WASHINGTON MPJE EXAM
COMPREHENSIVE QUESTIONS
ACCURATE ANSWERS
◉ What providers are out of state prescriptions allowed? Answer:
Out of state prescriptions are acceptable. WA allows the following
prescribers who are licensed in any state or US territory, or in
British Columbia, to issue prescriptions for legend drugs that are
valid
in WA. (Note: Canadian prescribers cannot issue prescriptions for
controlled substances unless they are also licensed in the US and
registered with the DEA.)
Physicians (MD, DO)
Podiatrists (PodD, DPM)
Dentists (DDS, DMD)
Veterinarians (DVM)
Nurse Practitioners (ARNP)
Physician Assistants (PA-C)
When licensed in any state, territory, or British Columbia (legend
drugs only from BC)
◉ Who can prescribe from British Columbia? Controlled or legend?
Answer: British Columbia physicians, NPs, and PAs, can prescribe
,legend drugs, but not controlled substances unless have a US-issued
DEA No.
◉ How long are prescriptions for legend drugs valid
from the date issued? Answer: All legend drugs expire after 1 year in
WA
◉ Is there a maximum number of refills allowed for
legend drugs? What is it? Answer: All legend drugs expire after 1
year in WA
Refill PRN = 1 year
Refills must be consistent with directions
If Rx expired, a refill should be treated as a new Rx and given new
number
The full quantity of a prescription refill may be dispensed up to the
last day before the Rx expires
Non-CSA drugs: an emergency supply for up to 72-hours may be
given (see WAC 246-869-100(f))
Refills must be consistent with directions for use and patients
monitored for overuse of drugs
Prescribers cannot delegate refill authorization to a nurse or staff
NQAC has ruled out "refill protocols" for RNs
◉ How long are prescriptions for each of the
,following valid: C-2s, C-3s, C-4s, C-5s? Answer: C2: No expiration
date on Rx under federal law; 6 months in WA
C3-5: May refill up to 5 times within 6 months; Rx expires after 6
months
◉ Is there a maximum number of refills allowed for
C-5s? What is it? Are the number of refills for C-3s
and C-4s the same as federal or less? Answer: C5: No refill limit or
expiration date for Rx under federal law; WA - 6 months from date
prescribed and no more than 5 refills
C3-4: May refill up to 5 times within 6 months; Rx expires after 6
months; federal and state the same
◉ Which of the following must be on the label of an
outpatient prescription:
Pt. address, Quantity, Expiration Date, Lot number,
Name of drug, RPh initials, Technician initials,
Pharmacy telephone number? Other items? Answer: Patient name,
prescriber, dose, directions, expiration date
Complete directions for use ("UD" not valid)
Call for verification as provider, or pharmacist will dispense per
package insert
Expiration date
Quantity dispensed
, Name and strength of drug
Initials of pharmacist (can be in computer system)
"Warning: State or federal law prohibits transfer of this medication
to any person other than the person for whom it is prescribed."
◉ Can the prescribed brand name be placed on the
label when a generic is dispensed? If so, what
wording is required? Answer: Washington requires a two
prescription blank. Substitution permitted is left line, and brand
only is right line.
"generic for ..."
◉ How does a pharmacist determine whether a
particular generic drug is suitable as a substitute
for a brand name drug? Answer: Orange book
May do "Therapeutic Substitution" based on prior authorization
from prescriber
Protocol, formulary
Per-prescription basis
Blanket prior authorization can be verbal, but are required to have
documentation of authorization in the pharmacy
COMPREHENSIVE QUESTIONS
ACCURATE ANSWERS
◉ What providers are out of state prescriptions allowed? Answer:
Out of state prescriptions are acceptable. WA allows the following
prescribers who are licensed in any state or US territory, or in
British Columbia, to issue prescriptions for legend drugs that are
valid
in WA. (Note: Canadian prescribers cannot issue prescriptions for
controlled substances unless they are also licensed in the US and
registered with the DEA.)
Physicians (MD, DO)
Podiatrists (PodD, DPM)
Dentists (DDS, DMD)
Veterinarians (DVM)
Nurse Practitioners (ARNP)
Physician Assistants (PA-C)
When licensed in any state, territory, or British Columbia (legend
drugs only from BC)
◉ Who can prescribe from British Columbia? Controlled or legend?
Answer: British Columbia physicians, NPs, and PAs, can prescribe
,legend drugs, but not controlled substances unless have a US-issued
DEA No.
◉ How long are prescriptions for legend drugs valid
from the date issued? Answer: All legend drugs expire after 1 year in
WA
◉ Is there a maximum number of refills allowed for
legend drugs? What is it? Answer: All legend drugs expire after 1
year in WA
Refill PRN = 1 year
Refills must be consistent with directions
If Rx expired, a refill should be treated as a new Rx and given new
number
The full quantity of a prescription refill may be dispensed up to the
last day before the Rx expires
Non-CSA drugs: an emergency supply for up to 72-hours may be
given (see WAC 246-869-100(f))
Refills must be consistent with directions for use and patients
monitored for overuse of drugs
Prescribers cannot delegate refill authorization to a nurse or staff
NQAC has ruled out "refill protocols" for RNs
◉ How long are prescriptions for each of the
,following valid: C-2s, C-3s, C-4s, C-5s? Answer: C2: No expiration
date on Rx under federal law; 6 months in WA
C3-5: May refill up to 5 times within 6 months; Rx expires after 6
months
◉ Is there a maximum number of refills allowed for
C-5s? What is it? Are the number of refills for C-3s
and C-4s the same as federal or less? Answer: C5: No refill limit or
expiration date for Rx under federal law; WA - 6 months from date
prescribed and no more than 5 refills
C3-4: May refill up to 5 times within 6 months; Rx expires after 6
months; federal and state the same
◉ Which of the following must be on the label of an
outpatient prescription:
Pt. address, Quantity, Expiration Date, Lot number,
Name of drug, RPh initials, Technician initials,
Pharmacy telephone number? Other items? Answer: Patient name,
prescriber, dose, directions, expiration date
Complete directions for use ("UD" not valid)
Call for verification as provider, or pharmacist will dispense per
package insert
Expiration date
Quantity dispensed
, Name and strength of drug
Initials of pharmacist (can be in computer system)
"Warning: State or federal law prohibits transfer of this medication
to any person other than the person for whom it is prescribed."
◉ Can the prescribed brand name be placed on the
label when a generic is dispensed? If so, what
wording is required? Answer: Washington requires a two
prescription blank. Substitution permitted is left line, and brand
only is right line.
"generic for ..."
◉ How does a pharmacist determine whether a
particular generic drug is suitable as a substitute
for a brand name drug? Answer: Orange book
May do "Therapeutic Substitution" based on prior authorization
from prescriber
Protocol, formulary
Per-prescription basis
Blanket prior authorization can be verbal, but are required to have
documentation of authorization in the pharmacy
