KASPER

Question 1

Legend Drugs aka

Answer 1

Prescription Drugs

Question 2

Scheduled Drugs aka

Answer 2

Controlled Drugs

Question 3

What drug category do LAs fall into?

Answer 3

Rx (legend) drugs

Question 4

What do you need in the state of KY to Rx prescription (legend) drugs?

Answer 4

Dental license

Question 5

What do you need in the state of KY to Rx controlled (scheduled) drugs?

Answer 5

DEA #

• Need a valid state dental license to get this #, through the federal government

Question 6

Are telephone Rxs allowed for C-II drugs?

Answer 6

No

• Except in a true emergency and with a written follow up Rx within 72 hours
• Facsimile (fax) transmission of Rx is prohibited

Question 7

Are refills allowed for C-II drugs?

Answer 7

No

A new Rx is required

Question 8

What class of drug is codeine?

Answer 8

• C-II when alone
• C-III if combined with an analgesic (e.g., ASA, APAP (acetaminophen), or Ibuprofen)

Question 9

For C-III and C-IV drugs how many refills are allowed?

Answer 9

Up to 5 times within 6 months, if authorized

Question 10

What does KASPER stand for?

Answer 10

The Kentucky All Schedule Prescription Electronic Reporting System

Question 11

What does Rxing a drug “off-label” mean?

Answer 11

• Off-label = what the drug is not FDA approved to treat
• Label = what the drug is FDA approved to treat

Question 12

What infomation must be included in a written Rx for a controlled substance under Federal Law? (10)

Answer 12

• The name and address of the prescriber
• The name and address of the patient
• Date on which the substance is written and signed
• Name of the drug
• Dosage unit and form of drug
• Quantity must be both placed in parentheses and written out in English
  
  • Disp: 25 (twenty-five) tablets
• Directions for use
• Manual Signature
• DEA registration #
  
  • Do not place on Rx for non-controlled substances
• Refills - do not leave this blank

Question 13

What does KY not require you to put on a Rx?

Answer 13

Dental license #

Question 14

What does KASPER track?

Answer 14

Not you writing the Rx, but when the pt fills the Rx it is tracked

Question 15

What must you do prior to the initial prescription of any controlled substance (schedule II, III, or “Listed” IV or V drugs)? (5)

Answer 15

• Obtain a KASPER report (what was dispensed) for the previous 12 months of data for the pt.
• Obtain a complete med hx and conduct a physical examination of the oral and maxillofacial area, and document the info in the pts dental record.
• Make a written tx plan
• Discuss risks and benefits of the use of controlled substances with the pt including the risk of tolerance and drug dependence
• Obtain written consent for the treatment

Question 16

What are the generic names of the C-III drugs?

Answer 16

• Buprenorphine
• Codeine + CA
• Dihydrocodeine + CA

CA = combination analgesic (ASA, APAP, ibuprofen)

Question 17

When do you NOT need to obtain a KASPER report?

Answer 17

• If you the dentist is Rxing a C-III or a “listed” C-IV or V drug after the performance of oral surgery provided no more than a 72 hr supply of such substance is Rx; or
• You are Rxing a pre-appointment medication fo the tx of procedure anxiety provided the Rx is limited to a 2 day supply and has no refills
• For a pt for drugs they will administer for performing IV sedation while the pt is in the office

Question 18

When do you not have to run a KASPER report when prescribing refills of a controlled substance?

Answer 18

• 1 refill within 30 days of the initial Rx for the same substance for the same amount or less, or
• Prescribe a lower schedule drug for the same amount without a clinical reevaulation of the pt by the dentist.

Question 19

What are the laws for a pt who requires additional refills or prescriptions for a controlled substance?

Answer 19

• Pt shall be clinically reevaluated by the dentist
• KASPER report

Question 20

What does ACME stand for?

Answer 20

Active Cumulative Morphine Equivalent

• ACME >= 100 MME may warrant increased clinical vigilance

Question 21

What other information is available in KASPER?

Answer 21

• Positive drug toxicity screen results related to a pts suspected OD treated in an ED
• Data on a pts drug convictions

Question 22

I have a current KY Dental License and a DEA #, however, I am in the military, and/or I do not practice currently in KY. Do I still need to register with KASPER?

Answer 22

Yes

Question 23

Can I have an employee in my office obtain KASPER reports for my pts?

Answer 23

Yes, establish a separate delegate account

Question 24

How long are KASPER reports considered valid for making decisions regarding prescribing a controlled substance?

Answer 24

KASPER reports must be less than 3 months old

Question 25

Is a dentist required to inform the pt that a KASPER report will be generated?

Answer 25

No

Question 26

What do you do if a pt requires a prescription for a schedule II analgesic for today's dental tx and you cannot obtain a KASPER report for the pt due to a system error or malfunction?

Answer 26

Yes * Document why you prescribed the drug * "Manual Process" = document the report request number in the pts chart * System unavailable = note the date and time