Mpje Wi Phar Chapter 7

Front 1

Describe the minimum procedures for compounding/dispensing:

Back 1

-receive rx orders and determine tx compatibility and legality
-read and interpret directions for use
-prepare product (tech may prepare if rph verifies accuracy)
-make a final check of the accuracy and correctness of the rx and indicate who performed final check on rx order
-give appropriate consultation (if delivering, must notify pt to call with questions)
-transfer product to patient
-receive renewal authorizations if applicable (date renewed, name of practitioner, quantity, RPh ID)

Front 2

What are the maximum number of interns and technicians a pharmacist can manage at a given time?

Back 2

one intern and 4 technicians

Front 3

define: pharmacy technician

Back 3

non-pharmacist/intern who, under the direction of a pharmacist, assists the pharmacist in the technical and nonjudgmental functions related to the practice of pharmacy in the processing of prescription orders and inventory management

Front 4

list activities that technicians can perform:

Back 4

-accept written or electronic rx orders
-accept oral orders if recorded and verified by a pharmacist
-request refills
-accept refill authorizations provided there are no changes
-accept refill requests from patients
-obtain and enter patient data into computer system
-prepare prescription labels
-retrieve medications from stock and place in final container
-reconstitute pre-fabricated dosage forms
-compound pursuant to written P&Ps
-affix label to final container
-place aux stickers on bottle
-prepackage and label drugs for pharmacist
-prepare unit dose carts for final review by rph
-retrieve and transport stock medications
-other technical functions not requiring professional judgment
-transfer product to patient if pharmacist has provided consultation

Front 5

list activities that technicians cannot perform:

Back 5

-provide final verification for accuracy, validity, completeness, appropriateness of a filled prescription
-participate in final DURs
-make independent tx alternative drug selections
-participate in final drug regimen screening
-perform any act necessary to be a managing pharmacist
-administer medications/vaccines
-provide patient counseling/consultation/pt specific judgement (including info about tx values, hazards, and uses)

Front 6

What are the labeling requirements for a brand name medication? Generic medication?

Back 6

-Brand name and strength
-generic name, strength, and manufacturer

Front 7

Label options for: rx for brand name, dispense brand name

Back 7

-brand name (generic name optional)

Front 8

Label options for: rx for brand name, dispense generic drug

Back 8

-generic name (brand name optional)

Front 9

Label options for: rx for generic name, dispense brand name

Back 9

-brand name (generic name optional)

Front 10

Label options for: rx for generic name, dispense generic name

Back 10

-generic name (not sure if brand name can appear on bottle)

Front 11

When do non-controlled substance prescriptions expire?

Back 11

-one year after issuance
-when the provider-patient relationship expires

Front 12

When can health items (drugs, syringes, etc.) be returned to a pharmacy?

Back 12

-provided by an inpatient health care facility (if still in original packaging)
-dispensed in error, were defective/adulterated/misbranded/dispensed after expiration date
-if harm could result to the public if they remain in the patient's possession
-inmates and LTC patients if: drug never in patient's possession, stored in tamper-resistant packaging, includes beyond use date and lot #, not mixed with other items unless being returned to same patient, item still in original container
-pre-packaged item for consumer use if package is unopened, sealed, intact, unaltered labeling, unadulterated contents

Front 13

What can be done with returned health items?

Back 13

-Destroy them or deliver them for destruction by an authorized person.
-Medications can be returned to same patients if LTC or jail patients.
-Returned meds can be re-used for jail patients.

Front 14

Can a patient return a medication to a pharmacy to be repackaged and redispensed to the same patient?

Back 14

Yes. This is not considered a return.

Front 15

What are the requirements of electronic prescription recordkeeping?

Back 15

-capable of providing a printout of rx data w/i 48 hours
-equipped w/ an auxiliary procedure for dispensing medications during down time

Front 16

How long do prescription records need to be maintained?

Back 16

5 years after the date of the last refill

Front 17

What information needs to be recorded in a prescription dispensing system?

Back 17

-patient ID
-name, strength, dosage form of dispensed product
-quantity dispensed
-all dispensing dates
-prescriber ID
-RPh ID
-retrieval designation

Front 18

Can prescriptions be transferred via fax?

Back 18

Yes, but only if verbally verified between 2 pharmacists

Front 19

How long must transferred prescriptions be maintained?

Back 19

At least 5 years from the date of last refill

Front 20

What information must be recorded when transferring a prescription in?

Back 20

-"TRANSFER"
-name and address of patient
-name, address, and DEA # of prescriber (if controlled substance)
-name, quanitity, and dosage form of medication
-directions for use
-original date of issuance
-original # of refills
-original dispensing date and most recent dispensing date
-refills remaining (and date of previous refills, if controlled substance)
-DEA # if controlled substance
-pharmacy name, address, rx #
-name of pharmacists
-name, address, telephone # of original pharmacy

Front 21

How many times can controlled substance Rx's be transferred?

Back 21

once, unless transferred between pharmacies with shared central processing units

Front 22

What information must be recorded when transferring a prescription out?

Back 22

-"VOID"
-pharmacy name, address, pharmacist name, date, transferring pharmacist name
-DEA # if controlled substance

Front 23

Can answering machines be used to receive prescription orders?

Back 23

Yes, if the voice if the prescriber is recognizable to the RPh.

Front 24

What information must be contained in a medication record system?

Back 24

-patient name
-address of patient
-DOB
-name of drug
-strength of drug
-dosage form
-quantity
-directions for use
-retrieval designation (Rx number?)
-dispensing dates
-prescriber
-allergy information and chronic disease states, if possible

Front 25

How long do medication profile records need to be maintained?

