Pharmacist Practice

Question 1

What two (2) requirements must be present for all Rx?

Answer 1

• Legit medical purpose
• Scope of practice (of prescriber)

Question 2

Who is responsible for a filled prescription that is NOT properly prepared or NOT issued for a legit purpose or out-of-scope?

Answer 2

Corresponding liability rests upon the Pharmacist who fills the prescription

Question 3

Is an online survey-based prescription sufficient for a patient-prescriber relationship? If not, what is?

Answer 3

No; Telehealth is okay

Question 4

Any prescriber that prescribes CS must have what?

Answer 4

Their own DEA number
* Included on the RX

Question 5

True or False. All prescribers must always prescribe in scope-of-practice, regardless of field of practice.

Answer 5

True

Question 6

Can a Pharmacist fill a CS prescription from an out-of-state prescriber? What is required?

Answer 6

Yes
* Prescribers must have a valid DEA number/licnese

Question 7

Can a Physician’s Assistant (PA) be allowed to prescriber CS II - V? If so, what is required?

Answer 7

• PA must be delegated by a Supervising Physician
• Must obtain a Mid-Level CS License
• CII RX – May not exceed 30 days supply

Question 8

Can an Advanced Practice Registered Nurse (APRN) be allowed to prescribe CS II - V? If so, what is required?

Answer 8

Required for CII Narcotics (Opioids) & Benzodiazepines
* Must have a physician consultation first before RX can be issued

Question 9

What are Optometrists allowed to prescribe?

Answer 9

Only medications for eye-related issues

• Oral Steroids - Up to 7 days supply max
• CIII, CIV, CV - analgesic agents for up to 72 hr supply max
• Only C2 Choice = Norco (Hydrocodone + Acetaminophen) Up to a 72 hr supply

Question 10

What are Dentists allowed to prescribe?

Answer 10

All CS
* As long as it relates to their scope of practice

Question 11

What are GI doctors allowed to prescribe?

Answer 11

• Only for medications for stomach-related issues

Question 12

What are Podiatrists allowed to prescribe?

Answer 12

Only for medications for foot-related issues, etc.

Question 13

When will Non-CS prescriptions expire?

Answer 13

15 months from the date of issuance

Question 14

If a Non-CS prescription issues #30 tablets with two (2) authorized refills, what is the Pharmacist allowed to dispense?

Answer 14

May dispense all 90 tablets all at once
* Must be Non-CS

Question 15

If a patient has 0 refills and the pharmacy is unable to contact the provider for a refill. What is the pharmacist allowed to do?

Answer 15

Pharmacist may fill for “emergency fill;” For an amount needed for this emergency time frame
* No more than 30 day supply
* Non-CS Rx Only
*For Chronic Condition

Other Requirements:
* Pharmacy has filled this medication (for the patient and from the same prescriber)
* Pharmacy must inform the prescriber of this (emergency) fill

Question 16

What must all prescription include?

Answer 16

• Patient name & address
• Prescriber name & address
• Prescriber telephone #
• Prescriber degree classification
• Prescriber License #
• Date of Issuance
• Drug name, strength, dosage form & quantity
• Directions for use
• Refills

If electric prescription:
* Date & Time of Transmission
* Name of Intended Pharmacy

Question 17

How must all CS prescriptions be issued?

Answer 17

Electronically

Question 18

Is a Pharmacist that dispenses a CS prescription, BUT was not prescribed electronically, liable to discipline or punishment?

Answer 18

No; May be exempt

As long as the pharmacist dispenses in “good faith” AND believes that the paper Rx is valid and written in “good faith”

Question 19

Can a Pharmacist refuse to fill a valid prescription (CS and Non-CS) solely because it is not prescribed electronically?

Answer 19

No; If believe true, must fill in “good faith”

Question 20

CII Prescription Requirements

Answer 20

• Written and Numberic form of quantity
• Valid up to 90 days of issuance
• May not exceed 30 days supply
• Not allowed any refills

If Dispensing C2 Opioid – The Pharmacist is required to inform the patient that opioids are addictive & must offer naloxone

Question 21

CII Prescriptions are only valid for how long?

