Ny Mpje Exam Latest Update A Pass 2023

NY MPJE EXAM LATEST UPDATE A PASS 2023 What must controlled substance prescriptions written by a PA contain? - Contain the imprinted name of both the PA and supervising physician and DEA # of PA Same applies to RPh in CDTM Not required to be countersigned by physician Rx's only within scope Can NPs write for controlled substances? - Yes Uses own Rx blank All Rx info including F reg number May prescribe controlled substances if registered with DEA for all classes Own signature appears on Rx Do you need ID to pick up controlled substances? - Not REQUIRED but should make an effort if you do not know the patient Can you receive a controlled substance prescription from an internet visit? - No How long is a controlled substance Rx valid? - 30 days no matter what schedule Do all prescriptions for controlled substances have to be on an official NYS Rx? - Yes, if they are written in NY What is required on a controlled substance Rx? - Prescriber - name, address, phone number, profession, DEA #, date written, signature, serial # Patient - name (species and owner if animal), address (no PO box), age, sex Drug info - name, strength, quantity, specific directions for use, MDD, refill # What is MDD and is it required for controlled substance prescriptions? - Maximum daily dose Require prescriber to indicate the MDD on all controlled substance Rxs Pharmacist should put this on prescription label If missing need practitioner authorization What can a pharmacist add to a controlled substance Rx without a prescriber's authorization? Change? - The same things Patient address, sex, or age What can a pharmacist add to a controlled substance Rx with a prescriber's authorization? Change? - Change/Add - practitioner DEA #, institution DEA#/suffix, directions, diagnosis code, MDD, strength Change - quantity, dosage form (NEVER ADD) What can a pharmacist never add/change to a controlled substance Rx? - Never add/change - patient name, practitioner signature, date written, drug name Never add - drug quantity When is an institutional DEA number sufficient? - Unlicensed resident, intern, foreign physicians Residents, interns, foreign physicians are not eligible for their own DEA number, anyone may use institutional blanks How many days supply can you dispense for controls? - 30 days unless diagnosis code then up to 90 days (180 days for steroids) What are the diagnosis codes for controlled substance extended fills? - A - anxiety B - ADHD C - epilepsy (Convulsions) D - chronic pain (debilitating) E - narcolepsy F - hormone deficiency How many days early can you get a controlled substance refill? - 7 days What schedule are anabolic steroids? - C3 federal C2 NYS How long are C3-5 prescriptions good for? - 6 months with 5 refills C-V no limit federally but NYS limit Can you partial fill a control at the patient's request? - Yes provided Each partial filling is recorded in the same manner as a refill Total quantity does not exceed total quantity prescribed for a 30 day period All part fills must be done within 30 days IF C2s OR BENZOS ARE REDUCED THE BALANCE IS VOID If LTCF/terminally ill have 60 days to fill rest Can you partial fill a control if you do not have enough in stock? - Yes, remaining must be filled within 72 hours Must make notation of quantity supplied on original prescription How are benzodiazepines treated with regards to schedule? - Like C2s What are the requirements for controlled substance telephone orders? - 5 day emergency only for everything except C-IV C-IV - up to 30 days or max 100 dosage units (mL, pills, etc.) No refills Required reporting for C2s, benzos, anabolic steroids if no written or electronic Rx in 72 hours Must report to NYS bureau of controlled substances within 7 days Everything else just document no electronic Rx on the prescription Authorization for emergency dispensing must appear on follow up Rx When is an oral prescription viable for a controlled substance? - Temporary power outage Temporary technical failure Practitioner is a veterinarian Practitioner is out of state Practitioner has a waiver Emergency (5 day supply)_ If the follow up Rx received for an emergency controlled substance is different what do you do? - Does not count as written for the emergency, does not cover oral prescription What does prn refills on a controlled substance prescription mean? - No refills How do you cancel a controlled substance Rx? - pharmacist endorse on face of prescription - signature, date of filling, and number of prescription under which it is recorded in pharmacy prescription file Can be annotated if E-rx What do you need to do when refilling a control? - Dispensing pharmacist must