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48 Cards in this Set

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Can a physician assistant practice on their own?
No, they are always under the supervision of a licensed physician
Who has prescribing authority, but is always under the supervision of a licensed physician?
Physician Assistants
Can a physician assistant prescribe at their own discretion?
No, they are only allowed to prescribe per a written guideline under supervised care
What conditions must be met in order for a physician assistant to issue a prescription?
1) Issued only in pt situations specified and described in written guidelines, including authorized drug catagories
2) An agreement must be made between the physician and PA stating they are qualified
3) The supervising physician is available for consultation
4) The order is prepared under procedures in this section contain all info required
How often must prescribing guidelines for physician assistants be reviewed?
Yearly
How will a physician review orders prescribed by a physician assistant?
1) Review a selection of the prescription orders prepared by the PA
2) Review a selection of pt records prepared by the PA in the office or facility of the supervising physician
3) Review by telecommunications or other electronic means pt records or orders prepared in an other facility
Why do physicians review prescription orders placed by PAs?
To ensure quality of care
Is there a set time frame for a periodic review by a physician?
No, the supervising physician shall determine the method and frequency of the periodic review based upon the nature of the prescriptive practice, the experience of the physician assistant, and the welfare of the patients.
Per Wisconsin statute, what is required to be on a legible label affixed to the immediate dispensing container?
1) Name & address of facility from which it is dispensed
2) The date on which prescription is dispensed
3) The name of the practitioner who prescribed the drug/device
4) The full name of the patient
5) The generic name and strength of the drug unless the prescriber requests omission
6) Directions for use and cautionary statements contained in the prescription or required by law.
How long must records for controlled substances be kept?
5 years
What must be recorded in a separate log book each time a controlled substance is dispensed?
In chronological order:
1) Name of substance
2) Dosage form and strength of substance
3) Name and address of the person for whom dispensed
4) Date of dispensing
5) Quantity dispensed
6) Name or initials of practitioner who dispensed the substance
What are the number of hours of experience in clinical pharmacology/therapeutics required before the issuing of a certification of an advanced practice nurse prescriber?
45 hours within 3 years preceding the application
What level of education is required before certification of an advanced practice nurse prescriber?
At least a master's degree in nursing or related health field granted by an accredited college or university
What are the requirements for certification as an advanced practice nurse prescriber?
1) Current RN license in this state or another which has adopted the nurse licensure compact
2) Certified by a national certifying body
3) Hold a master's degree in nursing or related health field
4) Complete at least 45 hours in clinical pharmacology/therapeutics within 3 years of application
5) Pass jurisprudence exam
What is required for an application to practice as an advanced practice nurse prescriber?
1) Signature of applicant
2) Fee
3) Evidence of current certification by national certifying body
4) Hold a master's degree or higher in nursing or a related health field
5) Complete at least 45 hours in clinical pharmacology/therapeutics within 3 years of application
What are the CE requirements for advanced practice nurse prescribers?
8 hours per year in clinical pharmacology/therapeutics relevant to their area of practice
How long must advanced practice nurse prescribres keep record of their CEs?
4 years
What are the prescribing limitations for advanced practice nurse prescribers?
1) Issue Rxs only in areas of competence as established by his/her education
2) No Schedule I substances
3) No amphetamine, symopathomimetic amine or Schedule II drug (There are exceptions)
4) N anabolic steroids for the purpose of enhancing athletic performance or other non-medical purposes
Under what circumstances can an advanced practice nurse prescriber authorize a prescription for a schedule II substance?
1) Use as an adjunct to opioid analgesics compounds for the treatment of cancer-related pain
2) Treatment of narcolepsy
3) Treatment of hyperkinesis
4) Treatment of drug-induced brain dysfunction
5) Treatment of epilepsy
6) Treatment of depression shown to be refractory to other therapeutic modalities
What are the additional requirements for writing a prescription for a controlled substance?
Shall be written in ink or indelible pencil or typewritten AND contain the practitioner's controlled substances number
Under what circumstances can an advanced practice nurse prescriber dispense medication?
1) If they are samples and in their original containers or packaging supplied by a pharmaceutical manufacturer or distributor

