! Prescription Writing

Question 1

What are the 2 groups of medication

Answer 1

OTC don’t need prescription

Legend need prescription andd erived from valid patient-prescriber relationship

Question 2

2 groups of legend drugs

Answer 2

Non schedules/non controlled which are not addictive and have no abuse potential

Scheduled/controlled which have addiction/abuse potential and/or dose

Question 3

Designation fo non scheduled vs scheduled designations impact what

Answer 3

Dispense quantity, refills allowed and prescriptions life span

Question 4

C-1 schedule

Answer 4

NO

Question 5

Example of scheduled drugs

Answer 5

Morphine, codeine, amphetamine, diazepam

Question 6

Examples of non scheduled drugs

Answer 6

Amoxicillin, propranolol, furosemide

Question 7

What are the 9 legal requirements of prescriptions

Answer 7

1. Name and address of prescriber
2. name address patient
3. date prescription was written with year
4. name, strength, dose
5. direction for use
6. Quantity to be dispensed
7. Number of refills allowed
8. Prescribers signiture
9. prescriber DEA number (for controlled drugs)

Question 8

What is the DEA number

Answer 8

A 2 letter and 7 digit number (personally identifies physician)
-required by law if scheduled/controlled compound

Question 9

What is quantity

Answer 9

30

Wt/vol/number and spelling

Question 10

Non controlled legend lifespan

Answer 10

12 months or number or refills-whichever ccomes first

Question 11

Limit to refills

Answer 11

7 day for opoid

No legal limit on # of refills or quantity dispensed during 12 month life span (limits set by insurance)

Question 12

Partial filling non controlled legend

Answer 12

Possible until full quantity of prescription and all refills dispensed or expiration date 1 year

Question 13

Controlled prescription lifespan

Answer 13

6 months or # or refills whichever occur first

Exception -C-V which has a lifespan of 12 months

Question 14

Wnumber of refills

Answer 14

C-II=none (0 refills)
CIII-CIV=5 refills over 6 months
C-V=no limit on refills (prescribable )

Question 15

Legal limit on quantity dispensed

Answer 15

90 days for C-III through CV

30 days for CII up to 90 days with documentation of medical reason

Question 16

Partial filling controlled

Answer 16

Possible only for CIII/IV/V until full quantity of prescription and all refills dispensed or expiration

Question 17

Partial filling for CII is not possible , UNLESS

Answer 17

Pharmacist doesn’t have full quantity (72 hours) or long term care/hospice

Question 18

Schedule II controlled substances:prescription validity, quantity limits, refills

Answer 18

6 months

30/90 days with documentation medical reason

May not be refilled

Question 19

Schedule III-IV controlled substances

Answer 19

Six month

90 days

Up to five times within six months

Question 20

Schedule V controlled

Answer 20

One year
90 days
As prescribed

Question 21

Non controlled substances

Answer 21

One year

As prescribed

As prescribed

Question 22

How send in prescriptions

Answer 22

Call/fax original prescription or refills for all legends except CII

Patients cant fac

Question 23

Prescriptions for legends can be electronically submitted with what

Answer 23

Board approved software, scan or fax with valid electronic signicatied or confidential digital key/identifier

Question 24

Faxed prescriptions must be signed ___

Answer 24

Manually

Security paper required by Missouri state and strongly recommended by BNDD

Question 25

CII prescription transfers not allowed

Answer 25

Except in emergency a physician can telephone only

Question 26

Prescription transfers allowed if for not CII in what case

Answer 26

Still in date and with refills (pt request or by pharmacy on request of patient; only pharmacy to pharmacy)

Question 27

CIII through CV can be transferred __

Answer 27

Once

Question 28

When can CIII-CV be transfers more than once

Answer 28

If pharmacies share a real time online database0federal law still requires involvement of 2 pharmacists in transfer

Question 29

___ __ orders are not transferable outside of the facility (need to be converted to a new order/prescription)

Answer 29

Nursing home

Question 30

What can be changed on a controlled substance prescription

Answer 30

``` Date written Patients address Drug form Drug strength Quantity to be dispensed Prescribers DEA number Directions for use Substitutions permitted Refill information Reasons for extended supplies for schedule II prescriptions ```

Question 31

What can never be changed/added

Answer 31

Patients name Drug name Prescribers signature

Question 32

What constitutes an emergency for controlled substances

Answer 32

Immediate administration is necessary for roper treatment of the intended ultimate use No appropriate alternative tratment is available including a non CII It is not reasonably possible for prescriber to provide written prescription to the pharmacist prior to dispensing

Question 33

In the case of emergency __ hours is allowed for delivery of Rx to dispensing pharmacy and how is the quantity limited

Answer 33

72 Limited to amount needed during emergency time

Question 34

Collaborative practice (APRN/RPh) or supervisory (PA) agreements

Answer 34

These professionals may write for any legend drug if documented in a signed agreement - need name and contact information of physician and personal writing prescription - physician and personnel writing prescription must be registered with the BNDD and DEA to prescribe controlled substances - legend prescriptions by these proverbs have different limits

Question 35

Self prescribing of controlled substances

Answer 35

Illegal in MO Self prescribing of non controlled substances is not illegal but discouraged by board of healing arts

Question 36

Prescribing for family

Answer 36

Sure as long as the same records are maintained as for any other patient

Question 37

Can you return dispensed medications for credit or Reid spending

Answer 37

No

Question 38

How can you give drugs back

Answer 38

Medication disposal events Drug take back events sponsored by DEA Proper disposal

Question 39

__ also carry liability, and are bound by moral/ethical principles similar to a physician

Answer 39

Pharmacists

Question 40

What happens is pharmacist deliberately ignores a questionable prescription

Answer 40

May lose license Felony