QUESTIONS AND ANSWERS 100% CORRECT OHIO MPJE EXAM SET

Medical marijuana can be used for the following conditions? - correct answer (a) Acquired immune deficiency syndrome (b) Alzheimer's disease (c) Amyotrophic lateral sclerosis (d) Cancer (e) Chronic traumatic encephalopathy (f) Crohn's disease (g) Epilepsy or another seizure disorder (h) Fibromyalgia (i) Glaucoma (j) Hepatitis C (k) Inflammatory bowel disease (l) Multiple sclerosis (m) Pain that is either chronic and severe or intractable (n) Parkinson's disease (o) Positive status for HIV (p) Post-traumatic stress disorder (q) Sickle cell anemia (r) Spinal cord disease or injury (s) Tourette's syndrome (t) Traumatic brain injury (u) Ulcerative colitis Define guidance - correct answer best practice not a law, although the FDA can take action based on its guidance What does shall and should mean in terms of laws? - correct answer shall - it is required should - strongly recommended Define abandoned application - correct answer an application for any license with the Board of Pharmacy is considered abandoned if the application fails to complete all application components within 30 days after being notified by the board of an incomplete application *a terminal distributor or wholesaler has 90 days to demonstrate compliance of all laws once a complete application is submitted define access to drug stock - correct answer this includes not only physical access but also influence over the handling of prescription drugs including purchases, inventories, issuance of medical orders, etc. it does not include maintenance, janitorial, IT, or other staff that may need limited, supervised access Define pharmacist responsibility - correct answer a pharmacist is ultimately responsible for every prescription dispensed by a pharmacy. It is up to the pharmacist to conduct the final check for accuracy and DUR on every prescription dispensed Define pharmacy - correct answer any area or room where prescriptions are filled or where drugs dangerous drugs, or poisons are compounded, sold, offered, or dispensed What is a drug? - correct answer an article USP recognized for use in diagnosis, cure, treatment, or prevention of disease in man or animals, Also, any article, other than food, intended to affect the structure or any function of the body of humans or animals Define dispense - correct answer the final association of a drug with a particular patient pursuant to a prescription, drug order, or other lawful order of a prescriber. It also means the professional judgement and responsibility for interpreting, labeling, preparing, compounding, and packaging a specific drug What is a dangerous drug? - correct answer -A drug that is required to have "Rx only" or any similar language -Can only be dispensed with an Rx -Contains CV substance (except Robitussin AC) -Drug intended to be administered by injection into the human body other than thru a natural orifice What is a drug of abuse? - correct answer any dangerous drug What is a prescription? - correct answer written, oral, fax, or electronic (if board approved) --pharmacies are no longer required to print out electronic prescriptions but still must be maintained for 3 years Define prescriber - correct answer a person authorized by the ORC to prescribe dangerous drugs as part of their professional practice or a pharmacist authorized to manage drug therapy pursuant to a consult agreement but only if authorized in the agreement and only to the extent specified in the consult agreement Can drugs be removed from a terminal distributor? - correct answer 1) a licensed health professional authorized to prescribe may temp remove drug from the terminal distributor to treat current or prospective patients - must be returned within 24 hours 2) a person authorized to furnish or dispense naloxone must return in it within 24 hours 3) a licensed health professional may temp remove non-controlled drug or immunizations from the terminal distributor to treat current or prospective patients - must be returned within 24 hours What must faxed prescription contain? - correct answer -Includes full name of prescriber or agent that transmitted Rx -the original prescription or the refill authorization must be manually signed by the prescriber -Include header info to identify origin of Rx -the original prescription should be placed in the pts file Can a fax be sent from a computer? - correct answer No they become illegal except: 1. the fax prescription operates within a closed system 2. can be accepted during a temporary outage What is required if electronically prescribing in an inpatient facility? - correct answer positive identification of a licensed health care professional What price information must be available for those that ask? - correct answer -pharmacists must disclose price information for all drugs EXCEPT those schedule II drugs What must be included if a pharmacy advertises a price of a medication? - correct answer -brand name -generic name -strength -dosage form -price for specific quantity What is considered to be "readily retrievable"? - correct answer -records must be able to be produced for review within 3 business days What does it mean to refuse to grant or renew a license? - correct answer -to deny original or continued licensure for a period of at least 24 months What is a terminal distributor? - correct answer -pharmacy that dispenses drugs at a retail price -this includes laboratories What is a virtual wholesale distributor? - correct answer -any person engaged in wholesale distribution of dangerous drugs in or into OHIO -the wholesaler has title to the drugs but does not take physical possession of the drugs When can drugs be removed from a terminal distributor? - correct answer -a licensed health professional authorized to prescribe may temporarily remove prescription drugs from the terminal distributors to treat current