MPJE NY EXAM QUESTIONS AND 100% CORRECT ANSWERS RATED A+

MPJE NY EXAM QUESTIONS AND 100% CORRECT ANSWERS RATED A+ “Waiting period for MPJE after failing - CORRECT ANSWER 30 days" "Adjusting drug regimen shall not... - CORRECT ANSWER include substuting or selecting a different drug which differs from that initially prescribed by pt's physician unless substitution is authorized in order or protocol." "RPH can make changes to pt's drug therapy - CORRECT ANSWER IF authorized in protocol" "Ordering or performing route patient monitoring fxns - CORRECT ANSWER may be necessary in drug therapy management." "OTC drugs that require CRC - CORRECT ANSWER 1) APAP 2) ASA / Ibuprofen / ketoprofen / naproxen 3) Dibucaine 4) Diphenhydramine 5) Ethylene glycol > 10% 6) Glue removers containing acetonitrile 7) Human rx drugs 8) Lidocaine 9) Loperamide 10) Methyl salicylate liq > 5% 11) Methyl alcohol 12) Mouthwash w/ 3g or more of ethanol per pckage 13) Perm wave neutralizers w/ Na bromate or K bromate 14) Petroleum distillates Can market one size container w/o cap if it states: for households without young children." "If package not child resistant must state: - CORRECT ANSWER -This package is for households w/o young kids -Package not child resistant" "CRC Waivers - CORRECT ANSWER -Pt can do req for individual rx or do blanket waiver for all -MD can only do Non-CRP for one at a time, no blanke. ***MUST DOCUMENT WAIVER REQUESTS." "MUST HAVE Tamper-resistant seals OTC - CORRECT ANSWER All non-rx drug products -Contact lens, tabs -Cosmetic liquid oral hygiene products -Cosmetic vaginal products" "Exceptions for tamper-res for OTC - CORRECT ANSWER -Derms -Dentrifrices -Insulin -Throat lozenges -OTC administered by HCP in hospitals -OTCs in vending machines -Prodts via mail, package delivery service etc" "Emergency - CORRECT ANSWER 1) Alleviate severe pain. 2) Threaten disability. 3) Take life if not treated." "Dosage forms not interchangeable - CORRECT ANSWER EC tabs CR products Injectable susp suppositories different delivery systems for aerosol and nebulizer drugs" "Orange book - CORRECT ANSWER A_ = no bioeq problems// B_= docuemented bioequivalence problems!! /// BX = insufficient data /// O = oil solns // T = topical, C = tabs, caps, D = active ing and dose form, E = delayed release oral, N = aerosol neb delivery system, R = suppository or enema, S = standard deficiencies" "RPH doesnt have to sub if: - CORRECT ANSWER 1) RPH dispense brand at generic price. 2) Medical emergencies when generic not available. 3) no equivalent exists." "Sub issues - CORRECT ANSWER Pt can't request brand if DAW not written = RPH must calls MD to get auth... NYS Generic sub law doesn't apply to RX's written and filled out of state or vitamins. Applies to NURSING HOMES." "EPIC (Elderly pharmaceutical insurance coverage) - CORRECT ANSWER -Changed lower half of rx blank, prescriber not liable for poor prod, must inform PT that Rx is generic, and indicate in order order - brand or generic? /////// Dispensing = cannot waive or reduce copay, quantity limited to 30 days or 100 dosage units, must be filled in NYS. Claim higher fee, must make emergency delivery at no cost to consumer!" "EPIC Higher Fee - CORRECT ANSWER 24 hour emergency rx service, medical emergency delivery service at no charge to patient (5 miles), pt drug profiles maintained for all pts, direct pt consultation with every Rx." "NYS Medicaid Mandatory Generic Program - CORRECT ANSWER Encourage prescribers to give A rated generics. If want to give BRAND< must call 24 hour prior authorization call line and answer questions for reason. MUST WRITE ON THE FACE OF RX: 1) Prior auth # 2) DAW in box 3) Words: Brand necessary or brand medically necessary in handwriting. -------RPH must call number and validate. GOOD for 6 MONTHS." "Exempt products from mandatory Medicaid Program - CORRECT ANSWER Coumadin // Gengraf, sandimmune, neoral // clozaril, tegretol, dilantin, zarontin // lanoxin, levothyroxine" "Poison - CORRECT ANSWER Drug, chemical, or preparation likely to be DESTRUCTIVE to adult human life in quantity of 60 GRAINS OR LESS.... Schedule A = arsenic, atropine, chloral hydrate, strychnine, hydrocyanic acid.... Schedule B = belladonna, ergot, digitalis, chloroform, mineral and oxalic acids" "Poison label - CORRECT ANSWER Name of article, word POISON, name and address of seller. ALL IN RED!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!`" "Poison Register - what required? - CORRECT ANSWER 1) Date of sale. 2) Name or address of purchaser. 3) Name and quantity of substance. 4) Purpose of purchase. 5) Name of dispenser. Must keep records for 5 years." "Drug Prices - CORRECT ANSWER 1) Retail price list in all pharmacies reg by NYS, must provide to any person upon request. 2) Posted sign near cmpding and dispensing, waiting area, etc 3) Contain 150 most freq prescribed drugs 4) Not unit price list 5) Price must be price charges 6) Prices updated every week 7) Must state = consult your RPH for te selection of the most economical drug product available to fill your MD's RX. 8) Hospitals not exempt from this. 9) Pharmacy may change current selling at any time." "Unprofessional conduct with advertising - CORRECT ANSWER False / Intimidation / Testimonials / Professional superiority / Unsubstantiated claims / Guarantees / Offer bonuses // Also RX blanks with pharmacy name (NO!), or refusing to quote price of written RX" "Daily log must contain - CORRECT ANSWER 1) Name of prescriber 2) Name of pt 3) Sig or initials of RPH who filled 4) Rx number" "Electronic data processing - CORRECT ANSWER 1) Printout must list both new and refilled Rx's 2) Refills must be identified with initials o fRPH 3) Log must be signed by RPH 4) Refills for non-CS drugs dont have to be recorded on back of original rx" "Verbal order for refills must include what? - CORRECT ANSWER 1) Date 2) Time 3) Initials of RPH or intern 4) Name of authorizing practitioner. ***Date of refill and RPH / intern initials must appear on back of RX." "Partial fill requirements? - CORRECT ANSWER 1) Req'd by pt 2) Needed to comply with insurer's restrictions ***Providing some when OOS doesnt count." "What cant be transferred? - CORRECT ANSWER 1) CONTROLLED SUBSTANCES. 