Answer 21

90 days from the date of issuance

Question 22

What is the max day supply of CII Prescriptions?

Answer 22

30 days

Question 23

How many refills are CII Prescriptions allowed?

Answer 23

None

Question 24

Which fields allow CII Prescriptions to be issued by fax?

Answer 24

• Hospice
• Long-Term Care Facility (LTCF)
• Compounded Preparation (for direct administration)

Question 25

Can a prescriber issue an "Emergency Rx" for a CII Prescription Verbally? What is required?

Answer 25

Yes; Amount may not exceed what is needed for the emergency period Prescriber must deliver a written/electronic Rx to the pharmacy within 7 days Pharmacist is required to immediately reduce the verbal order into writing

Question 26

What is required in order for a physician to issue three (3) sequential CII Prescriptions (for 30 days supply each)?

Answer 26

* Same patient * Same drug * Must use "earliest fill date..." * Up to a 90 day supply Issue date must be the true date of issue Cannot pre-date or post-date

Question 27

If a CII Prescription is issued with errors or lacking information, what is a Pharmacist allowed to do?

Answer 27

Pharmacy may contact prescriber to change: * Quantity * Dosage form * Patient Address * Date of birth

Question 28

Which information on Rx scripts are Pharmacists NOT allowed to change on prescriptions with errors or lacking information?

Answer 28

* Date issued * Name of Patient * Name of Prescriber * Name of Drug

Question 29

For CIII-CV Prescriptions, how many refills can be allowed? When do they expire?

Answer 29

May be refilled 5 times Valid for 6 months from the issuance date * Partial filling of CIII-CV is allowed within 6 months of issuance

Question 30

Can an individual practitioner obtain CS via an issued prescription to have a supply of CS for the purpose of general dispensing to patients?

Answer 30

No; if a prescriber wants to stock drugs, they must do so through an invoice RX = Particular (Specific) Patient

Question 31

Can a practitioner self-prescribe or self-dispense controlled substances? Are they able to prescribe CS to an immediate family member?

Answer 31

No; Cannot self-prescribe nor self-dispense To immediate family members * No; unless there is a bonafide practitioner-patient relationship AND appropriate records are maintained for all treatment

Question 32

Can a prescription be issued for the dispensing of narcotic drugs (in any Schedule) to a narcotic drug dependent person for the purpose of continuing dependence?

Answer 32

No; except in the case of conducting an authorized clinical investigation * In a Narcotic Addict Rehabilitation Program

Question 33

Can a Pharmacist dispense hormonal contraceptives (pursuant to the statewide standing order)? If so, are there any additional requirements?

Answer 33

Yes; Must complete: * Education Training Program (ACPE Accredited) * Provide counseling on Proper Use & Effectiveness * Patient must complete a Self-Screening Risk Assessment Tool Keep records for 5 years (self-assessment, counseling, referrals)

Question 34

What is the maximum amount a Pharmacist can dispense for hormonal contraceptives? What dosage forms can they be?

Answer 34

Not to exceed 12 month supply; per visit Contraceptive forms may be oral, topical, injections, and vaginal rings

Question 35

Can a Pharmacist dispense PrEP and PEP (through a standing order? How?

Answer 35

Yes; Only if patient provides a non-reactive HIV result Standing order is through the IL Department Public Health * Authorizes pharmacists to prescribe with no RX needed * Proper training is still required

Question 36

What should a Pharmacist do if a patient presents with a reactive HIV test result at the pharmacy?

Answer 36

Must refer the patient to a physician

Question 37

When is verbal counseling required for patients?

Answer 37

New prescriptions; and Prescriptions that have changed previously

Question 38

When must the offer to counsel (verbally) be required?

Answer 38

For no-change refill prescriptions So an offer must be made on basically all prescriptions

Question 39

What happens when a patient declines an offer to counsel on their medication(s)?

Answer 39

The Pharmacist must document that an offer was made

Question 40

Which pharmacy setting does NOT require the pharmacist to counsel patients?