or prospective patients but these must be returned within 24 hours -a person authorized to furnish or dispense naloxone must return it within 24 hours to a terminal distributor -a licensed health professional may temporarily remove non-controlled substance prescription drugs or immunizations from the terminal distributor to treat current or prospective patients but these must be returned within 24 hours What must be on a faxed prescription to ensure that it is valid? - correct answer -it must be manually signed by the prescriber -if an "agent" of the physician is transmitting the faxed prescription, his/her full name must be included -it must have a header with location transmitted and date it was faxed -the original prescription at the physician's office will be placed in the patient's chart What is a third party logistics provider? - correct answer -contracts with a manufacturer or wholesaler to provide or coordinate warehousing, distribution, or other services on their behalf but does not take title of prescription drugs or have responsibility for their sale or disposition -must have a license as a wholesale distributor, registered as a business What is a wholesale sale? - correct answer -means any sale in while the purpose of the purchaser is to resell the article purchased or received What is the 5% rule? - correct answer -if a pharmacy has >5% of sales due to selling medications to people other than patients, they must receive a wholesaler's license When does the 5% rule not apply? - correct answer -inter-company sales between pharmacies that are under common ownership -among hospitals or health care entities under common control What is an occasional sale? - correct answer -a wholesale sale of a commercially available prescription drug to another terminal distributor or person exempted from being a terminal distributor such as vets, dentists, docs What 2 conditions cause a medication to be considered a prescription drug? - correct answer -habit forming -unsafe for use except under the supervision of a practitioner define dispense - correct answer sell, leave with, dispose of, change, barter, give away, or deliver define personal supervision - correct answer pharmacist must be in the prescription department in full and actual charge What is a federal legend? - correct answer -all prescription drugs must have "Rx only" or a variation of this on the stock bottle What is a serial number? - correct answer -prescription number What is considered to be a business day? - correct answer -any day other than Saturday, Sunday or holiday recognized by the state of Ohio What is the minimum standard of a pharmacy? - correct answer -Drug library (laws and references) -Poison Control Center # -Equipment necessary to conduct pharmacy -Drugs and Rx containers -Well-lighted, well-ventilated, clean and sanitary -Adequate physical security -Posted pharmacy hours -appropriately staffed -Staff in contact with patients, must have name tag with job title Define pharmacy practice - correct answer 1. managing drug therapy nsing and compounding drugs 3. dispensing devices 4. counseling pts 5. review of drug regiments 6. review of drug utilization 7. drug therapy advice How far in advanced can drugs be compounded based on routine, regularly observed dispensing patterns? - correct answer 30 days What conditions must be met for drugs that are returned to stock in a pharmacy? - correct answer -an expiration date must be placed on the container -the drugs returned to stock must be kept in the prescription bottle it was dispensed in with the original patient label on it -when dispensing the product to a new patient, a new container must be used -if there is a drug recall, all medication on the shelf must be removed if the exact lot number is not known -if the medication wished to be returned was with a delivery agent, the medication either needs to have been in the stock bottle still or there is a way to show that it had not be tampered with -none of these apply to medications that are dispensed inpatient How far in advanced can drugs be compounded based on routine, regularly observed dispensing patterns? - correct answer What can a pharmacist do under a consult agreement? - correct answer -changing the duration of treatment of current therapy -adjusting the strength, dose, dosage form, frequency, administration, or route of administration -discontinue the use of a drug -administer a drug, if the drug is included in the consult agreement -add a drug to the patient's drug therapy -order blood and urine tests and if specified within the practice protocols that are part of the consult agreement, evaluate the results related to drug therapy being managed --HOWEVER, these tests do NOT authorize the pharmacist to make a diagnosis Who can terminate consent for a consult agreement? What must happen after that? - correct answer -The pharmacist, physician, or patient can terminate it -if pt terminates - pharmacist and physician must be notified in writing -if the pharmacist or physician terminates - provide written notification to all other parties involved and record in medical record When can a pharmacist enter into a consult agreement with one or more physicians? - correct answer -each physician has an ongoing physician-patient relationship with each patient whose drug therapy is being managed -the diagnosis for which each patient has been prescribed drug therapy is within the scope of practice of each physicians practice -each pharmacist has training and experience related to the particular diagnosis for which drug therapy is prescribed What must be included on the written consult agreement? - correct answer -the diagnoses and disease being managed under the consult agreement including whether each disease is primary or comorbid -a description of the drugs or drug categories the agreement involves -a description of the