Lecture 22 Flashcards
(15 cards)
Indiana Prescription Drug Monitoring Program (PDMP)
Every time a pharmacy dispenses ephedrine, pseudoephedrine, or any controlled substance is dispensed pursuant to a prescription; the dispenser must transmit to INSPECT the following information:
-The recipient’s name
-The recipient’s identification number
-The recipient’s date of birth
-The NDC of the drug dispensed
-The date of dispensation
-The quantity dispensed
-The days supply dispensed
-The dispenser’s DEA number
-The prescriber’s DEA number
-An indication of how the prescription was transmitted
-Other data as required by the board
Information must be submitted within 24 hours of dispensation.
Only in this chapter, controlled substance includes gabapentin**
Identification Number
In Indiana, all the following are suitable forms of identification:
A valid driver’s license issued from Indiana or any other state
A valid military ID
A valid ID card issued by the bureau of motor vehicles
A valid photo exempt ID issued by the bureau of motor vehicles
An ID designated by the central repository (INSPECT)
Not on the list: U.S. Passport (though this is generally accepted as well)
Valid means in-date. Cannot accept expired IDs
Ephedrine and Pseudoephedrine in Indiana
First off, there are no legal limits to the amount of these products you can sell pursuant to a prescription.
When selling ephedrine or pseudoephedrine in Indiana without a prescription, the following limitations apply:
-Max of 3.6 grams in one day
-Max of 7.2 grams in one 30-day period
-Max of 61.2 grams in one 365-day period
-Purchaser must be 18-years old or older
-Purchaser must have a relationship on record with the pharmacy, or the pharmacist has deemed that the medication is to be used for a legitimate medical purpose
Ephedrine and Pseudoephedrine Sales Logs
Logs must be maintained for at least 2 years, and include:
-The name and address of each purchaser
-The ID presented
-The governmental entity issuing the ID
-The ID number
-The product purchased, including grams of the product and date and time of the transaction
856 IAC 2: Controlled Substances
Much of this section is somewhat repetitive in relation to the Controlled Substances Act. Don’t forget the CSA, it still applies! A few things to note:
1.856 IAC 2-6-10 and 856 IAC 2-6-15 discuss labeling requirements for C-II, and C-III/C-IV, respectively. Remember you must have the “Federal Law prohibits the transfer of this drug to any person other than the patient for whom it was prescribed” clause on these labels
- Dispensing a C-V without a prescription is the same as well, not more than 8 oz. or 48 doses of a substance containing opium, or 4 oz. or 24 doses of any other C-V
C-V sales and syringe/needle sales
Must be 18 to purchase C-V without a prescription, no age restriction related to syringes/needles
Each transaction recorded in the bound book must include:
1.Name and address of the purchaser
2.Name and quantity of product purchased
3.Date of each purchase
4.Name or initials of the pharmacist dispensing the product
856 IAC 4: Pharmacist Vaccinations, Minimum Requirements
To administer immunizations, a pharmacist, pharmacist intern, or technician must:
1.Complete an ACPE-accredited course of training on administering immunizations
2.Be certified in cardiopulmonary resuscitation and maintain that certification
The “qualifying pharmacist” is responsible for maintaining records related to immunization training and CPR certification within the pharmacy
Immunization Protocol Requirements
Any protocol for immunization administration must include:
For each immunization:
-The name and strength of the vaccine
-Precautions and contraindications
-The intended patient population
-The appropriate dosage
-Administration schedules according to CDC ACIP guidelines
-Routes of administration
-Injections sites
Protocols must be executed with a licensed physician actively practicing with a medical office in Indiana, and must be renewed annually
Immunization Items to Know
For a pharmacist intern to administer an immunization, they must identify themselves to the patient and receive consent from the patient.
Pharmacist Prescribed Hormonal Contraception
In 2023, Indiana passed a law allowing pharmacists to independently prescribe and dispense hormonal contraceptives to patients 18-years old and older. This applies to:
Hormonal contraceptive patches
Self-administered hormonal contraceptives
Hormonal Contraceptive Prescribing Requirements
Complete an approved training program
Provide a self-screening risk assessment tool to the patient
Refer the patient to a PCP or women’s health care practitioner upon prescribing the product
Provide the patient with a written record of the product and advise them to consult with a PCP or women’s health care practitioner
If the pharmacist works at a site with a physician, APRN, or PA who is available to deliver patient care and capable of prescribing the product, suggest the patient see that provider
The prescription issued may not be for more than a six-month period and the pharmacist may not issue a prescription for the patient after twelve months unless they have been seen by a physician, APRN, or PA in the previous twelve months
Hormonal Contraceptive: Objection to providing service
Can object for religious reasons. This is the only section where that is allowed
Remote Dispensing Facilities
where prescription drugs are prepared or dispensed without the requirement of an onsite pharmacist, and where pharmacist supervision is provided remotely.
Remote dispensing facilities must:
1.Be supervised by a pharmacist designated by the supervising pharmacy
2.Be at least 10 miles from an existing retail pharmacy unless
-The facility exclusively serves patients of a mental health center, hospital, or physician clinic; or
-The applicant demonstrates to the board how the proposed facility will promote public health
3.Maintain a counseling area
4.Display a sign with a lot of information…
Remote Dispensing Facility Sign
That the facility provides remote services supervised by a pharmacist located in another pharmacy
The identification and address of the supervising pharmacy
Disclosure that the pharmacist is required to speak to the patient using audio and visual communication any time a new drug or device is dispensed
Whether patient counseling is provided on prescription drug refills
That the facility is under continuous and recorded video surveillance
Remote Dispensing Facility: Operator Responsibilities
The pharmacy operating a remote dispensing facility must do the following:
1.Ensure that the remote dispensing pharmacy is sufficiently staffed to avoid the risk of harm to public health and safety.
2.Operate no more than one remote dispensing facility at a time, unless otherwise approved by the board
3.Ensure a pharmacist in good standing with the board is able to be physically at the remote dispensing facility within a timeframe set by the board, or have a designee to fulfill this requirement.
4.Require a pharmacist to visit the remote dispensing facility at least as often as required by the board
5.Develop and implement a continuous quality improvement program, including a mechanism for reporting errors that occur at the remote dispensing facility
6.Complete an inventory of all controlled substances at least monthly (remote dispensing facility must maintain a perpetual inventory for CS)