2) MEDICAID RXS ***Can only do one refill at a time, per patient request ONLY. If another transfer expected, must call again. Can pick full RX at original pharmacy." "Prohibited activities for unlicensed persons? (only RPH or intern can do) - CORRECT ANSWER -Received oral rx -interpret rx -make determination of therapeutic equivalence -measure, weight, cmpd or mix ing -counsel -sign or initial record -perform fxns requiring professional judgment" "Registration is valid for - CORRECT ANSWER one address only" "30 days notice to board when: - CORRECT ANSWER 1) change of location 2) change of corporate officers 3) change in corporate stock greater than 10%" "What utensils must pharmacy keep? - CORRECT ANSWER 1) weigh device senstive to 6mg 2) metric wts if needed for operation of weighing device 3) devices to measure from 0.1ml to 500ml 4) mortar and pestle." "renew registration every - CORRECT ANSWER 3 years." "Registration - CORRECT ANSWER Must be displayed. SP's name posted on store registration. Owner and SP have equal responsiblity for conduct of pharmacy." "nursing homes, etc can return meds if for reuse if? - CORRECT ANSWER can use single dose sealed oral or parenteral meds, unused multiple dose parenteral meds, or blister packs if = 1) no sign of deterioration 2) NMT 90 days since repacked 3) original date, expn date and lot # still on pkg 4) can't empty partials back into orig bottles 5) No bulk drug in dispensing container can be returned 6) no controls can be returned 7) pharmacy must reimburse purchaser ****Blister packs must contain -Date when repacked, lot number, exp date." "How must drugs be repackaged in a pharmacy? - CORRECT ANSWER Only under pharmacist supervision labels must be good to ID drug Must keep a repacking record" "What's the exp'n date of repackaged? - CORRECT ANSWER For in house use only Max of 6 months of 25% of expn date on bottle, whatever is less." "What must be in repacking record? - CORRECT ANSWER 1) Name of drug 2) Strength of drug 3) Date of repacking 4) Name of manu/distribitor 5) Lot # of drug repackaged (from manu/dist) 6) Quantity of drug repackaged (from manu/dist) 7) # of packages prepared 8) Number of dosage units per package 9) Exp date 10) Sig of repacker 11) Sig of RPH supervising activity" "Outdated drugs - CORRECT ANSWER -Cant sell, cant remove exp date, must be segregated from regular stock. Last day of month is exp date." "Nuclear pharmacist - CORRECT ANSWER -meet minimal stds of training by APHA, and certified -complete 200 hrs of instruction -500 hrs of clinical training" "Nuclear pharmacy must be equipped with - CORRECT ANSWER 1) laminar flow hood 2) dose calibrator 3) exhaust hood and filter system 4) chromatography apparatus 5) pH apparatus 6) scintillation detection system 7) microscope" "OBRA 90 (omnibus budget recon act) - CORRECT ANSWER 1) manu rebates to state medicaid programs 2) mandatory DUR 3) gov sponsored demonstration projects Requires active resolution of detected problems --Screen RX's prior to dispense --Pt counseling by RPH --RPH documentation of relevant info" "Oral auth (non-CS)? What must RPH do? - CORRECT ANSWER -Reduce RX to writing -Dispense conforming with label req's -Make effort to verify their identitiy." "Pharmacy as a distributor - CORRECT ANSWER May distribute up to 5% of annual GROSS sales of CS to -Neighbor pharmacy if they give you DEA -Auth prescribed if they give you form -Sell back to manu/wholesaler." "DEA 222 form - who keeps what? - CORRECT ANSWER Copy one / two mailed to supplier by purchaser. Copy one = retained by supplier. Copy two = mailed to DEA Copy three = retained by purchaser." "Discontinue pharmacy business. What to do? - CORRECT ANSWER -Surrender DEA reg, and unused DEA form 222 -Must send letter showing: DATE CLOSED, DISPOSITION OF CS, and LOCATION of invoices, files, and records." "DEA Form 222. How long for supplier to make shipment? - CORRECT ANSWER 60 days. Receiver of drugs must record amt received and date." "What if you make error on DEA Form 222? - CORRECT ANSWER Void all copies, and keep on file. Only SUPPLIER may void a single item on form, not purchaser. Only SUPPLIER can cancel the order. Purchaser cannot cancel single items or cancel order." "DEA Cancelled - d/t revocation, surrender, delinquency, death... - CORRECT ANSWER REFILLS NOT AUTHORIZED. If you refill when not valid, its VIOLATION" "DEA CS Inventory - CORRECT ANSWER -Q2 years -Sched 2 separate from 3-5 -Signed by person doing it -Records maintained ON PREMISES for 5 yrs" "How to do audit - CORRECT ANSWER 1) Time period since last inventory 2) Calc quantity of each CS (quantity of inventory + quantity purchased) 3) Substract quantities sold (from rx's filled, from destruction records, from returned subs records) 4) Get difference." "Don't employ any person who - CORRECT ANSWER Convicted of a felony regarding CS" "All CS RX should be - CORRECT ANSWER -Dated, signed on day issued -Have name, addy of pt -Drug name, strength, dose form, quantity Directions -Name, addy, reg # of the MD" "CS RX - CORRECT ANSWER -Must be filled within 30 days of date written, signed -Can be written for no more than 30 days -RX's written of drugs for CII, steroids, and diazepam MAY NOT BE REFILLED -Other CS by MD but not more than 6 months, and not more than 5 refills -No RX can be refilled sooner than 7 days -If request early refill d/t change in directions, must get NEW RX or RPH must get ORAL RX" "Partial dispensing for Sched II - under federal law - CORRECT ANSWER -Make notation on FACE of RX of quantity -Advise prescriber -Supply med w/i 72 hrs. If not, then balance cancelled, then tell MD and pt." "Partial dispensing of Sched II in LTCF or Terminally Ill - CORRECT ANSWER -May be partially filled for 60 days -Med dx documented as: terminally ill or LTCF pt" "Each partial fill recorded on back of RX must have - CORRECT ANSWER 1) Date of partial fill 2) Quantity dispensed 3) Remaining quantity 4) ID of RPH" "CS RX Notes - CORRECT ANSWER -Legit medical purpose -One RX per blank -No CS Rx's prepared prior to exam -Issued to practitioner with DEA" "Patient Assistance Program - CORRECT ANSWER -Designed to be pt specific -Reimburse pharmacies for dispensing meds for those who cant afford meds -Voluntary program for all parties" "Purpose of Issue of CS RX - CORRECT ANSWER Responsibility for legit prescribing and dispensing shall be on prescriber and corresponding liability shall rest with RPH that fills it." "Sched II Drugs - CORRECT ANSWER -Cannot be refilled -May not be prescribed for weight loss -Maintain on file for 5 years -Cannot use another's blank." "Pharmacist Test Area - CORRECT ANSWER When rubbed - heat sensitive ink will fade from blue to clear to verifiy its authentic." "RX Files - CORRECT ANSWER -Non CS (syringes and needles) -CS for drugs in Sched II (steroids and chorionioc gonadotropin) -CS for drugs in