Law And Ethics Pt 1 - 24%

Question 1

The Drug Enforcement Administration (DEA) was established in 1973. What is the main function of the DEA?

Answer 1

The DEA is the primary federal law enforcement agency charged with the responsibility of combatting the abuse of controlled substances.
*The Controlled Substance Act requires that anyone who manufactures, distributes or dispenses a controlled substance must register with the DEA.

Question 2

What are the rules in place by the DEA for veterinarians that work at more than one location?

Answer 2

A DVM can prescribe (write a prescription to dispensed at a pharmacy) Phenobarbital to a seizing dog (for example) at four different locations owner by the same business owner, but that same DVM can not administer or dispense the Phenobarbital unless they are an employee of the practice
OR they are registered at that specific location.

Question 3

What is the interpretation of the federal law provided by the DEA in regards to administration of controlled drugs by non veterinary staff?

Answer 3

1.) Must be agents or employees of the registered practitioner
2.) They are performing the task in the usual course of business
3.) They are acting under the direction of a licensed veterinarian ( refers to a tech administering a controlled drug while a DVM directly instructs or observes).
4.) They are under the direct supervision of a licensed veterinarian. (Veterinarian on premises and knows what is going on)

Question 4

Administration of controlled drugs by independent contractors…
If any doubt exists,

Answer 4

It is better to require that independent contractor veterinarians maintain a separate DEA registration. This assures compliance with the Controlled Substance Act, and also helps to support the independent contractor status to the tax authorities who may consider challenging the relationship.

Question 5

If a veterinarian dies, goes out of business, ceases professional practice, or no longer is licensed or practicing veterinary medicine for any reason. How much time is given before the DEA must be notified?

Answer 5

The DEA must be notified immediately so the registration can be terminated. Any unused drug order forms must be returned to the DEA so the registration can be terminated.

Question 6

When it comes to ordering controlled substances , no special order form is needed to order drugs in schedule III , IV, or V

What form is needed for all controlled substances in schedule II ?

Answer 6

All controlled substances in schedule II must be ordered with the federal triplicate order form DEA-222.

Question 7

When completion DEA forms, which copies of the DEA-222 must be submitted to the supplier.

Answer 7

Copies 1 and 2 of the DEA-222 must be submitted to the supplier.
Copy 3 of the form is retained by the registrant (the registered DVM).

**The supplier retains copy 1 and send copy 2 to the DEA.

Question 8

When it comes to the DEA-222 form copy 3 (the copy retained by the registered DVM) what should written on that form when the shipment arrives?

Answer 8

When the shipment arrives; the date of receipt and the number of containers of each drug should be documented on the copy 3 of the original order form that was retained when ordered.

Question 9

Describe a DEA schedule I drug -

Answer 9

Has a high potential for abuse. Has no current accepted medical use for tx in the US. Lack of accepted safety for use of the drug or other substance under medical supervision.

Question 10

Describe DEA schedule II

Answer 10

Has a high potential for abuse. Has a currently accepted medical use in tx in the US or a currently accepted medical use with severe restrictions.

Question 11

Describe DEA schedule III

Answer 11

Has a potential for abuse less than the drugs or substances in schedules I and II. Has a currently accepted medical use in tx in the US. Abuse of the drug may lead to moderate or low physical dependence or high psychological dependence.

Question 12

Describe DEA schedule IV

Answer 12

Has a low potential for abuse relative to the drugs in schedule III. Has a currently accepted medical use in tx in the US. Abuse of the drug may lead to limited physical dependence relative to the drugs in schedule III.

Question 13

Describe DEA schedule V

Answer 13

Has a low potential for abuse relative to the drugs or other substances in schedule IV. Has a currently accepted medical use in tx in the US. Abuse of the drug may lead to limited physical dependence.

Question 14

When lending a scheduled III, IV or V drug to another practitioner, what steps must be taken ?

Answer 14

1.) Transfer the quantity of drug to another registrant.
2.) Obtain a signed receipt/Invoice from the registered veterinarian who received the drug.
3)Store the invoice in your controlled drug record keeping system.

*The receiving veterinarian should keep keep copies of the receipts showing the drug was received from another veterinarian rather than a supplier.
*Drugs can be returned to the veterinarian from who they were borrowed using these same record keeping methods.

Question 15

When lending a scheduled 2 drug to another veterinarian, what steps must be taken?

Answer 15

Must use the DEA 222 form. Copy 3 of the form stays with the veterinarian who received the drug. Copy 1 stays with the registered practitioner supplying the drug. Copy 2 is sent to the DEA.

Question 16

When a veterinarian acquires an existing practice, an initial inventory of controlled substance must be taken. The practitioner transferring the drug should prepare an invoice of all drugs being delivered, what should be on the invoice by both parties?

