Who can issue a prescription for a controlled substance?

practitioner of medicine

osteopathy

podiatry

dentistry

veterinary medicine

or by a:

license nurse practitioner

licensed physician assistant

TPA certified optometrist

No prescription shall be filled unless there is a bona fide ______ _______ _____ _______.

practitioner - patient - pharmacist relationship

In order to determine whether a prescription that appears questionable to the pharmacist results from a bona fide practitioner-patient relationship, the pharmacist shall contact the prescribing practitioner or his agent and verify the identity of the patient and name and ______ of the drug prescribed.

quantity

A practitioner may prescribe Schedule VI antibiotics and antiviral agents to other persons in close contact with a diagnosed patient when?

(i) practitioner meets all requirements of a bona fide practitioner-patient relationship

(ii) practitioner deems there is urgency to begin treatment to prevent the transmission of a communicable disease

(iii) when such emergency treatment is necessary to prevent imminent risk of death, life-threatening illness, or serious disability

Note: practitioner doesn't have to meet the requirement of having physically examine the proxie patient.

What are the two examples in which prescription orders can be faxed?

(i) patients or residents of long-term care facilities served by a Virginia pharmacy from a remote location

(ii) patient's receiving parenteral, intravenous, intramuscular, subcutaneous or intraspinal infusion therapy and served by a home infusion pharmacy from a remote location

What is the scenario when a medical technologist can transmit a prescriber's verbal or written order?

If the order is for a radiopharmaceutical

What is an authorized agent of the prescriber?

an employee of the prescriber who is under his immediate and personal supervision, or it not an employee, and individual who holds a valid license allowing the administration or dispensing of drugs and who is specifically directed by the prescriber.

Can a pharmacist dispense a controlled substance from an out-of-state practice?

Yes.

A pharmacist may dispense a controlled substance pursuant to a prescription of an out-of-state practitioner of medicine, osteopathy, podiatry, dentristry or veterinary medicine

Can a licensed nurse practitioner adminster samples of controlled substances?

Yes.

"a license nurse practitioner who is authorized to prescribe controlled substances may issue prescriptions or provide manufacturer's professional samples for controlled substances and devices within the scope of his professional practice."

Can a licensed physician assistant give samples of controleld substances?

Yes.

"A licensed physician assistanc who is authorized to prescribe controlled substances may issue prescriptions or provide manufacturer's professional samples for controlled substances and devices within the scope of his professional practice"

What must intern prescriber's submit with their prescriptions in order for their prescriptions to be valid?

prescription form for the prescribing of drugs for use by medical interns or residents who prescribe only in a hospital shall bear the prescriber's signature, the legibly printed name, address, and telephone number of the prescriber and an identification number assigned by the hospital.

The identification number shall be the Drug Enforcement Administration number assigned to the hospital pharmacy plus a suffix assigned by the institution.

What must be written on the back of a prescription if it is declined for reasons other than drug availablility?

write the word "declined"; the name, address, and telephone number of the pharmacy; the date filling of the prescription was declined; and the signature of the pharmacist

Note: Don't have to record why the prescription was declined!

A prescription may be issued in order for an individual practitioner to obtain controlled substances for supplying the individual practitioner for the purpose of general dispensing to patients. True/False?

False

A prescription may not be issued in order for an individual practitioner to obtain controlled substances for supplying the individual practitioner for the purpose of general dispensing to patients.

A prescription may Be issued for “detoxification treatment” or “maintenance treatment,” unless the prescription is for a Schedule III, IV, or V narcotic drug approved by the Food and Drug Administration specifically for use in maintenance or detoxification treatment and the practitioner is in compliance. TRUE/FALSE?

FALSE!

A prescription may not be issued for “detoxification treatment” or “maintenance treatment,” unless the prescription is for a Schedule III, IV, or V narcotic drug approved by the Food and Drug Administration specifically for use in maintenance or detoxification treatment and the practitioner is in compliance.

A prescription for a Schedule III, IV, or V narcotic drug approved by FDA specifically for "detoxification treatment" or "maintenance treatment" must include the ___________ __________

identification number

Where a prescription is for gamma-hydroxybutyric acid, the practitioner shall note on the face of the prescription the medical need of the patient for the prescription.

Statement. Not a question.

A practitioner may administer or dispense directly (but not prescribe) a narcotic drug listed in any schedule to a narcotic dependant person for the purpose of maintenance or detoxification treatment if the practitioner meets both of the following conditions?

(1) The practitioner is separately registered with DEA as a narcotic treatment program.

 

(2) The practitioner is in compliance with DEA regulations regarding treatment qualifications, security, records, and unsupervised use of the drugs pursuant to the Act.

Can doctors who are not registered with the DEA for narcotic dependence administer scheduled drugs for acute narcotic dependence?

Nothing in this section shall prohibit a physician who is not specifically registered to conduct a narcotic treatment program from administering (but not prescribing) narcotic drugs to a person for the purpose of relieving acute withdrawal symptoms when necessary while arrangements are being made for referral for treatment. Not more than one day's medication may be administered to the person or for the person's use at one time. Such emergency treatment may be carried out for not more than three days and may not be renewed or extended.

A pharmacist may dispense a therapeutically equivalent drug product for a prescriptino that is written for a brand name drug product unless?

(i) the prescriber indicates such substitution is not authorized by specifying on the prescription

(ii) the patient insists on the dispensing of the brand-name drug product

In the case of an oral prescription, the prescriber's oral dispensing instructions regarding substitution shall be followed

See page 315 in the printed book for a discussion on generic drug substitution!

Statment. Not a question.

Prescribers using prescription blanks printed in compliance with Virginia law in effect on June 30, 2003, having two check boxes and referencing the Virginia Voluntary Formulary, may indicate, until July 1, 2006, that substitution is not authorized by checking the "Dispense as Written" box. If the "Voluntary Formulary Permitted" box is checked on such prescription blanks or if neither box is checked, a pharmacist may dispense a therapeuitically equivalent drug product pursuant to such prescriptions.

Statment. Not a question.

A pharmacist muhst inform the patient that a therapeutically equivalent drug was dispensed and must also state on the label "generic for" when dispensing a therapeuitically equivalent drug.

Statement. Not a question.

When dispensing a drug product other than the drug product prescribed, the dispensed drug product shall be at a lower retail price than that of the drug product prescribed. Such retail price shall not exceed the usual and customary retail price charged by the pharmacist for the dispensed therapeutically equivalent drug product.

Definition of Therapeutically Equivalent

means drug products that contain the same active ingredients and are identical in strength or concentration, dosage form, and route of administration and that are classified as being therapeutically equivalent by the United States Food and Drug Administration pursuant to the definition of "therapeutically equivalent drug products" set forth in the most recent edition of Approved Drug Products with Therapeutic Equivalence Evaluations, otherwise known as the "Orange Book"