2) The treatment facility in which the pt is treated is at least 30 miles from the nearest pharmacy
Who has the authority to prescribe in the state of Wisconsin?
1) Physician (MD)
2) Osteopath (DO)
3) Dentist (DDS,DMD)
4) Podiatrist (DPM)
5) Veterinarian (DVM)
6) Optometrist (OD)
7) Advanced Practice Nurse Prescriber (APNP)
8) Physician Assistant (PA)
What are the limits on the scope of prescribing authority for dentists?
Scope of practice - treating conditions of the oral cavity
What are the limits on the scope of prescribing authority for podiatrists?
Scope of practice - treating conditions of the feet
What are the limits on the scope of prescribing authority for veterinarians?
Scope of practice - treating animals
What are the limits on the scope of prescribing authority for optometrists?
Limited by law - administering or prescribing certain medications
What are the limits on the scope of prescribing authority for advanced practice nurse prescribers?
Appropriate to their area of competence, but is not formally outlined
What are the limits on the scope of prescribing authority for physician assistant?
Must abide by written guidelines decided upon by the PA and a physician
Define: "Practitioner"
A person holding a license to practice in their respective field
What did the Durham-Humphrey Amendment accomplish?
1) Created prescription and non-prescription drug classes
2) Legalized verbal transmission of prescriptions
3) Legalized the right to honor refills of prescriptions
Under what authority does the FDA have to classify a drug as prescription only?
1) Unsafe for use except under supervision due to toxicity, method of use or collateral measures necessary to use the drug

2) If the drug is subject to the NDA process
Per Federal Law, what is the minimum required information that must be included on the label of a dispensed drug?
1) Name and address of dispenser
2) Serial/Prescription Number
3) Date of prescription or dispensing
4) Name of the prescriber
5) Name of patient
6) Directions for use (if stated)
7) Cautionary statements (if stated)
What is the term to describe a drug who's label does not meet minimum state or federal requirements?
It is misbranded
By what three methods are prescription drugs transferred to OTC status?
1) The manufacturer may do so by submitting a supplemental application to its approved NDA
2) The manufacturer may petition the FDA
3) The FDA may add or amend an OTC monograph
What is the "third class of drugs"?
Drugs that are held behind the counter and are to be sold only by a pharmacist. Not legally defined, but most often pertains to some Schedule V drugs in some states and Plan B.
What is the minimum age to purchase Plan B?
17 years or older
What is an "off-label use" of a drug?
The usage of a drug for a treatment or condition that is not listed in its official labeling.

While it may not be specifically indicated it, prescriptions for off-label usage is allowed.
What are some examples of "Behind-The-Counter" drugs?
Plan B
Pseudoephedrine
Schedule V Cough Syrup
What is a collaborative practice agreement?
When others may engage in prescribing pursuant to being directed, supervised and inspected by a physician.

Relation to pharmacists: Flu shots in a retail setting
Is prescriptive authority decided at the state or federal level?
State level only
True or False

Per Wisconsin law, records must be maintained for inspection for a time period not less than five years
True
Which amendment legalized oral prescriptions as well as refills?
Durham-Humphrey Amendment
True or False

It's okay to have a BUD that goes beyond the manufactures expiration date?
False
How are BUDs usually determined for labeling on a prescription?
Either expiration date given by manufacturer OR 1 year from date of dispensing

Whichever is shorter
What is a collaborative practice agreement?
This gives a pharmacist the power to start or change drug therapies in collaboration with a physician.

Usually consists of a written contractual agreement listing protocols and procedures and extent of authority can vary.
Define: "Third Class of Drugs"
These are OTC medications that are sold exclusively by pharmacists, typically behind the counter.

Examples include Sudafed, Plan B and Schedule V cough syrup
How old does a patient have to be to purchase Plan B over the counter?
17 years of age with a valid ID
True or False

A 16 year old patient needs a prescription to purchase Plan B
True