Answer 16

It should be dated and signed by both the transferor and the receiver and indicate whether it was taken at the beginning of the day or the close of the day.

*Estimated counts for Scheduled III, IV, V are permitted unless the container holds more than 1000 tablets or capsules, then an exact count is needed. (An exact count of all Scheduled II substances is required.)
*These records must be maintained along with all receipts from distributors.
**Every 2 years following the initial inventory date, the registrant must take new inventory of all controlled drugs and maintain the records at the location for 2 years.

Question 17

What should you do if you have had a loss , spillage, breakage or theft of a controlled substance?

Answer 17

Notify the regional office of the DEA using a DEA form 106. Notify your local police department.

Question 18

True or False;
A practice cannot employ an individual who has had their DEA application or license revoked or denied if, as a result of their employment , they will have access to controlled drugs.

Answer 18

True.

Question 19

It is the employees responsibility to report drug diversions like theft by any fellow employees. You will treat all such information confidential. Failure by the employee to report drug diversions by fellow employees will be considered a determining factor in the feasibility of the employee continuing to work in a drug secure area. Who is responsible for informing all employees about this policy?

Answer 19

Employers.

Question 20

The code of Federal Regulations States that a representative of the DEA is authorized to enter controlled premises and conduct inspections for the purpose of copying and verifying accuracy of records, reports, and other documents related to controlled substances .
However, they cannot without our permission inspect any financial records, sales, and pricing data.

What is required from the DEA representative prior to the inspection taking place?

Answer 20

Inspectors must identify themselves, state their purpose, present their credentials, and the written notice of their authority to inspect with informed consent of the business owner or their representative and if that is not obtained, they can inspect via an administrative warrant.

*The inspection must be at reasonable times and conducted in a responsible manner.

Question 21

Employees working in a controlled substance environment may be screened and rejected for reasons described by the DEA. What are a couple of pre - employment questions permissible to ask surrounding controlled drugs?

Answer 21

*Within the last 5 years, have you been convicted of a felony/ Or a misdemeanor in the last 2 years/ or a you presently charged?

*In the past 3 years, have you ever knowingly used any narcotics, amphetamines, or barbiturates, other than those prescribed to you by a physician?

Question 22

What is the Controlled Substance Act (CSA) 1970 ?

Answer 22

It is title II of the Comprehensive Drug Abuse Prevention and Control act both of 1970.

The CSA will have the most relevant information about creating a closed system for the legitimate handling of controlled substances in veterinary medicine.

*Regulates by way of federal registration, all persons involved in the legitimate chain of manufacture, distribution, or dispensing of controlled drugs.

*Was designed to provide a “closed system” for legitimate handlers of controlled drugs and reduce opportunities for controlled drugs entering into the illlicit drug market.

Question 23

Why must Veterinarians always be aware of their state drug control laws.

Answer 23

*In the event the state drug control regulations are more stringent than the federal law, the STATE regulations will take precedence.

*Practitioners can contact their state boards of examiners or state veterinary associations regarding the individual state requirements

Question 24

The Controlled Substance Act divides controlled substances into five schedules. What do you know about Schedule I ?

Answer 24

Highest potential for abuse and severe dependence.
Lowest potential for accepted medical use.
Examples include heroin and LSD.

Question 25

The Controlled Substance Act divides controlled substances into five schedules. What do you know about Schedule II ?

Answer 25

High potential for abuse and severe dependence. Currently accepted medical use in the United States. Examples include Morphine and Oxymorphone

Question 26

The Controlled Substance Act divides controlled substances into five schedules. What do you know about Schedule III ?

Answer 26

*Less potential for abuse than schedules I & II and abuse may lead to low to moderate dependence. *Currently accepted medical use in the United States. *Examples include compounds that contain limited quantities of the narcotic drugs such as Tylenol with codeine and Nalline

Question 27

The Controlled Substance Act divides controlled substances into five schedules. What do you know about Schedule IV ?

Answer 27

Low potential for abuse relative to drugs in schedule III and may lead to limited dependence. *Currently accepted medical use in the United States. *Examples include Diazepam and Tramadol.

Question 28

The Controlled Substance Act divides controlled substances into five schedules. What do you know about Schedule V ?

Answer 28

*Lowest potential for abuse * Currently accepted medical use in the United States * Examples include Robitissin A-C and Lomotil

Question 29

Who has the powers to reschedule a drug, bring an unscheduled drug under control, or remove the controls on a drug?

Answer 29

A section of the controlled substance act states that the Drug Enforcement Agency and the Attorney General have broad powers to reschedule a drug, bring an unscheduled drug under control, or remove the controls on a drug.