Sched 3-5." "CS RX (Requirements for ORAL) - Information Required - CORRECT ANSWER -Prescriber's name, addy, dea, # -Pt name, and addy -Name quantity and directions of drug -RPH's initials or sig -Date of oral order -Generic sub (Yes or no?) -Notation (telephone order) Physician or RPA Info -Name -Addy -Telephone" "Sig requirements for CS - CORRECT ANSWER -Physician name (imprinted, handwrite, stamp) -RPA's name, imprinted or stamped -RPA's sig, f/b RPA written -RPA's license # -RPA's DEA #" "Dispensing Requirements for CS - CORRECT ANSWER -Date, RX #, and RPH's sig -Label as required for CS -Good effort to identify prescriber" "Follow up RX - when received RPH must - CORRECT ANSWER Write on the FACE of the RX -RX Number -Date of filling -Their signature -State that it is F/U. ON THE BACK -Follow up RX to oral order ___(RX #), oral order filled on _____(date), written RX received ____ (date). ****Oral order must be attached to F/U RX and filed with Sched 3-5." "When F/U RX NOT RECEIVED - CORRECT ANSWER Record on back of oral order - written RX not received with DATE and NAME of pharmacist. ***MUST notify NYS Bureau of CS in writing in SEVEN days. DEA must be notified too (time period not stated)." "F/U RX"s must include the statement either written or typed upon the FACE of RX - CORRECT ANSWER Authorization for emergency dispensing." "Copies of ALL F/U RX must be sent to - CORRECT ANSWER Bureau of Computer Operations the following month." "CS Drugs (pg 97) - CORRECT ANSWER -Amobarbital and salts (Amytal) -Anabolic steroids -Cocaine -Dihydromophinone -Methamphetamine (Desoxyn) -Numorphan Oxymorphone (Numorphan) -Opium Tincture -Pentobarbital and salts (Nembutal) -Seconal (Rectal injection) - secobarb -Tuinal pulvules - secobarb and amobarb -Tylox - oxycodone and APAP -ALL BZDs (librium too) Steroids -Androderm -Testoderm -Cmpds containing it -Methyltestosterone (Testred) -Fluoxymestrone (Halotestin)" "EXEMPT from C2 - CORRECT ANSWER Growth hormones - humatrope, serostim, protropin Other hormonal products (Estratest, estratest HS, premarin with methyltestosterone) - estrogen and methyltestosterone." "Anabolic Steroids - CORRECT ANSWER NYS: 2, Fed: 3 Includes - all cmpds, mix, prep inany amt EXCEPT - implants to NON-humans species." "Exemption for Anabolic Steroids - CORRECT ANSWER -May be Sched 3-5 if *Another active ing added (not C2) *Reduce potential for abuse. May write for six months (180 days) if medical condition is noted on the FACE of the RX===== Hormone deficiency in males Gyne conditions responsive to tx with steroids Metastatic breast CA in women Anemia and angioedema" "Emergency? For C2 - CORRECT ANSWER -Immediate admin necessary -No alternative tx -No way to write RX now" "In C2 emergency, RPH MUST - CORRECT ANSWER 1) Reduce to writing 2) Good effort to verifiy prescriber and user 3) NO MORE THAN 5 DAY SUPPLY. 4) F/U needed by prescriber in writing, and receive in 72hours. If not --> tell DOH in writing within 7 days. FEDERAL LAW states *F/U postmarked within 72 hrs, tell DEA. *Must attach F/U to oral order." "Is it RPH's responsibility to determine if real emergency? - CORRECT ANSWER NOPE, its MD's business" "Prescriber dispensing - CORRECT ANSWER -MD keep copy for 5 years -Label and container requirements the same as pharmacy except 1) no serial # required 2) Must include MDD on label 3) Must have address, phone number of prescriber." "Sched 3-5 Written MUST HAVE - CORRECT ANSWER Patient - name, addy, age Prescriber - name, addy, dea #, telephone, signature, profession, registration # Drug - name, strength, quantity, directions, MDD, date, dosage form." "Sched 3-5 - CORRECT ANSWER -Filled no more than 30 days -Valid for 30 days since date written -Filed separately -Maintain 5 years -Refills NTE 5, written within 6 months -Cannot refill no earlier than 7 days" "EXCEPTION to 30 day rule on ALL SCHEDULES - CORRECT ANSWER Can give up to 90 days. (or 180 for steroids or HCG) as long as DIAGNOSIS CODE Is written on RX by MD A = panic disorder B = minimal brain dysfxn - adhd, hyperkinesis C = conclusive disorder - chronic debilitating neuro condition char by movement disorder or sz's D = relief of pain in pts suffering from dx's that's chronic and incurable E = narcolepsy F = hormone deficiency in males, gyne conditionsn responsive to tx with steroids, metastatic breast CA in men/women, and angioedema" "ONE REFILL ONLY FOR - CORRECT ANSWER Sched 3-5 if prescriber specifies a refill (for those 31-90 day supply stuff)" "Written F/U for C3-5. - CORRECT ANSWER Attach to oral ones. Endorse FACE UP -Follow up to prior oral order -Date filled -Rx no -RPH Sig Endorse on BACK -Follow up rx to oral order -Date received -Date filled -Rx number" "Written F/U For C3-5 Difference with C2 - CORRECT ANSWER If no F/U RX, DO NOT NEED TO REPORT TO DOH. After 72 hrs, just record: Written rx not receivd Name of RPH Date recorded. ****6 month/5 refills ***If written rx differes from oral, must consider it as a new rx, that doesnt cover the oral one." "Summary of CS Regulations - 107 - CORRECT ANSWER Up to 90 day exception refils (1 refill) - for C3-5, EXCEPT for BZDs Up to 180 days - for CII anabolic steroids, no refills. Oral Rx's max quantity: C2, C3, C5 = Max of 5 days for emergency. C4 = Up to 30 days or 100 dosage units, whatever less Oral Rx's = NO REFILLS." "Required on RX number - - CORRECT ANSWER RPH's sig, date, rx number" "What is required for C3-5 RX? - CORRECT ANSWER Same as C2 but sex of pt not required." "What CANT be filled by RPH? - CORRECT ANSWER -MD signature or addy -Date -CS name or quantity -Name of pt" "What CANT be changed by RPH? - CORRECT ANSWER -MD sig -Date -CS name -Name of pt" "CIV MAXIMUM QUANTITY FOR ORALS - CORRECT ANSWER Up to 30 days - max 100 dosage units. Others are 5 days" "Oral Review - CORRECT ANSWER Max quantity *5 days for emergency ONLY: steroids, CIIs, BZDs *5 days supply = CIII, CV *Up tp 30 days/100dose = CIV ------------------------------------- Must report if no F/U RX = CII (+steroids), BZDS Don't have to report = C3-5 ... Basically, steroids and BZDs treated as C2" "Federal Caution label (orange) - C2-C4 only - CORRECT ANSWER Caution: federal law prohibits transfer of this drug to any person other than the pt for whom it was intended." "State caution label for All CS in NYS - CORRECT ANSWER Controlled substance, dangerous unless used as directed." "Info required on LABEL of CS - CORRECT ANSWER 1) Name and addy of pt 2) Name of prescriber 3) Name, addy, telephone # of pharmacy 4) Name / strength / directions of drug 5) Rx number 6) Date filled 7) If for animal, indicate species and owner." "RPH CANT add to C3-5 - CORRECT ANSWER -Sig of prescriber -Date -name of drug -quantity -name of pt -printed name of prescriber -legend, line, and box -daw -dose form" "RPH can add - CORRECT ANSWER -address of pt -age of pt -directions -address of prescriber -telephone of prescriber -profession of prescriber -dea of prescriber -reg number of prescriber -strength" "Destruction in INSTITUTION - CORRECT ANSWER May destroy if 1) notation made on record sheet 2) witness by RPH, RN or other" "Destruction in RETAIL - CS - CORRECT ANSWER 1) Return to manu where bought (full only) 2) Return to someone w/ authority to destroy 3) Destroy in presence of RPH, RN ***Must have inventory of substances to destroy, must request to DOH TWO WEEKS prior to date. ***DOH may refuse based on ur hx ***Destroy only after you get permission. If DOH refuses, you surrender. 