's?
central fill pharmacies
What is the criteria for dispensing pursuant to an oral C2 prescription?
dispense the minimum necessary amount, prescriber must provide the original prescription within 7 days electronic or written and must state "authorization for emergency dispensing" and contain the date of the oral prescription
What should the pharmacy do if they do not receive the original prescription within 7 days after receiving an oral emergency C2 prescription?
report to the local DEA office
What is the federal law for expiration of C3-4 prescriptions?
6 months
What must be documented for each refill of C3-4 refills?
dispensing pharmacists initials, date dispensed, quantity dispensed
What schedule drugs require a backup procedure to document dispensing of refills during system downtime?
C3-4
What are the federal laws for transferring schedule 3-5 prescriptions?
can be transferred once directly between 2 licensed pharmacists unless the pharmacies share a real time online database
What are the transferring pharmacy requirements for transferring controlled prescriptions?
write void on the front of the original copy, write the pharmacy name, address, DEA number, name of pharmacists involved, date of transfer on back of prescription
What are the receiving pharmacy requirements for transferring controlled prescriptions?
write transfer on the front of the prescription, write the original date written, original number of refills, date first dispensed, number of refills remaining transferring pharmacy info, pharmacist info
What are the laws surrounding transferring C2 prescriptions?
if a pharmacy cannot fill an electronic prescription they should contact the prescriber or transfer the unfilled original electronic prescription to another pharmacy
What schedule controls require the DEA warning statement?
C2-4
What are the label requirements for central fill pharmacies filling controlled medications?
retail pharmacies name and address and a unique identifier such as DEA number
What are the federal limits on non-prescription products containing opium?
8 oz or 48 dosage units
What are the federal limits on non-prescription controlled products that aren't opium?
4 oz or 24 dosage units
What are the requirements to dispense a non-prescription controlled product?
must be sold by a pharmacist to a person at least 18 years old and they must record patient name and address, drug name and quantity, date of sale, pharmacist name
What is the dose of methadone used for treatment of opioid addiction?
methadone 40mg
What are the laws surrounding methadone and opioid treatment programs?
they can only dispense and not prescribe
What are the methadone take home supply dispensing restrictions?
first 90 days one take home dose and increase by 1 every 90 days up to day 270 then 270 to 1 year a max of 6 days then after 1 year receive 2 weeks and after 2 years a max of 1 month supply but must have monthly visits
How many patients did the DATA 2000 act allow prescribers to treat for opioid dependence?
30 in the first year and up to 100 after the first year
How many patients did the SUPPORT act allow prescribers to treat for opioid dependence?
up to 100 in the first year and increase to 275 after treating 100 patients for 1 year
What prescriptions can DATA waved practitioners use for treatment of opioid dependence?
buprenorphine, Suboxone
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