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88 Cards in this Set
- Front
- Back
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What is a prescription order?
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(1) Order for medication dispensed to or for the ultimate user (2) Typically used in the out-patient setting
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What is a medication order?
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(1) Order for medication which is dispensed for immediate administration to the ultimate user (2) Typically used in the in-patient setting
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Can prescriptive authority be delegated by the prescriber to an employee or agent of the prescriber?
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NO; A physician's employee/agent CAN transmit/communicate the prescription or refill authorization on behalf of the prescriber (UNLESS state law has specifically granted the person this authority)
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Prescribers in AZ may not write prescriptions for themselves or family members. This is considered _____
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Unprofessional conduct
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Does a PA have prescriptive authority for CS drugs?
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PA = Physician Assistant; Yes with board approval
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Does a RNP have prescriptive authority for CS drugs?
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RNP = Registered Nurse Practitioner; Yes with board approval
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What are the limitations of an NMD?
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No CII except Morphine; CIII-V refills ok; No Cancer or IV or antipsychotic meds
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Does a PDM have prescriptive authority for CS drugs?
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PDM = Doctor of Podiatry; Yes with board approval
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Does a OD have prescriptive authority for CS drugs?
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OD = Doctor of Optometry; Yes but with CIII Analgesics only and with board approval
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Does a DVM have prescriptive authority for CS drugs?
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DVM = Veterinary Doctor; Yes, no board approval necessary but limited within scope of practice
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Does a DMD or DDS have a prescriptive authoristy for CS drugs?
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DMD or DDS = Dentist; Yes, no board approval necessary but limited within scope of practice
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When do prescriptions expire?
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1 year from the date issued
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Can prescription orders issued by a medical practitioner in Canada or Mexico be dispensed?
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Yes as long as (1) The practitioner is licensed by the appropriate licensing board in Canada or Mexico (2) Non-CS drugs only (3) CMMS requires written (NOT faxed) prescriptions to be on tamper-resistant prescription paper
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Whatinformation MUST all prescriptions include prior to dispensing?
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(1) Full name and address of patient (2) Full name, address, and telephone number of the prescriber (3) Date issued (4) Drug name, dosage form, strength, and quantity (5) Directions for use (6) Prescriber's signature - can be manual/electronic/exempt if orally-transmittted Rx (CANNOT be a stamped signature) (7) DEA # if a CS
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Who can accept written prescriptions?
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Pharmacist/Intern/Technician
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Who can accept faxed prescriptions?
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Pharmacist/Intern/Technician
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Who can accept e-prescriptions?
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Pharmacist/Intern/Technician
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Who can accept orally-transmitted prescriptions?
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Pharmacist/Intern
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If a prescription is faxed by a prescriber, where MUST it be faxed from?
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From prescriber practice location (exeption: hospital, LTCF, in-patient hospice)
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Can patients fax prescriptions?
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Yes, but must also bring in the hard copy of the prescription
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Can patients email prescriptions?
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Yes, but must also bring in the hard copy of the prescription
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How many transfers can be done for Non-CS prescriptions?
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Limited to the number of original refills
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Who can make oral transfers of prescriptions?
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Licensed pharmacists/graduate interns/pharmacy interns
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Where can electronic transfers be done?
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Between stores sharing a common database by pharmacists, interns, or techs
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When can a CS electronic transfer be done?
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MUST only happen between two pharmacists
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What MUST the sending pharmacist record for prescription transfers?
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(1) VOID on the face of the transferred prescription, to be kept for 7 years (2) Date of transfer (3) Name of receiving pharmacist (4) Name of sending pharmacist (5) Name of receiving pharmacy (6) Store # or address and phone of the receiving pharmacy (7) DEA # of receiving pharmacy if it is a CS
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What MUST the receiving pharmacist record for prescription transfers?
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(1) All info required on a prescription (2) TRANSFER on the face of prescription (3) Date of transfer (4) Date of issuance (5) Date of first dispensed (6) Original # of refills (7) Number of refills remaning (for Non-CS) and the date/locations of previous refills (for CS) (8) Name of sending pharmacist (9) Name of receiving pharmacist (10) Name of the sending pharmacy (11) Store # or address and telephone number of sending pharmacy (12) DEA # of transferring pharmacy if CS
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All prescription orders must be maintained for a minimum of ____
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7 years from the date of last fill (AZ requirement); Federal requirement = 2 years
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For electronic imaging recordkeeping systems, the prescription image and all associated annotations must be maintained for ____
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7 years from the date last dispensed
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For electronic imaging recordkeeping systems, the original hard copy must be maintained for at least _____
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30 days
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What MUST be documented upon filling/refilling a prescription?
