Reading 4

Question 1

Who are the Big Four that are able to prescribe in all states and jurisdictions?

Answer 1

• Physicians [MD/DO]
• Dentist [DDS/DMD]
• Podiatrists [PDM]
• Veterinarians [DVM]

Prescriptions from these can be filled anywhere [in US]

Question 2

Who are the practitioners that are outside of the BIG FOUR?

Answer 2

• Mid-level prescribers: may not have prescibing power because of needing additional requirements

i.e.; APN, PA, Pharmacist, Optomitrists, Cairopracters, Neruopaths…

Question 3

What is the Scope of Practice for Physicians and how does that affect their prescribing power?

Answer 3

• