Flashcards in Pharmacy Practice Deck (35)
Does a collaborative practice agreement need to be submitted to the board?
How often does a collaborative practice agreement need to be renewed?
CPA renewal period is not addressed in the Michigan law
What actions are pharmacists allowed to perform under a CPA (e,g. initiate, modify, monitor medications)?
Initiate new therapy and modify existing therapy. There is nothing to prohibit a pharmacist from monitoring with lab tests or physical assessment
Are there any restrictions on what diseases a pharmacist can manage under a CPA?
Is every pharmacy required to have a PIC
Except for a remote pharmacy, a pharmacy shall designate a pharmacist licensed in this state as the pharmacist in charge for the pharmacy.
For a remote pharmacy, the pharmacist designated as the pharmacist in charge of the parent pharmacy shall also serve as the PIC of the remote pharmacy
How many pharmacies can a pharmacist serve as the PIC for at one time?
A pharmacist may be PIC for no more than 3 pharmacies, including remote pharmacies
What is the minimum number of hours the PIC must be present at the pharmacy?
A PIC must work an average of at least 8 hours per week at each pharmacy for which he or she is PIC, unless he or she is serving as the PIC of a remote pharmacy.
The PIC of a remote pharmacy is not required to be physically present at the remote pharmacy to satisfy the hours, and can satisfy the requirement through the use of a telepharmacy system
What activities are interns permitted to perform (e,g. counseling, compounding, final verification, taking verbal prescriptions)?
All activities of a pharmacist as long as the intern is under the direct supervision of a pharmacist preceptor
Can technicians accept new prescriptions over the phone?
Yes, technicians can accept verbal orders for prescription drugs, except orders for controlled substances
What are the requirements for tech-check-tech (e,g. practice site type, training or certification required)?
The role of pharmacy technicians is broadly defined in Michigan to include "any other specifically authorized functions"
This allows for institutions to permit tech-check-tech, although there are no state regulations or limitations on practice setting or training requirements.
The pharmacist is ultimately responsible for any allowed activites
What activities can a clerk perform (e,g. cashier functions, receive refills, put a bottle of medication on the shelf)?
The Michigan Board of Pharmacy does not specify what tasks a pharmacy clerk/cashier can perform
What are the limits on prescribing controlled or non-controlled drugs to oneself or family members?
Requires prescribers to be in a bona fide prescriber-patient relationship prior to prescribing schedule 2-5 controlled substances.
There are no state regulations preventing prescribing of non-controlled substances for oneself or family. The AMA code of Ethics states that generally, a prescriber should not treat themselves or immediate family members unless it is an emergency. Under Michigan law, a violation of the AMA Code of Ethics could result in administrative action against the prescriber.
Can new prescriptions or refills be filled if the prescriber is known to be deceased or retired?
The board does not specify if it is acceptable to fill or refill a prescription if the prescriber is known to be retired.
A prescription cannot be filled or refilled if the prescriber is knowingly deceased
Can pharmacists fill prescriptions written by prescribers in other countries?
The board does not specify if it is acceptable to fill prescriptions written by prescribers of another country
How many years must prescription records be kept?
Within what time frame from the issue date are non-controlled prescriptions permitted to be refilled?
Is there a maximum number of refills permitted for non controlled drugs?
Is emergency refilling of non-controlled drugs permitted without prescriber authorization?
What is the maximum days supply that can be dispensed for an emergency refill of non-controlled drugs without prescriber authorization?
The pharmacist may dispense and additional quantity up to the total number of dosage units authorized by the prescriber on the original prescription for the patient
What information is required to be on a prescription container label?
1) Pharmacy name and address
2) Prescription number and fill date
3) Patient's name
4) Prescribers name
5) Directions for use and quantity dispensed
6) The name of the medication and the strength, unless the prescriber indicated "do not label"
7) The name of the manufacturer or supplier of the drug if the drug has no brand name
8) The phrase "Discard this medication 1 year after the date it is dispensed" or the actual expiration date if sooner
Is it required to provide a larger type size on the container for patients with visual impairments?
Are patient profiles required to be kept in the pharmacy for all patients (e,g. a traveling patient on vacation getting a one-time fill)?
What is required to be in a patient profile?
Not addressed in Michigan law, follows federal law
1) Full name, address and phone number of the patient
2) Patients age or date of birth
3) Patients gender
4) Chronic medical conditions
5) A list of all prescription drug orders with the drug name, strength, quantity and date received, prescription number and prescriber
6) Known allergies, drug reactions and drug idiosyncrasies
7) Other information deemed relevant by the pharmacists judgement (e,g. any information peculiar to the patient or drug, patients weight, over the counter drug use)
Is patient identification required to dispense non-controlled drugs in the community pharmacy setting?
When must the offer to counsel a patient be made?
Who can provide the offer to counsel?
Pharmacist or intern
What are the counseling requirements for medications delivered to the patient or sent by mail?
If the patient or caregiver is not present at the pharmacy, printed information designed to help the patient use the medication safely and effectively must be provided
What are the requirements for providing translation services to limited-english proficient patients?
To encourage intended, positive patient outcomes, pharmacists must communicate with a patient regarding safe and effective medication use at the time a new prescription is dispensed
What are the requirements for generic substitutions?
1) The patient must be notified
2) The prescription label must indicate the name of the brand prescribed and the name of the generic drug dispensed
3) The substituted drug cannot cost more than the original drug