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(1) Date of dispensing (2) Quantity dispensed (3) Name/initials of dispensing pharmacist (4) Name of the drug's/device's manufacturer or distributor if the Rx order is written generically or a substitution is made
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When can a pharmacist fill the prescription order with a generic equivalent drug?
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When a medical practitioner prescribes a brand name drug and does not indicate an intent to prevent substitution
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What is the other name for the FDA Orange Book?
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Approved Drug Products with Therapeutic Equivalence Evaluations
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How often is the FDA Orange Book published?
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Annually with monthly supplements
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What is a pharmaceutical equivalent?
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Drug products that have the same form, route, strength, and active ingredients
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What is a therapeutic equivalent?
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Pharmaceutically equivalent + Bioequivalent
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What is a generic equivalent?
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Term applied to therapeutic equivalent drug products approved for generic substitution
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Describe the TE code
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TE = Therapeutic equivalency (two-lettered system); Drugs under the same heading with the same equivalence code are considered generic equivalents
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According to the TE code, what does AA mean?
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Drug in conventional dose forms, no equivalency problems
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According to the TE code, what does AN mean?
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Solution and powders for aerosolization with no known equivalency problems
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According to the TE code, what does AO mean?
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Injectable oil solutions with no known equivalency problems
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According to the TE code, what does AP mean?
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Injectable aqueous solutions with no known equivalency problems
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According to the TE code, what does AT mean?
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Topicals with no known equivalency problems
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According to the TE code, what does AB mean?
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Drugs meeting necessary bioequivalence requirements
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According to the TE code, what does BC mean?
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Time-release drugs with bioequivalence issues
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According to the TE code, what does BT mean?
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Topicals with bioequivalence issues
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According to the TE code, what does BX mean?
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Insufficient data to determine therapeutic equivalence
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According to the TE code, what does B* mean?
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No determination of equivalence made, unresolved questions
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What products may be substituted in AZ?
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A or AB-related products (However, it is also possible to allow substitutions of drug products that are not listed in the Orange Book as long as they satisfy substitution requirements)
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What regulates DUR?
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DUR = Drug Utilization Review; OBRA '90 and State Law
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During DUR, what is the purpose of documentation?
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(1) Serve as a reminder to the RPh writing the information (2) Provide info for other pharmacists working in the same pharmacy (3) Show a record of what was done, so that someone may be able to connect an action with an outcome (4) Show that OBRA '90 and state law requirements are being met
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What are required on outpatient pharmacy labels?
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(1) Pharmacy name and address (2) Dispensing pharmacist's initials (3) Rx number (4) Patient name (5) Prescriber's name (6) Directions for use and any cautionary statements contained in the prescription order (7) Date of dispensing (Include the date of the current fill and the date of the initial fill for refills)
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What are required on outpatient pharmacy labels for compounded products?
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(1) Pharmacy name and address (2) Dispensing pharmacist's initials (3) Rx number (4) Patient name (5) Prescriber's name (6) Directions for use and any cautionary statements contained in the prescription order (7) Date of dispensing (Include the date of the current fill and the date of the initial fill for refills) (8) Beyond use date (9) Statement or symbol designating a compounded pharmaceutical product
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What are required for a compounded product designated For Office Use Only?
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(1) Beyond use date (2) Statement or symbol designating a compounded pharmaceutical product (3) Pharmacy telephone (4) Pharmaceutical product's name (5) Lot/control number (6) The statement Not For Dispensing (7) The statement For Office or Hospital Administration Only
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What are required for Inpatient pharmacy labels (inc LTCF) for unit-dose packages?
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(1) Drug name, strength, and dosage form (2) Lot number and beyone use date (3) Appropriate auxiliary labels
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What are required for Inpatient pharmacy labels (inc LTCF) for repackaged preparations?
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(1) Drug name, strength, and dosage form (2) Lot number and beyone use date (3) Appropriate auxiliary labels (4) Mechanism to identify pharmacist accountable for repackaging
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What are required for Inpatient pharmacy labels (inc LTCF) for intravenous admixture preparations?
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(1) Patient's name and location (2) Name and quantity of the basic parenteral solution (3) Name and amount of drug added (4) Date of preparation (5) Beyond use date and time (6) Guidelines for administration (7) Appropriate auxiliary label or precautionary statement (8) Initials of pharmacist responsible for admixture preparation
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Are child-resistant packaging required in institutional settings?
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NO; not required where the medication will be dispensed by a licensed health care professional
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What does Shared order filling mean?
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Preparing, packaging, compounding, or labeling an order, or any combination of these functions
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What does Shared order processing mean?
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Interpreting an order, performing order entry verification, DUR, drug compatibility and drug allergy review, final order verification, and when necessary, therapeutic intervention, or any combination of these order processing functions
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What does Shared services mean?