Back 25

Five years unless other documentation source is also used (then just 1 year)

Front 26

Are faxed prescription orders considered electronic or written?

Back 26

generally written
-but depends how generated (if from computer and signed electronically, then it is an electronic rx)

Front 27

T/F: CII medications can be prescribed electronically

Back 27

false

Front 28

When are electronic prescription orders allowed?

Back 28

-order was sent to the pharmacy designated by the patient w/o third party access (other than for relaying rx info)
-order identifies sender's name, telephone #, time and date of transmission, intended pharmacy
-designated as "electronically transmitted prescription"
-contains all normally required information

Front 29

Are electronic signatures acceptable?

Back 29

Yes

Front 30

T/F: electronically received prescriptions should only be visible within the professional pharmacy service area

Back 30

true

Front 31

T/F: electronic orders do not need to be password protected

Back 31

false

Front 32

T/F: automated dispensing systems used by inpatient facilities may be located outside of the institutional pharmacy and inpatient health care facility

Back 32

false

Front 33

What are the requirements of a manager of a community pharmacy before implementing an automatic dispensing system?

Back 33

-assure system is in good working order and is accurate
-implement quality assurance program, with P&Ps
-provide board with notice of installation (including location of installation)
-assign/reassign personnel access to the system
-assure that access to medications complies with federal/state laws
-ensure system is stocked according to P&Ps

Front 34

T/F: the managing pharmacist must notify the PEB if an automated dispensing system will be moved within a community pharmacy

Back 34

false, only when first installing

Front 35

What documentation must a pharmacy maintain on-site regarding its automated dispensing system?

Back 35

-name and address of pharmacy where system is used
-mfgr's name, model, serial #
-description of how system is used
-written quality assurance procedures
-written P&Ps for system operation, safety, security, accuracy, access, and malfunction

Front 36

Where must written P&Ps regarding automated dispensing systems be stored?

Back 36

within the pharmacy responsible for the ADS

Front 37

Describe the records that must be kept by an automated dispensing system

Back 37

-must be electronic
-time and location system accessed
-identification of individual accessing the system
-type of transaction
-name, strength, dosage form, and quantity of the drug accessed
-name of patient drug ordered for

Front 38

Who can stock an automated dispensing system? What type of supervision (general or direct) is required?

Back 38

-qualified personnel under at least general supervision
-unless ADS is in pharmacy, then supervision must be direct

Front 39

How long must ADS restocking records be kept?

Back 39

5 years, including name of person restocking and pharmacist checking for accuracy

Front 40

T/F: automated dispensing systems must be able to account for returned items and wasted items

Back 40

true

Front 41

T/F: remote dispensing sites are registered as pharmacies

Back 41

false

Front 42

T/F: remote dispensing sites are registered as remote dispensing sites

Back 42

false, but most notify board 30 days before opening

Front 43

T/F: remote dispensing sites may display the title "Pharmacy"

Back 43

false

Front 44

Where can remote dispensing sites be located?

Back 44

-health care facilities
-clinics/office of a practitioner
-county jail, rehab facility, state prison, county house of correction
-juvenile correctional facility

Front 45

What must be displayed at a remote dispensing site?

Back 45

Sign stating:
-prescriptions may be filled here
-info for supervising phcy (name, address, telephone)
-pharmacist is requried to talk to you each time you pick up meds

Front 46

T/F: remote dispensing sites can operate if the supervising pharmacy is closed

Back 46

false

Front 47

T/F: remote dispensing sites can dispense drugs if the patient is unable to speak to a pharmacist due to technical difficulties

Back 47

false

Front 48

T/F: remote dispensing sites must have centrally monitored alarms

Back 48

true, personnel must record name, date, time, and purpose for entering after hours and maintain these records for 2 years

Front 49

T/F: remote dispensing sites must comply with all minimum activities for dispensing and labeling requirements

Back 49

true

Front 50

What address is written on the label of a prescription dispensed by a remote dispensing site?

Back 50

address for supervising pharmacy

Front 51

What are the requirements of the managing pharmacist for a remote dispensing site?

Back 51

-have written P&Ps
-quality assurance program to monitor # of Rxs/month, errors per month, diversion, remedial training of staff
-visit the site at least monthly and conduct controlled substance inventories
-retain documentation of visits for at least 2 years

Front 52

What are the technician/intern requirements for remote dispensing sites?

Back 52

18 yo, high school graduate/GED, 1500 hrs work as a technician within previous 3 years or certified as a technician

Front 53

T/F: a central fill pharmacy and the originating pharmacy must be owned by the same person

Back 53

True, unless both pharmacies have a written contract outlining responsibilities of each

Front 54

If not defined by P&Ps, which pharmacy (central fill or originating) is responsible for compliance with compounding and dispensing requirements?

Back 54

originating pharmacy

Front 55

When is it acceptable/unacceptable for a central fill pharmacy to perform profile reviews/DURs/refill authorizations/interventions/drug interactions, etc?

Back 55

only acceptable when both pharmacies share a central processing unit

Front 56

What address is placed on the label of a prescription filled at a central pharmacy?

Back 56

originating pharmacy

Front 57

What date of dispensing is placed on the label of medication filled by a central fill pharmacy?

Back 57

date of fill at central pharmacy

Front 58

Which pharmacy (originating or central fill) maintains the original prescription?

Back 58

originating

Front 59

Which prescriptions do central fill pharmacies keep?

Back 59

records of refill and new rx requests made by originating pharmacy