Question 30

Who gives authority to the Food and Drug Administration Center for Veterinary medicine also known as the FDA CVM to govern the manufacturing , distribution and use of veterinary drugs that are distributed between states?

Answer 30

The Food and Drug and Cosmetic Act (or FD&C Act)

Question 31

True or False: The FDA is relevant when it comes to reporting adverse events related to FDA approved products?

Answer 31

True.

Question 32

True or False; The FDA CVM (Food and Drug Administration - Center for Veterinary medicine) is responsible for regulating animal feed and foods and most animal health products.

Answer 32

True.

Question 33

What are drugs that contain unsanitary components, lack of adequate control in manufacture, differ in strength from official compendium, or that are mixed with another substance. **Example - A practitioner takes two or more FDA approved drugs and mixes them in one syringe or bottle. In doing this the drugs have been adulterated and administering such a drug is a violation of the FD&C ACT (Food and Drug and Cosmetic Act).

Answer 33

These are known as adulterated drugs.

Question 34

_________________ Drugs include drugs in which the labeling is false or misleading, including any drug in a package form that does not bear a label that contains the name and place of business of the manufacture/packer/ distributor, and an accurate statement on quantity. **Label must include adequate directions for use (defined as directions, by which, a lay person can use a drug safely and for the purpose for which it was intended).

Answer 34

Misbranded Drugs.

Question 35

________________drugs are used only by or under the supervision of a veterinarian. *Is in the possession of a person (or agent of) who is regularly and lawfully engaged in the manufacture, transportation, storage or sale of veterinary drugs - or - on the prescription or order of a licensed veterinarian. *Is in the possession of a licensed veterinarian for use in lawful business.

Answer 35

Prescription/Legend Drugs.

Question 36

What are the label requirements for prescription drugs?

Answer 36

*The statement “Caution: Federal law restricts this drug to use by or on the order of a licensed veterinarian. *Recommended dose and route of administration *Quantity or proportion of each active ingredient *Names of all inactive ingredients if drug is for non oral use. *Identifying lot or control number from which it is possible to determine the complete manufacturing history of the drug.

Question 37

What are “Over the counter drugs” -

Answer 37

Drugs that you can purchase in a store. Directions for use can be readily understood and followed by the lay individual. Example…Essential fatty acid products or joint supplements.

Question 38

Explain “Extra Label Use” -

Answer 38

The use of FDA approved drugs in a manner other than what is approved on the label. **Think of the many human drugs we use for animals in our profession.

Question 39

Explain what are “Generic Drugs” -

Answer 39

FDA approved, which requires a demonstration of bioequivalence of safety and efficacy with the original pioneer drug product. Example - Carprofen vs Rimadyl

Question 40

Differentiate EXTRA LABEL use of “approved drugs” from the use of “unapproved drugs”.

Answer 40

The key difference between these two is that extra label drugs have been approved by the FDA for at least one purpose but have not been approved for the specific use or for the manner employed by the veterinarian. Unapproved drugs, on the other hand, are drugs that are not generally recognized as safe and effective by experts and never have been subjected to the FDA approval process.

Question 41

An unapproved drug is an illegal drug according to the FD&C Act (Food and Drug and Cosmetic Act) Most often, unapproved drugs are generic copies of drugs that are legally approved and on the market. Unless the drugs have a __________________, they are illegal under the FD&C Act.

Answer 41

NADA —- A NADA is used to seek approval of a generic new animal drug.

Question 42

True or False: All new animal drugs (and copies) must be approved by the FDA to be sold legally?

Answer 42

True.

Question 43

New animal drugs that are marked without NADAs violate the ____________ Act, and that violation can carry civil and criminal penalties.

Answer 43

FD&C Act (Food and Drug and Cosmetic Act)

Question 44

What four conditions do most state laws and FDA regulations allow the compounding of drugs for animal use?

Answer 44

1.) The veterinarian believes that there is a need to alter the approved drug to adequately medicated a non-food animal with a diagnosed medical condition. 2.) There is an established Veterinary Client Patient Relationship (VCPR). 3.) The individual patient has a medical condition for which prescribed medication is needed. 4.) The veterinarian determines that a compounded drug is needed for the animal

Question 45

True or False; Veterinarians cannot purchase compounded drugs from a pharmacy and then resell that compounded drug to a client.

Answer 45

True. Veterinarians may either compound the drug themselves, or the pharmacy can sell the compounded drug directly to the client via a prescription from the veterinarian.

Question 46

Adverse drug event reporting - By law, drug companies in the United States must inform the FDA/CVD of any adverse events involving their marketed products. Drug companies typically receive adverse event information from professionals and consumers. An event can be reported via a phone call to the FDA (1-888-FDA-VETS) or by filling out FDA Form 1932a and mailing it in. What must the report include?