4) Surrender CS to DOH on rewuest forms (no needles or syringes, CS pkged separately. 5) May surrender CS to DEA" "Can investigators accept CS? - CORRECT ANSWER No." "Samples of CS permitted? - CORRECT ANSWER Yes" "NYS versus Federal for Schedules p. 125 - CORRECT ANSWER Steroids (androterm, fluoxymsterone): NYS: 2, Fed: 3 HCG: NYS: 3, Fed: Not controlled. Butorphanol. NYS: 5, Fed: 4 Hydrocodone: NYS: 2, Fed: 3 Tramadol: NYS: 4" "HSN (hypodermic syringes and needles) - RX MUST HAVE: - CORRECT ANSWER Patient - name, addy, age Prescriber - name, addy, telephone, profession, reg #, and signature" "Refilling needles/syringes - CORRECT ANSWER Lasts no longer than 2 years from date written" "For HSN, law doesnt require a - CORRECT ANSWER -Specific size of syringe/needle -Quanty -Directions -DEA" "Must RECORD on RX for HSN - CORRECT ANSWER On FACE of RX, for ORIGINAL FILLING = -RPH sig -Date of filling -Rx number on BACK of RX, for REFILLS = -RPH sig -Date of refill -Quantity dispensed" "Who can use HSN w/o RX for use within scope of practice - CORRECT ANSWER 1) Physicians 2) Dentists 3) Podiatrists 4) Pharmacists 5) Residents MD or interns 6) Nurses 7) Hospitals 8) Sanitariums 9) Clinical Labs 10) Medical institutions 11) MFGHS or dealers in medical supplies 12) Certified personell to euthanize dogs/cats 13) Vets 14) Undertakers" "Must need WRITTEN auth for use of HSN? - CORRECT ANSWER -Commercial activities -Industrial -Agricultural -Educational **Must be authorized by commission of health." "HSN - DOH/BCS Info - CORRECT ANSWER -Devices, not drugs -Need Rx blank - have pt's addy/age, and prescriber's addy and telephone (not missing, dont get from record) -Upon FILLING, need SIGNATURE, QUANTITY, and DATE on face -No LIMIT on quantity -Can be on same RX w/. others except CII and BZDs -Retain record 5 years -No orange label can be atached -Refills max of TWO YEARS. -Emergency ORAL orders: NMT 100 HSN with written F/U within 72 hrs. Must endorse on F/U RX FACE with SIG, DATE, and RX NUMBER. On Back write: "FlU RX to oral order _____, filled on ___. Written Rx received on _____. ****NO REFILLS permitted for emergency ORAL rx" "HSN Oral orders must have? - CORRECT ANSWER -Name -Addy -Syringe type -Quantity -Directions -Document that its oral" "HSN Program - CORRECT ANSWER - > 18 years or older may get 10 or less HSN w/o RX -Those under 18 OR want more than 10 --> need RX -Pharmacies that want to be in HSN must register and abide by safe disposal of waste. -Can't advertise program w/o RX, but may advert for HSN requiring RX ...... -Providers of HSN must make circular explain: proper use of HSN, blood born dx, proper disposal, danger of IVDA, how to access drug tx, info bout HIV/AIDs. -NO RECORD KEEPING REQUIREMENTS FOR FURNISHING WITHOUT RX, but DOH wants VOLUNTARY REPORTING for evalulation." "ESAP - Expanded Syringe Access Demonstration Program? - CORRECT ANSWER -Pharmcies, HCF, HCP may register to sell/furnish up to TEN HSN to 18> years pts w/o RX. -To accept sharps under ESAPmust register for this. -Registration for those with good standing --> need complete reg form, agree to abide by laws, how they will participate in safe disposal, and a sig. -Similar to the HSN Program." "US Postal Regulations - Drugs. - CORRECT ANSWER CS - narcotic, hallucinogen, stimulant, depressant Sched 1-5 under CSA Narcotics - defined under CSA - opium, cocaine, opiates Non-Narcotic CS - MAY be mailed from practitioner to user POISONS - CANNOT be shipped w/o permission of postmaster. Alternatives - any drug req'ing Rx may be mailed authorized to receive it." "What CANT you mail? - CORRECT ANSWER -Poisons - need permission first -Flammable substances (acetone), and alcoholic beverages" "What requirements for mailed meds? - CORRECT ANSWER -Must be in plain outer container or securely overwrapped in plain paper. -Must be markings on outside wrapper/container that indicate THE NATURE OF THE CONTENTS." "SAMHSA - SA and Mental Health Services Administration - CORRECT ANSWER -Can provide maintenance tx to established and stable pts in office setting away from clinic. -Registration signifies them as Narcotic Tx Program (NTP) at their office -Must keep records and storage -Can give methadone and levo-alpha-acetylmethadol (LAAM) -Can give 3-5 narcotics in combos or by itself -Must REFER pts to counseling and limit practice to a max of 30 patients" "Licensing under NTP - CORRECT ANSWER -Certified in addiction psychiatry in Amer Board of Medical Specialties -Certified in specialty from Amer Osteopathic Association -Certified from Amer Society of Addiction Medicine -Participate in clinical trial on narcotic drug -Approved by state licensing board or has training/exp." "Orlaam (levomethadyl acetate) - 2nd line. Why? - CORRECT ANSWER Prolonged QT interval --> Torsades" "Institutional Dispenser - CORRECT ANSWER Class 3: In house pharmacy, DEA#, bulk stock in CS, sub-stock, - dispersed Class 3A: In house or prescriptions are filled by outside pharmacy, may have bulk CS's Class 3B: Limited to prescriptions (no bulk CS's) - mental health clinics, no bulk CS's" "Inpatient orders - no ONYSRx used - CORRECT ANSWER -RPA orders countersigned w/i 24hrs by MD - may be bypassed if permitted by bylaws of hospital -Oral orders for CS - signed w/i 48 hrs **emergency -Routine orders not allowed for CS -PRN CS orders valid for 72 hrs, renewed Q72hrs -Standing orders (specified time) for CS - good for 7 days. EXCEPTIONS ********Up to 30 days for convulsive disorder, chronic spasticity, brain dys, residential HCF or in prison -PRN with no frequency for CS - ONE DOSE ONLY. -Transfer orders - single