Answer 40

Hospital (Inpatient)

Question 41

What can be used as alternatives forms to supplement counseling?

Answer 41

Videos, print-outs, and etc.

Question 42

Is consultation still requires when an Rx is mailed or delivered to the patient? Is it different from the regular version of required counseling?

Answer 42

Yes; By providing written information to the patient regarding the medication being dispensed Additional requirements: * Availability of the pharmacist to answer questions * Provision of a toll-free phone number (for long distance calls)

Question 43

Can a retail pharmacy accept returned drugs from patients (after dispensing) for the purpose of re-dispensing?

Answer 43

No; Can only accept medications for the purpose of destruction / disposal Drugs cannot be returned to stock

Question 44

Can a retail pharmacy accept a returned medication if it was the wrong medication dispensed, and for the purpose of re-dispensing?

Answer 44

You can accept the return BUT NOT for the purpose of re-dispensing Drug may not be returned to stock

Question 45

If a pharmacy accepts returned drugs from patients (after dispensing) for the purpose of destruction / disposal, where should be kept?

Answer 45

Any returned or recalled medication must be kept SEPARATED from regular inventory

Question 46

Can a pharmacy accept returned drugs for the purpose of donations? If so, how?

Answer 46

No; Except for pharmacies enrolled in a "donation program" * Charitable Clinics * Prison Pharmacies

Question 47

Can an "Institutional Healthcare Facility" (in which medications are administered to patients) return drugs to the pharmacy that provided them? If so, what are the requirements?

Answer 47

Yes; As long as the drugs were stored properly...meaning * Drugs were in the possession of a healthcare professional the entire time and never reached the patients Drugs must not be contaminated, deteriorated, or expired

Question 48

Can a pharmacy return dispensed drugs from "Will Call" back to the inventory?

Answer 48

Yes; Only if the patient never picked up the medication * Patient's information must be removed The returned stock vial must have the expiration date -- not to exceed 12 months from the fill date

Question 49

Can a hospital return drugs to the pharmacy (from within hospital storage areas?

Answer 49

Yes; But must meet requirements of: * Sealed * Intact * Unaltered * Stored under good conditions

Question 50

Can Pharmacists administer vaccines? To whom?

Answer 50

Yes; To patients at least 7 years old (with a prescription or standing order)

Question 51

What are the requirements needed that allow Pharmacists to administer vaccines?

Answer 51

* Complete 2 CE hours on Vaccines Topic * Completed proper training course * Current BLS/CPR Certification Must give VIS to patient before administration

Question 52

When must the Pharmacy report a vaccine administration to the I-Care System?

Answer 52

Within 30 days of giving the vaccine

Question 53

Where must vaccine adverse events be reported?

Answer 53

VAERS

Question 54

Do Nuclear Pharmacies have any additional requirements in order to provide servce?

Answer 54

Must be separated from the "hot" laboratory, compounding, and dispensing areas * Radioactive Storage * Product Decay Facility The amount of radioactivity must be determined (for each Rx) at the time of preparation

Question 55

Do Remote Sites / Telepharmacies have any additional requirements in order to provide service?

Answer 55

Counseling must still be performed Audio & Video Communication is required * For the supervision of the remote technician

Question 56

For Remote Sites / Telepharmacies, are there any specific license requirements?

Answer 56

Yes; Each remote site must have their own license

Question 57

What information from Remote Sites / Telepharmacies should be remembered?

Answer 57

* No prescription inventory is required * Written RXs must be delivered to the home pharmacy within 72 hours * Monthly inspections by a pharmacist

Question 58

A Pharmacist violating patient confidentiality results in what?

Answer 58

Violation of Professional Conduct May be subject to disciplinary actions & fines

Question 59

What must pharmacies give to patients before serving them in the pharmacy?

Answer 59

Notice of Privacy Practices

Question 60

When can patient information be released to another party?

Answer 60

Another provider who is actually providing care to that patient There is a legal-requirement (legit law enforcement inquiry, etc.)