Answer 46

1) The reporter or person familiar with the event who can provide additional information. 2.)Clinical sign or symptom occurring right after product exposure, regardless of perceived causality. 3.) Product name and lot number if available. 4.) Patient, an identifiable animal or human.

Question 47

Is there a mandatory reporting of adverse events involving unapproved or off label drugs for manufactures?

Answer 47

No - there is no mandatory reporting in place for unapproved or off label drugs. In order to provide data for unapproved product safety profiles, adverse events involving these products should be reported directly to the manufacture or distributor. THIS HELPS BUILD A DATABASE ON NON-FDA APPROVED PRODUCTS FOR PRACTITIONERS’ REFERENCE.

Question 48

To report an adverse event or defect associated with the use of an Animal Medical Device it is recommended to contact the device manufacturer or report the case directly to the FDA. What is considered an Animal Medical Device?

Answer 48

An instrument, apparatus, implement, machine, implant, in - vitro reagent, or similar article that is intended for the diagnosis of disease or other conditions, or to cure, mitigate, treat, prevent disease, or affect the structure or any function of the body of humans or animals and that does not achieve its primary intended purposes through chemical action or metabolism. **Needles, syringes, surgical instruments , prosthetic devices, x-ray equipment, certain diagnostic test kits, and dental appliances are considered medical devices.

Question 49

Is it mandatory for manufactures to report adverse events involving unapproved or off label drugs?

Answer 49

No, There is no mandatory reporting for adverse events involving unapproved or off label drugs for manufactures. *In order to provide data for an unapproved product safety profiles, adverse events involving these products should be reported directly to the manufacture or distributor. This helps to build a database on non-FDA approved products for practitioners reference.

Question 50

Who should you report adverse events or complaints regarding pet food or animal dietary supplements to?

Answer 50

Complaints should be reported to the manufacture or the FDA via its Safety reporting portal Http://www.safetyreporting.hhs.gov

Question 51

What does the USDA’s Center for Veterinary Biologics (CVB) define an events as in regards to Animal biologics such as vaccines, bacterins, and Diagnostic Kits?

Answer 51

The USDA’s Center For Veterinary Biologics (CVB) defines an event as any undesirable occurrence after the use of an immunobiological product whether or not the event was caused by the product. *Report adverse events to the manufacture or directly to the Center for Veterinary Biologics (CVB) Http://www.usda.gov/aphis/ourfocus/animal health/veterinary-biologics.

Question 52

Where should you report incidents involving pesticides or topically applied parasiticides?

Answer 52

Pesticide related incidents involving domestic pets can be reported via the reporting page provided by National Pesticide Information Center (NPIC) and the Environmental Protection Agency (EPA) Link: Https://www.epa.gov/pesticide-incidents/incident-reporting-pesticide-manufactures-registrants

Question 53

Why should one report adverse events?

Answer 53

Pharmacovigilance helps to maintain current, complete and relevant labels in order for practicing veterinarians to make informed choices for their patients. *The reporting system provides beneficial information to veterinarians, pet owners, drug companies and the FDA, and ultimately benefits the animals by ensuring that prescribed drugs are both safe and efficacious.

Question 54

Why was the Occupational Safety and Health Administration (OSHA) created?

Answer 54

The Occupational Safety and Health Administration (OSHA) was created to enact and enforce safety rules (standards) for the American workplace.

Question 55

True or False.. OSHA (Occupational Safety and Health Administration) applies to all workplaces in the United States?

Answer 55

True. *Many states have their own state version of OSHA standards that are expected to be minimally as effective as the federal standards. ***A Hospital Safety Manual is required.

Question 56

What is Hazard Communication (The Right to Know) -

Answer 56

Requires that all team members who come into contact with potentially hazardous materials in the workplace are aware of those hazards and be instructed on how to protect themselves.

Question 57

In regards to the Right To Know, what must a practice have?

Answer 57

* A designated Safety Manager or Officer *An annual hazard analysis inspection. (Internal) *Safety plans in place for all identified hazards *A chemical list and safety plans for Immediately Dangerous to Life and Health chemicals. *Safety Data Sheets on all chemicals and components. *Secondary labeling as needed and explanation and training on the labeling system. *A protocol in place for emergency evacuation *A training program focusing on PPE, monitoring devices, and have at the practice (11 or > (more) employees)

Question 58

OSHA Standards - Hazard Assessment. Regulations requires a _______________ of every workplace to determine the nature of the hazards that are present.