dose in transfer not EXCEED 3 HOURS travel time -ER orders good for NMT 24 hr supply." "Institutional Records - CORRECT ANSWER -Acquisition Invoices - C3-5, and DEA 222 -Admin records - hour, name of pt, name of MD, quantity, balance on hand, sig of admin RN" "Security - CORRECT ANSWER -Main stock: C2 in vault, C3-5 in locked cabinet -Working stock (C2-4) - dispersed. **Less than 72hr supply - stored with other pt meds **More than 72 hr supply - stored in double locked cabinets Med Carts - NO C2, C4-5 with double locks, locked drawers, limited access." "EMT - emergency medical tech - CORRECT ANSWER Ambulance unit may give Sched II from SUBSTOCK in ambulance if prescriber countersigns in 72 HOURS.!!!!!!!!!!!!!!!!!!!!" "Labels for nursing home pts - CORRECT ANSWER -Quantity of drug -Control number (lot number) -Expiration date ALSO -Brand name of drug from chart + name of drug dispensed. (Generic name + manu and distributor or brand name of less expensive substitute)." "Counseling should be provided if the patient hasn't been treated with the drug within the last - CORRECT ANSWER 90 days" "Mail order and internet pharmacies. If MD gives approval to make a change, RPH must - CORRECT ANSWER Two attempts to call pt and inform pt of change within 48 HOURS of mailing. Don't need to call if its generic sub." "Rx refills, must counsel? - CORRECT ANSWER YES - an offer to provide made EVERY TIME. Must document refusals always." "Tech to RPH Ratio - CORRECT ANSWER 2 unlicensed persons may assist RPH with FILLING. Staff doing other stuff NOT COUNTED in 2:1 ratio. INTERNS not part of this ratio!!" "Drug Retail Price List Sign = - CORRECT ANSWER Must be in BOLD letters, ONE INCH in height. Must update it WEEKLY. May tell pt's on the phone." "Out of State Establishment s - CORRECT ANSWER Must register w/ Education Department through SBOP. Includes mail order and internet pharmacies. EXCEPTION: Isolated transactions. Less than 600 Rx's a year and less than $10,000 per year. Waived for emergency. May verify these places on the office of the profession site." "To reactive NYS registration - CORRECT ANSWER Must complete 45 hrs.If not actively practicing, must count continuing education credits earned 12 months PRIOR to the month you reactive reg." "CE - CORRECT ANSWER -Credits dont carry over to next period. -No minimum annual requirement -One hour = 50 minutes. -One CEU (continuing education unit) = 10 hrs -One semester hr = 15 contact hrs -One quarter of college work = 10 contact hrs -CME from AMA can be used if related to pharmacology of drugs -Always keep documentation -CPR, BLS, ACLS, EMT - only count ONE of these courses. Not 1st Aid." "Training courses hours - CORRECT ANSWER CPR - 5 hrs. Renew = 3 hrs. BLS - 5 hrs. Renew = 3 hrs. ACLS = 12 hrs. Renew = 3 hrs. EMT = 10 hrs. Renew = 5 hrs. Can use card for credit. Can also use 20 credit CE for immunizations. Can use CE that you teach." "Providers for CE - CORRECT ANSWER Approved by American Council on Pharmaceutical Education - ACPE." "Live CE Hours - CORRECT ANSWER -No limit for self study CE -Can use Tele-course or teleconference as live." "Maintain CE Credit Records for - CORRECT ANSWER SIX years. Need to keep 1) Title of course/program, ID # 2) # of hrs 3) Sponsor name and ID # 4) Verification by sponsor of attendance 5) Date of locaton!!!!! Renew fee $45. If fail --> professional misconduct." "Exceptions to CE? - CORRECT ANSWER -Poor health (need MD verify) -Physical/mental disability -Armed forces -Extreme hardship - permission. IF YOU FAIL TO COMPLETE, may get ONE YEAER conditional registration, cant be renewed." "When is it okay not to meet CE and dont renew? - CORRECT ANSWER OKay if you dont practice in NYS> If you do --> professional misconduct." "Can MD direct RX's to certain pharmacy? - CORRECT ANSWER NO. Pt chooses. If they do --> professional misconduct." "Electronix RX's must have - CORRECT ANSWER DONT have to be printed and maintained as hard copy anymore. Same with refills. Maintain for 5 years electronically." "What professional reference books must pharmacies have? - CORRECT ANSWER Must have copies of current laws, rules, and regulations." "Can CS be electronically transmitted? - CORRECT ANSWER NO THEY CANNOT. Only oral (emergency), written, and faxed? (emergency)." "Transfers - CORRECT ANSWER CS = NEVER. Non-CS = one at a time." "Responsibility of RPH who transfers RX? - CORRECT ANSWER -Name of pt -Auth of refill -Name, addy, telephone, # of pharmacy -Name of RPH receiving -Name of RPH transferring -Date of transfer" "Responsibility of RPH who RECEIVES RX? - CORRECT ANSWER Must say REFILL TRANSFER on FACE Of RX -Name of pt -Auth of refill -Name, addy, tele # of pharmacy from transfer -Name of RPH receiving -Name of RPH transferring -Date of ORIGINAL, and most recent transfer -Original RX number." "Permission from patient to get access to shared database of pt's medical and rx info? - CORRECT ANSWER YES. and MUST DOCUMENT THAT. PT can refuse to have their info entered into shared database. If refused, must place a FIREWALL around the data." "What must transmitted electronic RX's have - CORRECT ANSWER -Prescriber's sig -Protected from unauthorized access -Initials of RPH or intern. *** ONLY PRESCRIBERS CAN DO THIS" "Can pharmacy accept e-rx that has electronic sig that is printed as hard copy and FAXED or HANDED to patient? - CORRECT ANSWER NEVER - must be signed in HANDWRITING." "How are intern hrs calculated? - CORRECT ANSWER One week = 7 day period One month = 173 hrs No credit for hrs exceeding 40 hrs a week. Valid for 5 years. Can renew ONCE for a period of two years. May be transferred to another state." "Written RX for CS must be written on - CORRECT ANSWER ONYSRx. If Out of state, dont have to be written?" "Can practitioner place sticker on official that has pt's info or drug name and directions? - CORRECT ANSWER NO, compromises security." "If fill out of state RX - CORRECT ANSWER Dont need to be on ONYSRx. Must deport to DOH by 15th of the month following month." "Can RPH dispense faxed official RX for CS? - CORRECT ANSWER YES - under SAME parameters as ORAL RX. Limited to 5 day supply, and must get official RX within 72 hrs. FAX = ORAL!