procedures, decision criteria, and plan the pharmacist is to follow in acting under the consult agreement -a description of the how the pharmacist is to comply with the records of each action taken and at what regular intervals this will take place What patients can be managed under a consult agreement? - correct answer only pts of physicians listed in the consult agreement How long is a consult agreement good for? - correct answer 2 years What is a comorbid disease? - correct answer -an additional disease that co-occurs with a primary disease What is a primary disease? - correct answer -a disease that arises spontaneously and is not associated with or caused by a previous disease, but may lead to a co-morbid disease What is included in the consent that must be received from the patient that will be involved in a consult agreement? - correct answer -a pharmacist may be utilized in the management of the patient's care -the patient has the right to participate or withdraw from the consult agreement this consent may be part of the patient's initial consent to treatment What is a managing pharmacist? - correct answer -a pharmacist managing a patient's drug therapy pursuant to a consult agreement What forms of communication can occur in a consult agreement between the pharmacist and physician? - correct answer -electronic mail that confirms delivery -interoperable electronic medical records system -fax that confirms delivery -electronic prescribing system -electronic pharmacy record system -documented verbal communication -any other method of documented notification as outlined in a consult agreement What can be considered a written notice? - correct answer -electronic mail -interoperable electronic medical records system -fax -electronic prescribing system -electronic pharmacy record system -any other method in writing that provides notice in a timely manner How long must pharmacists maintain record of each action taken for each patient under a consult agreement with positive identification? - correct answer 3 years What needs to be done if a pharmacist wants to be authorized to prescribe a non controlled substances as per a consult agreement? - correct answer -the rx should include the required info of the consulted physician -Phone # where the pharmacists can be reached -positive id (including manual signature) on the prescription of the pharmacist What needs to be done if a pharmacist wants to be authorized to prescribe controlled substances as per a consult agreement? - correct answer -have a valid controlled substance prescriber registration issued by the Ohio State Board of Pharmacy -must submit an application and valid consult agreement -must obtain and keep current a valid DEA registration from the federal government -the DEA registration must be submitted to the board within 30 days -if the consult agreement is not valid the license is void Who can participate in a consult agreement? - correct answer -only Ohio licensed pharmacists and physicians -NO PA's or nurse practitioners When should the pharmacist review OARRS if prescribing a controlled substance? - correct answer -when adding a controlled substance -adjusting a controlled substance (i.e. changing strength, dose, dosage form, route, or frequency) What should be done if a pharmacist is no longer authorized to prescribe controlled substances per the consult agreement? - correct answer -the Board must be notified within 5 business days What conditions must be met for a pharmacist to be able to dispense a dangerous drug other than a CII without a written or oral prescription from a licensed health care professional authorized to prescribe drugs? - correct answer -pharmacy has a record of a prescription for the drug in the name of the patient who is requesting it and the prescription has no refills or the refills have expired (they have to have record of the rx but this does not mean that pharmacy has specifically filled the rx before, could use a database or PMR) -R. Ph is unable to contact the prescriber for refill authorization -in the pharmacist's judgment, the drug is essential to sustain life, continues therapy for a chronic condition, or failure to dispense the drug could result in harm to the health of the patient What is a practitioner? - correct answer -licensed health care professional authorized to prescribe drugs How much medication can be given to the pt? - correct answer -the amount of drug cannot exceed a 72 hour supply -if the pt is on a consistent drug therapy the amount of drug cannot exceed a 30 day supply or the smallest standard unit. Only on non controlled rxs and only once in a 12 month period If copayments or deductibles are waived who is at fault? - correct answer the terminal distributor not the individual pharmacist How many attempts do you have to pass the NAPLEX and MPJE? - correct answer 5 How does the pharmacist fill an emergency fill? - correct answer -the pharmacist must create a new rx and document it as an emergency fill -for 1 years after the sale the pharmacist must keep record of: --the name and address of the pt --name and address of the individual receiving the drug (if different than pt) --amount dispensed --original rx number definition of a preceptor - correct answer -pharmacist whose license is in good standing, of good moral character, and is qualified to direct the practical experience of an intern -a pharmacist can be a preceptor for an unlimited number of pharmacy interns but no more than 2 interns can be working with each pharmacist on duty -unless employed by a school of pharmacy a preceptor must have at least one year of practice experience as a licensed pharmacist to receive an intern license what must the student do? - correct answer -apply to the board for a license -provide a head to shoulders photograph -pay a fee -must have completed 60 semester hours or 90 quarter hours of college already