Answer 58

Written Hazard Assessment for every location of the practice that lists the likely hazards and the personnel protective equipment and procedures necessary to minimize the risk. **Based on the assessment of the possible hazards in the workplace, the leadership of the practice must determine exactly what tasks require additional protection and select the appropriate PPE for the situation.

Question 59

In regards to OSHA’s Hazardous Chemical Plan, what must you know?

Answer 59

*It must be in writing *A complete list of all hazardous chemicals maintained in your hospital *Must have an up to date Safety Data Sheets library *All containers must be properly labeled *Staff training (Significant part of the Hazardous Chemical Plan) **Side note - If you regularly use Vetcove you can access a PDF report at the SDS pages for products that you’ve ordered over a specific period of time. It’s a great way to get your SDS finder going.

Question 60

What are the OSHA Standards on Administrative Requirements regarding posters and notices?

Answer 60

*It’s The Law poster - must be displayed in a common area. If available, the state poster should be on display instead of the federal poster. *Notices of pending inspections until the inspection is complete. *Inspection citations posted for 3 days or until corrected, whichever is longer. *Appropriate warning or identification signs (Exits, radiation, etc..) * Written plans for preventing fire, handling hazardous chemicals, preventing injury with PPE (Personal protective equipment), and informing workers of dangers in their workplace. THIS WRITTEN PLAN IS REQUIRED FOR ANY WORKPLACE WITH 10 OR MORE EMPLOYEES.

Question 61

Name some Employer rights in regards to the regulatory agency - OSHA

Answer 61

*Set and enforce safety rules and conduct for the workplace. *Be present or designate a representative during any inspection or investigation. *Require that the compliance officer obtain a warrant before entering (Not recommended) *Request that the inspection be postponed to a reasonable time. *Expect that the trade secrets will not be divulged to competitors as a result of an inspection or investigation. Consult with an attorney or advisor before, during or after an inspection and before responding to an injury. *See any complaint that has been alleged against the business. *Insist that staff members be interviewed at a time that does not interfere with that staff members duties. *Right to appeal findings.

Question 62

What are the Employers Responsibilities regarding the regulatory agencies - OSHA?

Answer 62

TRAINING MUST HAPPEN BEFORE STARTING *Must provide a workplace, in so far as possible, free from recognized or unnecessary hazards. *Set and enforce safety rules in the workplace and to communicate those rules in a clear and concise manner. *Provide personal protective equipment (PPE) and proper instructions for its use. *Provide training and instruction for staff members to understand the hazards associated with their jobs and the steps necessary to protect themselves.

Question 63

What are some staff member rights in regards to the regulatory agency - OSHA ?

Answer 63

*A workplace free from recognized hazards. *Be informed of their rights under the OSHA Act (OSHA poster 3165 - It’s the law) *Be informed of known hazards in the workplace and trained to safely perform their duties. *Be provided with and instructed in the use of personal protective equipment. * View and receive copies of all applicable OSHA standards. *Access to all medical and exposure records that may be maintained as part of the business. *Be present in the workplace when safety testing or monitoring is performed. *Present complaints to employer or OSHA when a hazard or suspected hazard requires attention or correction. *Speak with a compliance officer privately during an inspection of the workplace.

Question 64

What are staff members responsibilities in regards to regulatory agencies - OSHA?

Answer 64

OSHA does not cite employees for violations of their responsibilities, although every employee is required under the Occupational Safety and Health Act to comply with all occupational safety and health standards and all rules, regulations and orders issued under the act. This also includes workplace specific rules established by the employer. **An employer can and should have a written disciplinary policy in place for employees who willfully violate safety rule or standard, providing the employer has given proper instruction on the standard.

Question 65

What are staff members responsibilities in regards to regulatory agencies - OSHA?

Answer 65

*Read the OSHA poster *Comply with all applicable standards. *Follow all lawful employer safety and health rules and regulations *Wear or use prescribed personal textile equipment while working. *Report hazardous conditions to their supervisor *Report any job related injury or illness to the employer and seek treatment promptly. *Cooperate with the OSHA Compliance Officer during an inspection or investigation.

Question 66

What would you use the OSHA form 300 used for?

Answer 66

Log of Work-Related Injuries and Illness (Form 300) - record every work related death, or injury/illness that involves loss of consciousness, restricted work activity or job transfer, days away from work, or medical treatment beyond first aid (if it is a bandaid situation, you do not need to log it). You must also record significant work-related injuries and illness that are diagnosed by a physician or licensed health care professional. (This form is a running log with space for multiple employees) *Must be kept for 5 years.

Question 67

What would you use the OSHA form 301 used for?

Answer 67

Illness and Injury Incident Report (Form 301) - Within 7 calendar days after you receive information that a recordable work-related injury or illness has occurred, you must fill out this form or equivalent. (This form records individual illness and injuries). *Must be kept for 5 years.