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!! CIV non-bzds = 30 days?" "When can dispense FAX RX for CS? - CORRECT ANSWER Can do 30 day supply for CS if pt is HOSPICE, residential health care facility, and for those rx to be cmpded for direct administration by INFUSION. *****STILL NEED F/U RX within 72 hrs. If not report w/i 7 days." "What can other practitioners prescribe in terms of CS? - CORRECT ANSWER NP = 2-5 independently. Need DEA RPA = 2-5 under supervision. Their RX's always need the RPA and MD name." "Other CS info - CORRECT ANSWER -MD's dispensing CS must submit info to BNE -No ONYSRx form needed if dispense CS from office. -If no DEA, cant give CS. CANT use facility's DEA #." "The only people that can use the facility DEA # as their own are the: - CORRECT ANSWER Residents, interns, foreign physicians. Cant get their own yet." "Refilled CS must - CORRECT ANSWER -RPH signature -Date -Quantity dispensed. CANT USE A STICKER FOR SIG, ONLY DATE AND QUANTITY. MUST SIGN ON YOUR OWN." "How to get certified for immunizations - CORRECT ANSWER -licensed and reg in NY -evidence of approved imm course within last 3 years -evidence for CPR and BLS -app fee, with $100" "What can RPH do with immunizations? - CORRECT ANSWER ****CAN ONLY DO INFLUENZA AND PNEUMOCOCCAL VACCINATIONS. *****NOT LESS THAN 18 YEARS OLD. *****INTERNS CANT DO IT. If registered, has reg that has prefix I" "When practitioner prescribes CS must document - CORRECT ANSWER -pt ID data -chief complaint -pt's condition -amt, strength, and directions." "Can prescriber obtain stock of CS for OFFICE USE ONLY and fill at a pharmay - CORRECT ANSWER NOOOOOO. Must be pt specific." "If prescriber makes mistake on CS - CORRECT ANSWER Can cross out and initial error. Can authorize RPH to change rx info EXCEPT: Rx sig, date, pt name, drug name and strength. ***May alow RPH to change quantity but NOT allowed to add quantity if its missing." "ONYSRx required for - CORRECT ANSWER ALL RX's CS and NON CS" "In LTCF can fax RX's for CS? - CORRECT ANSWER Yes, its a written." "Can you use DEA # for nonCS? - CORRECT ANSWER Strongly opposed by DEA." "Provigil, Sonata, Stadol - CORRECT ANSWER NYS: NOT CONTROLLED. Federally: CIV." "Provide to each recipient of vaccine - CORRECT ANSWER -Signed certificate of immunizations which has: -Recipient's name, date, address, of adiministration -Administering RPH -Immunizing agent -Manu and lot number MUST KEEP THIS ON FILE FOR SIX YEARS." "If MD disagrees with professional judgment of RPH - CORRECT ANSWER Judgment of the MD shall prevail" "MD part of agreement/protocol authorizing collaborative drug therapy management must be - CORRECT ANSWER employed with same facility where RPH is employed/affiliated." "Cannot use collab drug therapy management if - CORRECT ANSWER pt or pt's rep consents IN WRITING to such management." "Label - CORRECT ANSWER Info on immediate container (must be on outside wrapper if exists)" "Labeling - CORRECT ANSWER Includes all info ON or accompanying drug/device" "Misbranding - CORRECT ANSWER Labeling = misleading or fails to reveal facts. Like misleading advertising." "Device - CORRECT ANSWER Instruments, apparatus, contrivances including: components, parts, accessories intended: ---For use in diagnosis, cure, mitgation, tx, prevention of dx in man or animals; or ---To affect the structure or any fxn of the body of man or animals" "Administer - CORRECT ANSWER A pt specific order or non-pt specific regimen prescribed or ordered by MD or NP who has practice site in the county." "Electronic RX - CORRECT ANSWER Created, recorded, or stored by electornic means, issued with electronic signature" "Original hard copy RX - CORRECT ANSWER If created electronically must be transmitted from MD to RPH by FAX --> MUST BE MANUALLY SIGNED." "Electronic Signature - CORRECT ANSWER Electronic sound/symbol/process, attached to electornic RX, executed by person with intent to sign RX." "Limited Permits - Pharmacy Interns - permits employments to pharm interns - CORRECT ANSWER -Issued to student enrolled in last 2 years of registered program in pharmacy. -Intern may practice as RPH under supervision of RPH -Must be posted at site of employment -Expires 5 years from date of issue -May be renewed ONCE for a period not to exceed TWO YEARS with permission from BOP -Must be relinquished if not licensed within this time." "Authorized prescribers - CORRECT ANSWER -Physicians - MD, DO -Physician assistants (RPA) -Podiatrists (DPM) -Dentists (DMD, DDS) -Vets (DVM) -Optometrists (O.D) -Nurse Practitioners, Certified (CNP) -Mid-Wives (F)" "NDC - CORRECT ANSWER XXXXX-XXXX-XX 1) Label code, assigned by FDA, the manufacturer. 2) Product code - strength, dosage form, and formulation 3) Package code - package size" "Anti-tampering act - CORRECT ANSWER 1) Tamper with interstate commerce with intent to injure person 2) Taint with intent to injure business 3) False info 4) Conspire to tamper" "Anti-Tampering - CORRECT ANSWER Hx: Passed by congress in 1984 d/t deaths bc of OTC meds contaminated with cyanide. Tamper resistant package - has indicators or barriers to entry - if breached/missing - expect to show visible evidence that tampering occurred. 1) Distinctive by design, cant be duplicated. 2) Use 1 or more indicator or barrier to entry that employ a characteristic." "OTC Labeling Tamper Resistant - CORRECT ANSWER Must alert consumers of the specific tamper resistant feature of package." "Drugs EXEMPT from PPA - CORRECT ANSWER Pg 12 for list. Cannot reuse any part of CRC in NYS. May reuse glass if new safety closure used. CPSC - consumer product safety commission" "SAUE - CORRECT ANSWER senior adult use effectiveness" "Manu's packaging - CORRECT ANSWER 1) Meds must be in CRC 2) Bulk packaging to be repackaged by RPH doesnt have to be in special packaging 3) Unit packaging from manu must comply with CRC" "Waiver for CRC - CORRECT ANSWER Must document waivers, don't need to have sig, pt can say it orally." "Prescription Drug Marketing Act - CORRECT ANSWER 1) Proper storage / handling of drugs. 2) Establish maintenance of records 3) Prohibits interstate commerce unless registered with shipping state 4) Bans reimportation of Rx Drugs (except same manu) 5) Bans sale/trade/purchase of samples. 6) Bans traffic in counterfeiting drug coupons 7) Prohibits resale of rx drugs by hospital for drugs purchased at special prices 8) Mandates storage/records of drug samples 9) MD's request for samples in writing 10) Criminal and civil penalties" "Samples - CORRECT ANSWER Only practitioners can receive. Pharmacies can receive if requested by practitioner. Written request needed: 1) Name, add, professional designation, sig of MD 2) drug name, quantity, and manu 3) date. ***Manu's must keep ANNUAL inventory. Must keep records for THREE years." "Drug Recall - CORRECT ANSWER -Remove products from market thats: 1) Misbranded. 2) Adulterated. 