L6 Prescribing, OBRA' 90, and DSHEA

Question 1

T or F:
authority to prescribe is defined by the federal gov

Answer 1

F, NOT defined, left to states to determine as established by the Durham-Humphrey Amendment

Question 2

what are the big 4 prescribers with authority to prescribe in every jurisdiction

Answer 2

physicians
dentists
podiatrists
vets

Question 3

T or F:
“Full Prescribers” scripts are honored only in the state of their jurisdiction

Answer 3

false, if they have a license in one place they can prescribe anywhere

Question 4

what are some examples of mid-level prescribers

Answer 4

NP
PA
optometrist
pharmacists
naturopaths
chiropractors
psychologists

Question 5

scope of practice:
Physicians

Answer 5

whole body authority for humans

Question 6

scope of practice:
dentists

Answer 6

mouth and maxillofacial area for HUMANs

Question 7

scope of practice:
podiatrists

Answer 7

feet
ankles
some places (hands) for humans

Question 8

scope of practice:
vets

Answer 8

whole body authority for all animals

Question 9

scope of practice:
mid-levels

Answer 9

depends upon their scope of training, the specialty of their supervisor, and/or formulary of drugs they are allowed to prescribe

Question 10

T or F:
From a federal standpoint, there are no uniform standards for non-controlled prescriptions in the US

Answer 10

true

Question 11

t or F:
federal law frequently addresses prescription expiration or refills

Answer 11

F, DOES NOT address. dont really know what this means

Question 12

if the fed gov does not address prescriptions, refills, and expiration dates, what do they address?

Answer 12

prescription labels

Question 13

what are the 4 prescription label requirements with no strings attached

Answer 13

-name and address of dispenser
- prescription number
- date of prescription OR its filling
- name of prescriber

Question 14

what are the 3 prescription label requirements with strings attached (if’s)

Answer 14

• if stated on the prescription -> name of patient
• if contained on the prescription -> any directions for use
• if contained on the prescription -> any cautionary statements

Question 15

why can the date on a script be either date written or date filled?

Answer 15

because nothing in fed law requires a prescription to be dated

Question 16

INDIANA refill rules:
OTC, Non-Control
A. one year
B. six months

Answer 16

A

Question 17

INDIANA refill rules:
Rx-only, Non-Control
A. one year
B. six months

Answer 17

A

Question 18

INDIANA refill rules:
OTC or Rx-only, CIII, CIV, CV
A. one year
B. six months

Answer 18

B

Question 19

INDIANA refill rules:
Rx-only, CII
A. one year
B. six months

Answer 19

A, surprisingly

Question 20

INDIANA refill rules:
How many refills?
OTC, Non-Control
A. No rule
B. Five
C. Not refillable

Answer 20

A

Question 21

INDIANA refill rules:
How many refills?
Rx-only, Non-Control
A. No rule
B. Five
C. Not refillable

Answer 21

A

Question 22

INDIANA refill rules:
How many refills?
OTC or Rx-ONly, CIII, CIV, CV
A. No rule
B. Five
C. Not refillable

Answer 22

B

Question 23

INDIANA refill rules:
How many refills?
Rx-only, CII
A. No rule
B. Five
C. Not refillable

Answer 23

C

Question 24

Indiana refill rules:
when does the expiration clock start ticking for any med basically

Answer 24

when it is issued (in the hands of the patient)

Question 25

What did the OBRA '90 aw target?

Answer 25

spending on medications by medicaid beneficiaries

Question 26

OBRA '90 4 primary requirements related to pharmacy practice:

Answer 26

1. Prospective Drug Utilization (DUR) 2. Retrospective Drug Utilization Review 3. Offer to Conduct Patient Counseling 4. Maintaining Patient Records

Question 27

T or F: OBRA '90: states were left to implement laws. many applied these laws to all patients, not just medicaid

Answer 27

true

Question 28

what is meant by prospective DUR from OBRA '90?

Answer 28

pharmacist must review drug therapy before each prescription is filled for accuracy and appropriateness

Question 29

6 things included in Prospective DUR

Answer 29

- therapeutic duplications - drug-disease CI's - DDI - Incorrect dosage or duration of treatment - Drug allergies - clinical abuse and/or misuse

Question 30

OBRA '90 T or F: states must review med use of drugs and compare how they are being used against accepted standards

Answer 30

true

Question 31

OBRA '90 Patient Records: pharmacist must make an effort to obtain, record, and maintain AT LEAST what 3 things? (kinda more than 3 but grouped up)

Answer 31

- name, address, phone #, DOB (or age), gender - individual hx where significant (disease states, drug allergies, list of meds and devices) - pharmacist comments relevant to individuals drug therapy

Question 32

T or F: most things related to patient counseling through OBRA '90 apply to all patients under law

Answer 32

FALSE, only to medicaid patients BUT most states have extended it to all pts

Question 33

T or F: the FDA has authority to classify supplements with a potency >150% of rec daily allowance as drugs

Answer 33

FALSE, stripped of this ability in 1976, could no longer regulate special dietary needs claims as a result

Question 34

what is DSHEA?

Answer 34

dietary supplement health and education act

Question 35

why was DSHEA passed?

Answer 35

to clarify the place in the law for dietary supplements

Question 36

DSHEA def of dietary supplement

Answer 36

a product (other than tobacco) intended to supplement the diet that contains one or more of the following: (will make another card for this)

Question 37

what are the 4 things that DSHEA defined a dietary supplement as? ("contains one or more of the following")

Answer 37

- a vitamin - a mineral - an herb or other botanical - an amino acid

Question 38

5 things all dietary supplement labels MUST contain under DSHEA

Answer 38

1. name of product and phrase "dietary supplement" 2. quantity of contents 3. manufacturers, packers, or distributors name and address 4. directions for use 5. a supplement facts panel containing serving size, list of dietary ingredients, amount per serving size, % daily value if established

Question 39

what are the 3 types of claims manufacturers CAN make about dietary supplements?

Answer 39

1. health claim 2. nutrient content claim 3. structure-function claim

Question 40

DSHEA: relationship between a product and it’s potential impact on an approved disease state or condition A. health claim B. nutrient content claim C. structure-function claim

Answer 40

A

Question 41

DHSEA: relative description of the nutrient or dietary substance in the product A. health claim B. nutrient content claim C. structure-function claim

Answer 41

B

Question 42

DSHEA: description of maintaining proper body function independent of specific disease states A. health claim B. nutrient content claim C. structure-function claim

Answer 42

C

Question 43

if a dietary supplement contains any of the 3 claims, what must accompany it?

Answer 43

FDA disclaimer: “This statement has not been evaluated by the FDA. This product is not intended to diagnose, treat, cure or prevent disease.”