Can an optometrist prescribe analgesics of hydrocodone products?
Yes, as long as they complete an exam and gives no more than 72 hours worth of med and the rx can not have refills
According to NRS 634 what can a chiropractor do?
They can not practice medicine, osteopathic medicine, dentistry, optometry or podiatry and they can not administer or prescribe drugs
What does the Controlled substance act provide ?
It provides 5 schedules of CS, and a drug is placed into one of the schedules according to its abuse potential and accepted medical use
What can not be written as directions for a controlled substance?
It can not say “take as directed” this doesnt fulfill the requirements.
What must be included on a CS rx in terms of directions
It must clearly state the dosage, frequency and manner in which the rx is to be taken or applied
Who is not required to register and lawfully possess and distribute a CS in NV?
- Agent or employee of a registered dispenser; if acting in normal course of business
- Common or contract carrier of warehouseman (delivery driver) *as long as normal course of business
- The ultimate user
- A physician who: holds locum tenens license issued by board, Has registered with DEA at location outside of the sate
When thinking about a chain pharmacy does the whole company need a DEA or do the individual stores need DEA numbers?
Each store needs a separate DEA to dispense CS.
*same goes for manufactures, distributors, research.
Only thing that does not is a warehouse where the CS are stored on behalf of the registered person
What does a certificate of registration show?
1 sets the name, address, and registration number of the registrant, what activities they are allowed to do and which CS they can handle.
2. it must be displayed
Can an individual practitioner dispense a CS of C2,3,4 to himself or family?
No, unless it is for a medical emergency
When can a pharmacist accept a C2 in an emergency?
Can be taken over the phone
- The qty can only be enough to treat the pt for the emergency.
- must immediatly write the RX and document all needed info *MUST also write “auth for emergency disp” and the date of oral order
- make reasonable effort to determine the rx came from authorized dr
How long do you have to get a written rx from the dr after taking an emergency C2?
Must within 72 hours deliver a written RX to the pharmacist. this must be attached to copy of phoned in RX.
**RPh must notify the board if the dr fails to bring in a written rx in 72 hours
What are some of the restrictions on CS rx?
- Individual practitioner may not issue a RX in order to obtain CS for the purpose of general dispensing to pts
- Rx may not be issued for dispensing any narcotic drug for the purpose of continuing his dependence except for the course of rehabilitation
- Administering or dispensing directly, any narcotic drug to a person dependent on a narcotic drug for the purpose of continuing dependence.
- a C3,4,5 can be sent over fax
What are some unlawful acts when it comes to CS?
- RPh shall not knowingly fill or refill a RX for a CS for use by a person other than the person the RX was issued for.
- Person shall not furnish a false name or address while trying to get a CS. *ID and proof must be presented per request
- RPh will not fill a RX for a CS if the RX shows evidence of alteration unless they speak to prescriber and verify rx is real.
- RPh will not fill a C2 unless it is tendered on or before the 14th day after issue
What must each RX for a CS contain in the state of Nevada?
- Name of prescriber
- address of prescriber if not RA
- Date the rx was issued expressed as (MM/DD/YYYY)
- full name and DOB FOR PT
- address of the pt is not RA
- name, strength and qty of drug
- directions of use
- THE DAYS SUPPLY OF MED, fewest number of days necessary to take it all
- ICD-10 code!!!
- Classification of license of prescriber
- DEA number must be printed on rx
What must a written CS include in terms of signing by dr.
it must have a wet signature if the rx is printed out.
What can an RPh change on the copy of a C2 drug?
Only if RPh has spoken to practitioner who issued the rx
- Strength of drug
- qty of drug
- Directions of use
- date the RX was written
- Days supply of drug
- ICD 10 code
- DOB of the pt
What can an RPh NOT change on the hard copy of a C2?
- name of the pt
- name of CS prescribed, unless changing to generic form only
- the signature of the prescribing dr
Once a change is made to a C2 hard copy what must an RPh do?
- initial any addition or change made
2. make a note of; the date and time it was changed and the reason for changing it
How many C2 drugs can be written on a single RX pad?
- another C2 drug
- Other CS not in C2
- any other rx drug
- The org file must be kept with the C2s and a copy must be placed for the other drug categories
If an RX has C2 written on it as well another another drug which is not a C2 how will it be filed?
- the org copy will be filed with the C2s.
- a copy of the other drugs will be placed in the correct file and contain a reference to the serial number to the rx with the C2.
Can an RPh return a C2 hard copy to the pt?
Yes, unless the RPh verifies that the Rx has been filled and dispensed to the pt, then they will not return it
What are the rules a dr must follow when writing a “do not fill before date”?
- the date must not be later than 3 months after the date the rx was writen
- the rx must be tendered on or before the 14th day after “date indicated”
- no combo of rx for the same medication can exceed a 90 day supply
- The C2 must be the only drug listed on the RX pad. Can not contain any other CS
Can an RPh partial fill a CS?
Yes, as long as you follow:
- Can not exceed the total amount the Rx was written for
- the remaining portion of the RX must not be filled more than 30 days after the date on which the rx was written
- In an emergency situation the remaining portion of the RX must be filled not later than 72 hours the rx was issued
How does partial filling of a C2 work in “long term care” (LTC)?
Must record on the rx:
- The pt is LTC
- Date of the partial filling
- qty of the med that is dispensed
- remaining qty auth to be dispensed
- signature or initials of RPh on record on back of rx