3) threaten consumer safety." "Recall classifications - CORRECT ANSWER Class I: Cause serious adverse health consequences/death. Class 2: Cause temp or medically reverisble adverse health consquences. Class 3: Not likely to cause adverse health probs" "Package inserts? - CORRECT ANSWER OC's, IU devices, estrogen containing products, progestational drug products . In COMMUNITY pharmacy - need inserts EVERYTIME product refilled. In INSTITUTION - req only on intial dispensing and Q 30 days." "OTC Labels - KNOW THIS - CORRECT ANSWER 1) Product name 2) Name and addy of manu or distributor 3) list of active or other ing (not amt?) 4) amt of contents (strength of ACTIVE ing) 5) adequate warnings 6) adequate directions for use" "CMEA - CORRECT ANSWER 3.6g daily limit // 9g monthly limit // 7.5g monthly limit if MAIL SERVICE // Must maintain: product name, quantity, name and addy, date and time, must ask for photo ID. Doesnt apply to 60mg or less." "Can prescriber dispense? - CORRECT ANSWER Prescriber cannot charge pt for more than 72 hrs of meds dispensed EXCEPT======= Prescriber working in hospital / dispense at no charge / greater than 10 miles from pharmacy / dispense in institutional clinic / licensed under Art 135 (vets) of this title / dispense under medical emergency / dispense drug reconstituted by prescriber / dispense allergic extracts // dispense drugs covered under oncology or AIDS protocol" "All prescription blanks MUST CONTAIN - CORRECT ANSWER 1) ONE SIGNATURE LINE // 2) Statement under lien: rx will be filled generically unless prescriber writes daw in box below // 3) that box 4) Words DISPENSE AS WRITTEN under box 5) profession 6) Imprinted name of prescriber" "Substitution - CORRECT ANSWER 1) Rx written by brand name, 2) DAW box empty, 3) drug is therapeutically equivalent, 4) less expensive. ****If OOS, give brand at generic price. ***If emergency, give brand at regular price and record on back: date/hour/nature of emergency." "RX Drug Advertising in Print MUST INCLUDE: - CORRECT ANSWER 1) Exp date of ad 2) RX must be separated from OTC 3) Prices agree with price list 4) Brand name must include generic (in not less than 1/2 size of brand) 5) Price must be specific 6) COPY OF AD KEPT ON FILE FOR ONE YEAR." "Professional Assistance Committee (PAP) - CORRECT ANSWER License will be accepted by committee if - 1) No harm done to pt 2) make app for permission to surrender license 3) must complete rehab before seeking restoration 4) must agree to restrictions" "Professional Assistance Committee (PAP) - applicant must agree to - CORRECT ANSWER -Seek treatment -The conditions of commmittee -Remain inactive until restored - Release of info by committee to facts why license surrendered, and if failed or completed program. *******Accepted applicant provides immunity from discipllinary action, but IMMUNITY MAY BE REVOKED if persons FAILS to complete TREATMENT!!" "Preceptor RPH - CORRECT ANSWER Must practice for one year prior to supervising intern. May supervise 1 full time or 2 part time. Pharmacy must fill 5M Rx/orders per intern per year." "Adulterated AND Misbranding - KNOW PG 41 - CORRECT ANSWER 1) Not manufactured acc to GMPs 2) Fails to meet stds of purity, potency, labeling, safety and effectiveness. EX of BOTH) OTC drug that is not packaged in tamper resistant packaging or is not labeled in conformity with tamper resistant regulations" "Misbranding Definition - CORRECT ANSWER Label is misleading, fails to reveal facts. Drug is sold or dispensed with a labeling that is in violation of the FDCA." "Adulteration - CORRECT ANSWER Change or variation from official formulary standards or from manufacturer's standards.." "Name badges - CORRECT ANSWER 1st line = full name. 2nd line = title! color doesnt matter." "KOW (kindly oblige with) - CORRECT ANSWER allows pharmacy to furnish drug to another pharmacy to fill waiting RX." "Refills - CORRECT ANSWER Must be authorized and dates of refill must be placed on BACK of RX." "Copy of CS RX - CORRECT ANSWER DO NOT GIVE TO PT" "Copy of Other RXs - CORRECT ANSWER may be given to pt - mark RX = FOR INFORMATION PURPOSES ONLY." "Oral Auth to REFILL RX ON FILE. MUST PLACE ON BACK OF RX ======== - CORRECT ANSWER 1) Date 2) Time 3) Name of MD authorizing refills 4) Initials and sig of receiver" "Examples of error in dispensing - CORRECT ANSWER Untrue label, Illegal sub, Dispense a quantity greater or less, Deviate from terms of Rx, W/O knowledge and consent of prescriber." "Can give less of a drug in cases= - CORRECT ANSWER 1) 3rd party restriction 2) request for less by pt 3) OOS 4) Rxs in which quantity would exceed expiration date....." "Can give more of drug if - CORRECT ANSWER 1) Dispensing package CANNOT be broken by law.. EX) SL NTG, Cytotec....." "Fire, flood,! Notify BOP in - CORRECT ANSWER 48 hrs" "LABEL of NON-CS RX CONTAINER MUST HAVE (KNOW THIS) - CORRECT ANSWER 1) Name and address of dispenser. 2) Serial number of prescription 3) Date prescription dispensed 4) Name and address of patient 5) Name of prescriber 6) Name of manu and distributior 7) Name / strength / directions of drug" "One RX per blank - CORRECT ANSWER Does not apply to drugs dispensed in hospitals, nursing homes, or residential health care facilities!!" "One RX per blank rules - CORRECT ANSWER Written Rx's only, not orals. Rx and non Rx drug on same Blank = not good. Needles and syrgines + insulin on blank? = okay. Two OTC in blank? No. Written out of state? Exempt - okay. Written in VA? - Exempt - okay." "All oral RX's must have same info as written except - CORRECT ANSWER 1) No sig of prescriber 2) Need initials of RPH" "Upon filling, RPH must - CORRECT ANSWER 1) Initial or sign RX 2) Date filled 3) Rx number 4) indicate number of MFGR/DIST." "Refill RX, must enter on back of RX (manual) - CORRECT ANSWER 1) Date 2) Initials or sig of RPH (and intern)" "Refill instruction (written on face of RX) - CORRECT ANSWER 1) Number of times 2) Time period or 3) PRN = 1 time (zero for CS)" "Substitution w/o auth if presumed unless entered on back of RX - CORRECT ANSWER 1) Date 2) Time 3) Manner of auth 4) Sig of RPH receiving auth" "Owner and new SP must notify department of change in SP within - CORRECT ANSWER 7 days" "SP can: - CORRECT ANSWER -Supervise one pharmacy only. -Work full time (30 hrs per week) -Auction sale of drugs under supervision of RPH" "Registered area shall measure: - CORRECT ANSWER Not less than 300 sq feet." "Dispensing area shall measure - CORRECT ANSWER not less than 100 sq feet." "Registered area must be equipped with: - CORRECT