Question 68

What would you use the OSHA form 300A used for?

Answer 68

Summary of Work-Related illness and Injury (Form 300A) - Post this summary page from February 1 -April 30th of the year following the year covered by the form. This form must be completed and displayed even if there were no recordable injuries or illnesses within the time frame recorded. *Must be kept for 5 years.

Question 69

When lending a controlled drug to another practitioner, what step in unnecessary for schedule III, IV and V drugs, that is necessary for scheduled II drugs? A) Using the DEA 222 form. Copy 3 of the form stays with the veterinarian who received the drug. Copy 1 stays with the registered practitioner supplying the drug. Copy 2 is sent to the DEA. B) It is illegal to lend schedule drug. C) Using the DEA 222 form, although both the received DVM and supplying DVM should log copies, no copy needs to be sent to the DEA.

Answer 69

A) Using the DEA 222 form. Copy 3 of the form stays with the veterinarian who received the drug. Copy 1 stays with the registered practitioner supplying the drug. Copy 2 is sent to the DEA

Question 70

Regarding Veterinarians who work at more than one location they may administer, dispense, and prescribe controlled drugs providing they have a current DEA registration at central place of business. True or False.

Answer 70

False. May prescribe controlled drugs if they are registered at some principle place of business. To administer or dispense they must be classified as an employee of a registrant, or they must register at each facility where they are employed.

Question 71

Under what circumstances can a DVM dispense an adulterated drug? A) When all ingredients are FDA/CVM approved B.) Under no circumstances C. As long as there are no more than 2 drugs combined and both are FDA/CVM approved.

Answer 71

B. Under no circumstances should a DVM dispense an adulterated drug.

Question 72

In regards to a DEA inspection, what can the inspector copy without the consent of the practice owner or representative. A.) All records and reports involving controlled drugs. B.) All records, reports, and financial information regarding controlled drugs. C.) They can not copy any document without consent.

Answer 72

A.) All records and reports involving controlled drugs. *Do not have to show them any information regarding financial information.

Question 73

A controlled drug with a high potential for abuse and severe dependence, but does have currently accepted medical uses in the United States, would be in what Schedule of narcotics?

Answer 73

Schedule II — Has a high potential for abuse. The drug or other substance has a currently accepted medical use in treatment in the U.S or a currently accepted medical use with severe restrictions.

Question 74

A non-veterinary staff member may prescribe any non-controlled drugs if directed to do so by a licensed, veterinarian who employs them, and if that veterinarian directly supervises the staff member. True or False ?

Answer 74

False. Non veterinary staff members may not prescribe any drug.

Question 75

Under what four conditions will many states allow a non-veterinary staff member to administer controlled drugs?

Answer 75

1.) If they are agents or employees of the registered practitioner 2.) They are performing the task in the usual course of business 3.) They are acting under the direction of a licensed veterinarian 4.) They are under the direct supervision of a licensed veterinarian

Question 76

What is the process for lending a fellow veterinarian a Schedule II drug?

Answer 76

Must use the DEA 222 form. Copy 3 of the form stays with the Veterinarian who received the drug. Copy 1 stays with the registered practitioner supplying the drug. Copy 2 is sent to the DEA .

Question 77

Regarding the DEA form 222: what is the correct destination for each of the three copies of the form.

Answer 77

1.) Copies 1 and 2 are sent to the supplier 2.) Copy 3 of the form is retained by the registrant 3.) The supplier retains copy 1 and sends copy 2 to the DEA.

Question 78

List two steps to take when a controlled drug has been lost or stollen

Answer 78

1.) Registrants are required to notify the regional office of the DEA using the DEA form 106 2.) The local police department should also be notified.

Question 79

Define Adulterated Drugs…

Answer 79

Drugs that contain unsanitary components, lack of adequate control in manufacture, differ in strength from official compendium, or that are mixed with another substance. Example - a practitioner takes two or more FDA - approved drugs and mix them in one syringe or bottle. In doing this the drugs have been adulterated and administering such a drug is a violation of the FD&C Act.

Question 80

List the five label requirements for prescription drugs.

Answer 80

1.) The statement “Caution : Federal law restricts this drug to use by or on the order of a licensed veterinarian” 2.) Recommended dose and route of administration 3.) Quantity or portion of each active ingredient 4.) Names of all inactive ingredients in drug is for non-oral use. 5.) Identifying lot or control number from which it is possible to determine the complete manufacturing history of the drug

Question 81

1.) The statement “Caution : Federal law restricts this drug to use by or on the order of a licensed veterinarian” 2.) Recommended dose and route of administration 3.) Quantity or portion of each active ingredient 4.) Names of all inactive ingredients in drug is for non-oral use. 5.) Identifying lot or control number from which it is possible to determine the complete manufacturing history of the drug

Question 82

In regards to OSHA inspection; employers have the right to deny access to specific areas of the building to avoid disturbing the business process. True or False.