sign actual prescription form, date it, and indicate quantity dispensed (computer sticker can generate all info minus signature) When refills are in an electronic recordkeeping system pharmacist must manually sign either 1. hard copy printout of each day's controlled substance prescription refill data 2. a bound log book containing a statement that the refill information entered into the computer that day has been reviewed and is correct as shown When rx received electronically, all annotations shall be retained electronically Pharmacy shall employ a procedure to be used for documentation of refills of C3-5 controlled substances in the event of system downtime How do you file prescriptions and for how long? - 3 seperate C2 C3-5 Non controls 5 years What is the orange label rule? - Orange label indicates controlled substance and label allow the choice of a. orange label & 2 caution labels (1 federal, 1 state) b. orange tape over white label & 2 caution labels c. your standard label with 2 orange CAUTION labels using black lettering on the caution labels Requirements for controlled substance inventory? - Biennial on May 1st of ODD years Recorded as to OPEN or CLOSE of the day's business C2 seperate from C3-5 Signed by the person taking it Records maintained on the premises Maintained for 5 years What controlled substance records do you need to keep? - Rx filled Receipts for all drugs returned All invoices of drugs purchased All KOW transactions Duplicate copies of 222 Current inventory What does the DATA 2000 waiver do? - Allows physicians/NP/PA to prescribe C3-5s for narcotic addiction treatment X UIN in addition to DEA number given in order to prescribe buprenorphine Authorized practitioner can only handle 30 patients for first year then up to 100 What are "for office use" controlled prescriptions? - Not valid for dispensing by a pharmacy practitioners must obtain any controlled substance for use in their practice only from a manufacturer or distributor Can you have multiple Rx's for the same patient to be dispensed at a future date? - No, only a single Rx for the same controlled substance to a patient on the same day No post dating What is the PMP? - A statewide electronic database which collects designated data on the dispensing and distribution of controlled substances The registry includes patient specific info on dispensed controlled substances What are the stipulations around pharmacist access to PMP? - Pharmacists may designate another pharmacist or pharmacy intern but no other employees Prohibited from providing a PMP report for any law enforcement officials including DEA agent May not access PMP report for someone they do not have a prescription for Are facsimilies acceptable for controlled substances? - Yes Must be a fax of original hard copy Rx Must be manually signed If issued in NY must be on NY prescription form When are there exemptions for not using electronic prescribing? - prescriptions by veterinarians Temporary technological or electrical failure Use of electronic prescribing would impact the patient's medical condition Prescriptions issued by a practitioner to be dispensed outside of NYS Not mandatory for prescriber to indicate which exception and not mandatory for a pharmacist to verify that a practitioner properly falls under one of these exemptions What blanket waivers exist for electronic prescribing? - Nursing home or RHCF Complicated directions or directions longer than 140 characters Compounded prescriptions containing 2 or more products Compounded infusion prescriptions containing 2 or more products A prescription containing certain elements required by the FDA such as an attachment Approved protocols under expedited partner therapy or collaborative drug management Response to a public health emergency that would allow a non patient specific prescription Approved research protocol A non patient specific prescription for an opioid antagonist What is the day supply limit for initial opioid prescriptions? - For acute pain, 7 days Based on opioid legislation in 2016 Does not apply to chronic pain What do NYS pharmacies have to handout with controlled substances? - Must distribute a handout developed by NYS which includes dangers and warnings, risk of addiction, warning signs, treatment resources, and safe disposal guidelines with all controlled substances What is a poison? - Substance that will cause death in 60 grains or less, about 4g or less What is the organizational structure of the state education dept, board of regents, BOP, etc. - Board of regents oversees state education department and regulates the health professions through the office of the professions NYS board of pharmacy under these