ANSWER storage facilities for safe storage heating and ventilation adequate lighting hot and cold running water in dispensing area Refrigerator with thermometer btwn 2-8 degrees Sanitation Copies of laws, rules and regulations in NYS" "Pharmacy operated as a department of a general merchandising establishment - CORRECT ANSWER -Not less than 300 sq ft -Enclosed floor to ceiling or 9 1/2 ft walls -Have hrs posted on exterior if different from general store hrs" "USP Storage limits - CORRECT ANSWER Freezer: -20 to -10 C Cold Fridge: 2 to 8 C Cool: 8 - 15 C Room Temp: 15 to 30 C" "Inspections and investigations concerning pharmacies and pharmacists? - CORRECT ANSWER State Education Department's Office of Professional Discipline" "What does investigator utilize? - CORRECT ANSWER Pharmacy inspection report form. As end of inspection, RPH asked to sign report. Signing doesnt mean they agree with violations, only signifies content of report." "When when you be charged with abandoning a pt? - CORRECT ANSWER If you negelected a pt in need of immediate professional care and didn't do it or make arrangements" "When would you be charged with abandoning a pharmacy? - CORRECT ANSWER If you vacate the premises withoug surrendering the registration to the BOP or making appropriate arrangements for disposal of rx drugs" "When a pharmacy closes, what does the owner have to do? - CORRECT ANSWER Notify the dept as to disposition of rx records Must give rx records to another registered pharmacy" "Can you take drugs back from pts? - CORRECT ANSWER You can take back NON CS only. But you can't put them back into stock." "Health care facilities can return unused Rx's if and use again? - CORRECT ANSWER They have their own pharmacy dispensed to inpatients unit dose meds with each marked with name, strength and expn date" "Prospective DUR? - CORRECT ANSWER -Duplication -Contraindications -Drug-dx interactions -Drug-allergy interactions -Incorrect dose or duration -Clinical abuse, misuse" "Retrospective DUR - CORRECT ANSWER -Monitor for therapeutic appropriateness -Overuse and underuse -Appropriate selection of multi-source products and -Duplication -Drug dx Contraindcation -DDI -Wrong dose or duration -Clinical abuse, misuse" "Pt counseling standards - CORRECT ANSWER -Name and description of med -Dose form, dose, route, duration -Directions and precautions for preparation, administration, and use -Common SE, interactions and CI and action required if they occur -Techniques for self monitoring -Storage -Rx refill info -Action to take if miss dose" "Pt med profile must include - CORRECT ANSWER -Name, addy, phone, age, gender -Hx: Dx states, allergies and drug rxns, -List of meds/devices -Comments relevant to drug therapy, other info" "Patient med profiles kept in retrievable form for - CORRECT ANSWER 5 years" "Pt's refusal of consultation - CORRECT ANSWER Must be documented" "Emergency Kit have - CORRECT ANSWER -24hr supply of a max of ten different CS -Administered by registered personal (RN, etc) -Maintain all records of CS furnished or transferred -Besides CS, may also include: SL NTG and up to 5 noninjectables, prepacked meds, NTE 24hr supply. -Total number of noninjectables may not exceed 25 meds for the entire facility. -VERBAL ORDERS must be COUNTERSIGNED within 48 hrs" "Midwives license must say - CORRECT ANSWER FXXXXXX. Number, name, office address, and office telephone # must be on blank.For CS, must have DEA. MD's name doesnt have to show." "Midwifety can be practiced if - CORRECT ANSWER -Licensed MD board certified as obstretrician-gynecologist. -Licensed MD who practices obstretrics and has privileges as a hospita; -Hospital that provides obstretrics through licensed physician having privilege" "CNP - CORRECT ANSWER -May write rx -May give oral rx -May write CS if has DEA -No supervision - INDEPENDENT. -Collab agreement with MD - written agreement, protocols, mechanism to settle disputes, periodic review of records Q 12 months -NO MORE THAN 4 CNPs if different location. NO LIMIT if within same structure." "CNP prescribing? - CORRECT ANSWER On RX, need= -Profession -Name -Address -Phone No. -MXXXXXX CS - need DEA CAN prescribe needles/syringes, oral rx, dispense. Just need to add SIG." "RPA (physician assistant) - CORRECT ANSWER -May write rx -May give oral rx -may write RX for CS if DEA -CS in hospital only if: INPATIENT, permitted by hospital laws, countersigned by SUPERVISING MD within 24 hrs -SUPERVISED by MD -MD MAY NOT SUPERVISE ***NMT 2 RPAS in community ***NMT 6 RPAS in hospital" "RPA's Written RX - CORRECT ANSWER Required: Supervising MD's -Profession -Name -Address -Phone no. -Reg no. -DEA # Can do needles/syringes, orals, dispense." "RPA must sign RX with: - CORRECT ANSWER 1) Name of supervising MD 2) Own name 3) Initials: RPA 4) Add own reg # 5) Own sig 6) If additional info needed call ___ to get specialty area, or get name of collab MD ***Plus DEA if its CS." "RPA Blank Concerns - CORRECT ANSWER C2's dont need address/phone number of supervising physician For Non-CS and C2 - dont need DEA or sig of superivsing physician." "Countersigning for RPA - CORRECT ANSWER Can be terminate the requirement for inpatient medical orders if PA demonstrates competence." "Optometrists Prescribing - "U" - Phase One - CORRECT ANSWER 1) Abx, antimicrobials 2) Decongestants/anti-allergenics 3) NSAIDs 4) Steroidal and anti-inflammatory agents 5) Antiviral agents 6) Hyperosmotic/hypertonic agents 7) Cycloplegics 8) Artificial tears and lubes" "Optometrists - "V" - Phase 2 - CORRECT ANSWER Tx of glaucoma and ocular HTN. 1) Beta blockers 2) Alpha agonists 3) Direct acting cholinergic agents 4) Carbonic anhydrous inhibitors 5) Prostaglandins MAY VERIFY what the optometrist can use or prescriber - Divison of professional licensing services or optometry board office." "Optometrists Auth to prescribe - CORRECT ANSWER T = diagnostic aids U = phase 1 V = phase 2 May also prescribe corrective lenses. IF IT HAS CAUTION STATION = Ready to wear non-rx glasses not intended to replace prescribed, corrective lenses or exams by eye care professional. Continuous eye checkups are necessary to determine eye health status and vision needs." "Can Optometrists can DEA #? - CORRECT ANSWER Yes but cant prescribed CS." "Comparison of Certain Prescribers in NYS - CORRECT ANSWER -NP and midwife has written agreement/protocol. -RPA must use regular rx blanks from superviser MD -RPA must have orders countersigned in 24 hrs -OD's can only have blank, do oral rx and give samples, may have dea... Read pg 80"