Reading 10

Question 1

When considering Controlled Substances, what are some of the ways to help with reducing thief?

Answer 1

• Putting C-II to V all together on the shelf
• Put in a safe or locked container
• C-I MUST be locked up

Mainly C-III to V in mixed with non-controlled and C-II in a safe

Question 2

What type of safe must be used for the C-I or IIs, especially within a practitioners office>

Answer 2

• Steel Cabinet equivalent to a U.S. Government Class V Security Container

Question 3

When employing people, who are some of the people we CANNOT employ?

Answer 3

• Convicted Felons [related to controlled substances]
• Someone that has had there registration revoked, deined or surrenedered

Someone arressted NOT felon, misdemeanor, felon UNRELATED to controlled substances CAN be employed

Question 4

What are some of the interview questions that you can ask that pertains to security?

Answer 4

• Crimes related to controlled substances [convicted or misdemeanor]
• Taken controlled substance thats not yours

Question 5

How long should record and reports be kept?

`

Answer 5

• 2 years from the inventory date

Question 6

What are some of the prescription storgae methods?

Answer 6

• Two-file
• Three-file

Question 7

What is a Three-File System?

Answer 7

• C-II in ONE file and C-III, IV, V in a SECOND file and non-controlled in a THIRD file

Question 8

What is a two-file system?

Answer 8

• C-II in ONE file and the rest in a SECOND file

Question 9

When using a Two-File System, was are two ways that help make prescriptions readilty available?

Answer 9

• Red-C: 1in high, stamped in lower right [shows it was filed?]
• Within the computer system [should identity Dr. name, patient name, drug, date filled]

Question 10

What Central Recordkeeping?

Answer 10

• DEA allowing records to be keeping at a central location
• Must noifty the DEA first tho [exact location, name, address, DEA #, Type of Registration, is the central location manual or computer?]

Could start within 14 days unless told so by the DEA

Question 11

What are three things that cannot be stored Centrally?

Answer 11

• CANNOT store; executed order forms [DEA form 222], Inventories, or Prescriptions

Question 12

What is the way that we can order C-III, IV, V contrlled substances?

Answer 12

• Same as non-controlled
• Invoice MUST have; date, controlled substance

Question 13

What is the way that we can order C-II contrlled substances?

Answer 13

• DEA Form 222
• OR with a prescription [If no 222]

Question 14

Who is able to order off of the DEA Form 222?

Answer 14

• By that who signed the MOST RECENT registration paper work
• Unavailable = give agency by power of attorney

Can have more that one person POA’d

Question 15

What is the way that we are able to obtain an order form?

Answer 15

• Submit an order to DEA form 222a [done as part of registration]
• Additional forms are done the same way OR contant local DEA office

Question 16

What are some of the pre-printed things on a DEA form 222 and what should you do if they are messed up?

Answer 16

• Pre-printed: Order from #, Name, Address, Registration #, Activites, Schedules they can handle
• Errors: Send back to DEA then get new ones

Question 17

How do we execute an order form?

Answer 17

• 20 lines: One thing per line
• Purchasers ONLY provide name of drug, strength, number of packages

NO NDC because that is what your going to have to get

Question 18

What is the way that we file an order form?

Answer 18

• Supplier adds DEA # and completes form [includes NDC, number of packages, date completed]
• Supplier keeps OG DEA 222 then sends a copy to the DEA by the end of the month

Question 19

What is the process of Partailly filling an order?

Answer 19

• Cant complete order; can patrially fill then supply balance within 60 days
• After 60 days, Order invalid

Question 20

What is the process of endorsing a order?

Answer 20

• ALL OR NOTHING
• If endoring; must be complete within 60 days
• Endorsee does all paper work then

Question 21

What happens if the supplier finds an unaccepted or defective order form?

Answer 21

• Forms that are imcomplete, erasure/alteration, not prepared must snd the DEA 222 back to the purchaser

Question 22

What happens when an order form is voided or canceled as part of an order?