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Shared order filling or shared order processing, or both (may be provided outside of a pharmacy - i.e. pharmacists that work from home)
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What are the requirements for shared service providers?
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Participating pharmacies MUST meet one of the following: (1) Same owner (2) Written contract (3) Shared prescription database
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What is needed to dispense in institutional settings?
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Medication order from an authorized medical practitioner [exemptions: (1) A facility that does not have a 24-hour pharmacy while pharmacy is closed (2) In an emergency when pharmacy is closed, supervisory nurse is allowed access]
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Is a patient allowed to self-administer medications in an institutional setting
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NO, unless allowed specifically by medical practitioner and patient is given proper training beforehand
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When is an oral consultation required?
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(1) New drug for the patient (2) Change in drug - strength, directions, etc (3) Requested by patient (4) Professional judgment warrants a consult
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What is REMS?
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REMS = Risk Evaluation and Mitigation Strategies; FDA may require a manufacturer to employ special procedures for certain drug products aimed at improving patient safety; These procedures typically involve pharmacists by requiring them to dispense additional information to the patient or verify the patient's health status prior to dispensing the medication
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Failure by a pharmacist/pharmacy to comply with REMS requirements constitutes _____
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Misbranding
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What are PPIs?
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PPI = Patient Package Inserts; Informational leaflet for patients regarding medication uses, risks, and precautions
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When are PPIs required?
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For all oral contraceptive drugs and estrogens; Pharmacists in community pharmacy must dispense a PPI each time the medication is filled/refilled; Pharmacists in an institutional pharmacy must dispense a PPI once prior to administering the first dose and once every 30 days thereafter
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When are Medication Guides/MedGuides required?
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For specific drugs posing a serious and significant concern; Pharmacists must dispense a MedGuide each time the medication is filled/refilled
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What are MedGuides?
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Informational leaflet for patients including indications, contraindications, serious adverse reactions, proper use, cautions, and other general information
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What are examples of REMS?
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(1) PPI (2) MedGuides (3) Risk Management Programs
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Can a drug product dispensed to a patient be returned for resale?
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Yes, if the pharmacist determines that: (1) The drug is in its original, manufacture's, unopened container (2) The drug or its container has not been subject to contamination or deterioration
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Can a device be returned for resale?
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Yes, if the pharmacist determines that: (1) The device is inspected and free of defects (2) The device is rendered incapable of transmitting disease (3) If resold or reused, the device is not claimed to be new or unused
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How can a drug be returned and redispensed in a LTCF?
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If the pharmacist determines that: (1) The drug has been stored in compiance with the official compendium (2) The drug is not obviously contaminated or deteriorated
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For adult immunizations, are prescriptions required?
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NO [exeptions: rabies, Japanese encephalitis, yellow fever, typhoid]
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What is required in order to administer adult vaccinations?
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(1) MUST be a licensed pharmacist (2) MUST be certified by ASBP to administer vaccines (current/unrestricted license, training program, CPR-certified) (3) CE for Immunization - biennially from date received, 2 hours (0.2 CEU) related to immunizations
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Can a pharmacist administer epinephrine or diphenhydramine?
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Yes, but only in an emergency, and if the pharmacist is licensed and certified
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A VAR (Vaccine Administration Record) must be sent to the PCP within _____ of administration
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48 hours
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Where MUST a report of the vaccination administration must be submitted?
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Arizona State Immunization Information System (ASIIS)
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Immunization adminiistration records must be maintained for ____ from immunization administration date
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7 years
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What is another name for Drug therapy management?
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Collaborative Practice Agreements
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What is Drug therapy management?
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With a written protocol, approved by a supervisory physician, a pharmacist may be allowed to assess a patient's status, order, and interpret, modify, implement, and monitor a patient's drug therapy
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What are qualifying sites for Drug therapy management?
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(1) Acute care hospital (2) Nursing care institution (3) Staff model HMO (4) Nonprofit community health center
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Who and when MUST every agreement for Drug therapy management be done?
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ASBP and renewed annually
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What are the pharmacist requirements for Drug therapy management?
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Must meet one of the following: (1) Completion of a pharmacy practice residency accredited by ASHP or APhA (2) Current Board of Pharmacy Specialties (BPS)) certification (3) Current Certified Geriatric Pharmacist (4) ACPE approved certification in each area of practice covered in agreement; Pharmacist must complete 0.6 CEU (6 hours) of CE in each area of practice covered in the agreement every year
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What are Consultant pharmacists NOT responsible for within LTCF?
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Dispensing of medication from a provider pharmacy
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Within LTCF, it is the Provider pharmacist's responsibility to evaluate emergency prescription drug orders within ____ of the first administration
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72 hours
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