Exam 2 Lecture 12 Flashcards
(17 cards)
what is a prescription?
an order for medication which is dispensed to or for an ultimate user but does not include an order for medication which is
dispensed for immediate administration to the ultimate user
a written order for diazepam administered by a nurse to a patient –> not a prescription
controlled substance prescribing
Can only be done by practitioners authorized to prescribe
Controlled substance prescribers must have a DEA number or be exempt from registration
Agents cannot communicate C2 emergency prescriptions, as DEA notes a prescriber cannot give agency to anyone for this type of prescription
Responsibilities of Issuing a Prescription
Legitimate medical purpose: patient has a medical need for this medication
Usual course of practice: prescriber has a valid patient-provider relationship (used to require in-person pt eval, but changed since COVID)
responsibility is on the prescriber, but also rests on the pharmacist to fill it
corresponding responsibility
Pharmacists are accountable in making sure controlled substances are prescribed and dispensed appropriately
They must knowingly filled a fradulent Rx to violate the law
Refusal to fill a controlled substance
When documenting issues, do not deface prescriptions bc they are patient property
If you do not fill a prescription from the patient, it should be returned unless the prescriber requests for it to be destroyed
USE PROFESSIONAL JUDGEMENT
Written prescription CS - signature
wet signature required (signed by hand by prescriber)
Fax prescription for CS - signature
wet signature required
Electronic prescription for CS - signature
electronic signature required (utilizes a two-factor authentication to verify identity in an electronic system)
Telephone prescription for CS - signature
transcribed by pharmacist or intern when received at pharmacy
can be called in by prescriber or an agent
C2 prescriptions may be dispense to pursuant of each of the following prescription types:
- A written, paper prescription signed by the prescriber
- An electronic prescription transmitted by the prescriber
- A fax prescription, if the patient presents the manually signed prescription to the pharmacist prior to dispensing
Acceptable C2 faxed prescriptions
Narcotic C2 Injection can be sent any location
All C2 Any route can be sent to LTCF
Narcotic C2 Any route can be sent to hospice
C3, C4, C5 prescriptions may be dispensed to pursuant of each of the following prescription types:
- A written, paper prescription signed by the prescriber
- An electronic prescription transmitted by the prescriber
- A fax prescription, if the patient presents the manually signed prescription to the pharmacist prior to dispensing
- A telephone prescription promptly reduce to writing by the pharmacist
controlled substance prescription quirks
any C2 - C5 may be dispensed or administered w/o a prescription by an individual prescriber
Institutions may administer or dispense (not prescribe) C2-C5 based on a prescription/order from a practitioner if it is dispensed for immediate administration to the user.
required info for controlled substance prescriptions
- Date the prescription was issued
- Full name and address of patient
- Drug name, strength, and dosage form
- Quantity prescribed
- Directions for use
- Name, address, and DEA# of prescriber
- Signature of prescriber
Correcting C2 prescriptions
You CANNOT update:
- Name of patient
- Name of drug
- Name of the prescriber, including signature
A new Rx must be issued for any mistake that cannot be updated
Correcting C3-C5
Bc C3-C5s you can accept verbal orders, we can convert erroneous written prescriptions into telephone prescriptions
- Need authorization from provider
- State-specific electronic prescribing requirements may impact the ability to perform this change
Who can fill controlled substance prescriptions
A prescription for controlled substances may only be filled by a pharmacist
For this, “pharmacist” includes any person authorized to dispense controlled substances under the supervision of a pharmacist
Prescribers cannot fill prescriptions. They can dispense controls, but not pursuant to prescriptions