Answer 82

False. Employers have the right to require a warrant, or to request a postponement, but not deny access once the inspection/investigation has begun.

Question 83

A veterinary acupuncturist leases space from a general practice. Does the general practice need to share the hazard assessments from their department, even if the acupuncturist works in a separate part of the building?

Answer 83

Yes. All separate businesses within a shared space must create a hazard assessment for the entire area. Bonus question: What else might the entities above be required to share or address? Each separate entity within the hospital will need to provide the other entity with their Safety Data Sheets, or store the safety information in a central location.

Question 84

What five elements must be in a Hazardous Chemical Plan?

Answer 84

1) Must be in writing 2) A complete list of all hazardous chemicals must be maintained. 3) Safety Data Sheets library 4) All containers properly labeled. 5) Staff Training

Question 85

Describe a hazardous waste plan for a veterinary clinic (CDN and U.S)

Answer 85

Each biomedical waste facility shall implement a written operating plan to manage biomedical waste and contain specific components as required by the regulations. The plan shall be available for review by the department and facility personnel.

Question 86

Explain the importance of why each veterinarian prescribing controlled substances should have their own DEA registration (U.S)

Answer 86

In order for a veterinarian to prescribe or dispense controlled substances based on a prescription, he/she must be registered with the US Drug Enforcement Agency (DEA).

Question 87

What regulations must veterinary hospitals follow for storage of controlled substances?

Answer 87

Regulations specifically states “ Controlled substances listed in schedule II , III, IV, V shall be stored in a securely locked, substantially constructed cabinet.

Question 88

What is the DEA Form -222 used for?

Answer 88

DEA form 222 is used for ordering controlled substances.

Question 89

How should Schedule II, III, IV and V inventory records be stored?

Answer 89

In a special file so that reconciliation of discrepancies can be done quickly. All records related to purchases of controlled drugs must be maintained for two years. Needs to be readily available.

Question 90

Food and Drug Administration (FDA) Differentiate prescription drugs, Over-the-counter drugs, Extra-label drug usage, and controlled substances.

Answer 90

Controlled substance - label contains a large letter “ C ” with roman numerals depicting the schedule of the drug in the middle of the “ C “. Over the counter products can be purchased over-the-counter. Extra-label drug usage is for medications that are safe for both humans and pets and are FDA approved. Prescription drugs - Prescription is written by a veterinarian directing a Pharmacist to prepare.

Question 91

Differentiate FDA and U.S Department of Agriculture (USDA) regulations as they pertain to veterinary products.

Answer 91

The Federal Food, Drug, and Cosmetic Act gives FDA the legal authority to approve and regulate drugs for animals. Before a drug company can market an animal drug, the company must get the drug approved by the FDA. The U.S. Department of Agriculture (USDA) is authorized, under the 1913 Virus-Serum-Toxin Act as amended by the 1985 Food Security Act, to ensure that all veterinary biological produced in, or imported into, the United States are not worthless, contaminated, dangerous, or harmful.

Question 92

What responsibility does the veterinary hospital have to monitor safety violations?

Answer 92

In practices with 11 or more employees, the details must be recorded on an OSHA 300 log. Keep accurate records of all accidents, injuries, and illnesses. If more that 11 employees you are required to keep additional logs and past year end summaries.

Question 93

Where does one locate state/province safety regulations?

Answer 93

Occupational Safety and Health Administration (OSHA) Safety and health conditions in most private industries are regulated by OSHA

Question 94

Describe how to document an employee’s work related injury.

Answer 94

First complete form 301 (illness and injury incident report) - within 7 calendar days after you receive information that a recordable work-related injury or illness has occurred, you must fill out this form or equivalent. Then, log it on your form 300 (This is your log of work related illness or injuries) - On this log you must record every work-related death, or injury/illness that involves loss of consciousness, restricted work activity or job transfer, days away from work, or medical treatment beyond first aid. You must also record significant work related injuries and illnesses that are diagnosed by a physician or licensed health care professional.

Question 95

What are controlled substances?

Answer 95

A controlled substance is a drug that has been labeled with high abuse potential, therefor the DEA has strict procedures for purchasing and dispensing the drug.

Question 96

What is the abuse potential for Ketamine?

Answer 96

Class III - Less potential for abuse than Schedules I & II and abuse may lead to low to moderate dependence. More examples included compounds that contain limited quantities of the narcotic drugs such as Tylenol with codeine and Nalline.