Answer 22

• Supplier crosses out items and printes “cancelled”
• Purchaser can cancel by contacting supplier by mail, fax, or email

Question 23

What are the two type of lost or stolen order forms?

Answer 23

• Unfilled: lost in the mail or before filled [MUST make new DEA 222 exactly the same as before]
• Unused: notify immediately; Known, must give form # & Unknown, must give date

Question 24

What is the way that we are able to use electronic order forms?

Answer 24

• HAVE to get a Digital Certificate [need for CSOS]
• Also need 9-digit code, registration #, supplier address/DEA #, date, product, amount

Forward to DEA within 2 days

Question 25

What are some of the important inventory dates?

Answer 25

- Initial: 1st do it - Official: ALL controlled substance on hand - Last: Non-controlled to controlled - Final: When going out fo business ## Footnote Official is completed **EVERY 2 YEARS**

Question 26

What are some of the methods of taking inventory?

Answer 26

- At open or close - OPEN: recieved/dispensed NOT counted for (use both) - CLOSE: recieved /dispensed COUNTED for (use

Question 27

For what controlled substance should you give exacts counts for and which should not?

Answer 27

- C-I & II: **EXACT** - C-III, IV, V: **ESTIMATE** only if bottle < 1000 units ## Footnote GREATER then 1000 units have to give exact counts

Question 28

What is the calculation for finding out inventory of controlled/non-controlled substances after a robbery?

Answer 28

- Biennial inventory [open or close] **+** - Received **-** - Dispensed, Distributed, Returned, Lost, Stolen, Destoryed **-** - On hand amount

Question 29

# Practice Question 1 A pharmacy is automatically granted authority to use the CSOS system when they apply for a DEA registration ## Footnote a. True b. False

Answer 29

- b. False ## Footnote it only for controls?

Question 30

# Practice Question 2 All methadone and hydromorphone products must be stored in a pharmacy in a locked safe due to their likelihood for abuse? ## Footnote a. True b. False

Answer 30

- b. False

Question 31

# Practice Question 3 Select all of the following that are true regarding who a person can emply and screening expectations for emplyees handling controlled substances? ## Footnote a. A pharmacy cannot emply an individual who was previously arrested for dealing cocaine b. A hospital should ask questions about previous drugs use when interviewing pharmacy technician candidates c. An individual who has had their DEA license revoked can apply for a waiver to work around controlled substances d. A pharmacy student with a felony conviction involving contrlled substances would need all APPE sites with controlled substances to apply for a waiver for them to be on site e. Prescribers who have surrendered their DEA registration for cause can still be employed because the DEA didn't find them guilty of a crime

Answer 31

- B, D

Question 32

# Practice Quesiton 4 A robbery occurred at your pharmacy. The pharmacy manager is wokring on figuring out how many tablets of methadone were taken and they ask you to check thier math. Here's the information they provide: i. last biennial inventory at closing - 1510 tablets ii. dispensed on inventory date - 240 tablets iii. dispensed after inventory date - 9500 tablets iv. received on inventory date - 500 tablets v. received after inventory date - 10400 tablets vi. remaining after robbery - 30 tablets How many tablets were stolen? ## Footnote a. 2380 tablets b. 2140 tablets c. 2670 tablets d. 2640 tablets e. 2410 tablets

Answer 32

- a. 2380 tablets

Question 33

# Practice Question 5 Which of the following is accurate regarding inventory requirements? ## Footnote a. A pharmacist can estimate Percocet quantities in a bottle with 500 tablets or more b. Initial inventory is recorded when you first have controlled substances at the location c. Inventory must be taken every year on a date determined by the DEA d. A tachnician can estimate lorazepam quantities in bottles containing no more than 1000 tablets e. If a product becomes a controlled in between inventory dates the pharmacy will first count the product during their next official inventory

Answer 33

- d. A tachnician can estimate lorazepam quantities in bottles containing no more than 1000 tablets