Question 97

Why are log sheets required for controlled substances?

Answer 97

Log sheets are required to track all products that have been dispensed. Any drug that is not accounted for must be reported as missing ( if more than 3% per year).

Question 98

What is the purpose of a year-end physical inventory?

Answer 98

A physical inventory is required by the DEA every 2 years. However, some states require a yearly inventory. This allows for drug reconciliation, any product with more than 3% missing must be reported.

Question 99

What is the DEA form 106 used for?

Answer 99

The DEA form 106 is used to report any missing controlled substances.

Question 100

The class with the highest abuse potential is: A) II B) IV C) V

Answer 100

A) Class II

Question 101

DEA form 222 is used to: A) Register a doctor for a DEA license B) Report lost or controlled substances C) Order schedule II controlled substances D) Order schedule V controlled substances

Answer 101

C. ) Order schedule II controlled substances

Question 102

Logs should be stored in the same place as controlled substances? True or False ?

Answer 102

False

Question 103

A loss of ________ or more must be reported to the DEA. A) 1% B) 2% C) 3% 4) 4%

Answer 103

C ) 3%

Question 104

A reverse distributor : A) Sells controlled substances to veterinary hospitals B) Incinerates expired controlled substances C) Both of the above D) Neither of the above

Answer 104

B) Incinerates expired controlled substances.

Question 105

What is a zoonotic disease?

Answer 105

A zoonotic disease is a disease that transmitted from animal to humans.

Question 106

How should animals heavier than 40 pounds be lifted onto a table?

Answer 106

Two employees are required when lifting any animal heavier than 40 lbs. The legs should be used, not the back. The back should remain straight up and down, not bent.

Question 107

What is the right to know poster?

Answer 107

Job Safety and Health - It’s the Law is a poster that is required to be posted by employers, informing employees that they have the right to know about hazards that are associated with their occupation.

Question 108

What is an SDS?

Answer 108

An SDS is a Safety Data Sheet that lists all pertinent information about a chemical, including fire and explosive capabilities. SDSs list methods of disposal, cleanup and use.

Question 109

What is the purpose of PPE?

Answer 109

PPE is personal protective equipment and must be used when provided by employers.

Question 110

When does OSHA form 300A have to be posted?

Answer 110

The OSHA form 300 A must be posted February 1 to April 30th of each year.

Question 111

What is a biohazard material?

Answer 111

A biohazard material is any material that is sharp, glass, or contaminated with human blood or pathogens.

Question 112

What are some hazardous chemicals used in a veterinary practice?

Answer 112

Examples of hazardous chemicals used in a veterinary practice include ethylene oxide, formaldehyde, and glutaraldehyde.

Question 113

Under OSHA guidelines, employees are responsible for which of the following? A) Read the Right To Know Poster B) Order PPE for the practice C) Training fellow team members on the use of PPE D) Document conditions in which PPE must be used

Answer 113

A) Read the Right to Know Poster

Question 114

If an OSHA inspector arrives at the hospital, which of the following options should be exercised? A) introduce the inspector to the Safety Officer B) Allow the inspector to proceed without a team member C) Hide violations from the staff. D) Do not allow OSHA access.

Answer 114

A. ) Introduce the inspector to the Safety Officer.

Question 115

Which of the following contribute to the majority of fires in the veterinary practice? A) Paper files stacked up to the ceiling B) Blankets next to a furnace C) Overloaded electrical outlets D) Heating units left unattended

Answer 115

C ) Overloaded electrical outlets

Question 116

Back injuries can be classified as which type of injury? A) Physical B) Biohazard C) Caustic D) Ergonomic

Answer 116

D) A back injury can be classified as an Ergonomic injury.

Question 117

Noise protection should be provided for employees when noise levels reach which decibel level? A) 75 db B) 85 db C) 95 db D) Ear protection is not required.

Answer 117

B) 85 db

Question 118

Why should computer systems be backed up at the end of each shift?

Answer 118

Computer data should be backed up at the end of every shift in case disaster or theft occurs overnight. The backup disk can be loaded onto a new computer and no data will be lost.

Question 119

Why should computer software be password protected?

Answer 119

Software should be password protected to prevent employees from stealing confidential information and to add another level of protection against hackers.

Question 120

What is the purpose of one way door locks?

Answer 120

One-way door locks require a key to enter , but the door can be used as an exit at anytime.

Question 121

What should a team member do if an armed individual enters the practice and demands money or drugs?

Answer 121

Team members should give an armed individual whatever they request, including money or drugs. The goal is to get the intruder out of the practice as soon as possible to protect team members and clients.

Question 122

What is an ASP baton ?

Answer 122

An ASP baton is used for personal protection and provides superior force when used to strike an attacker.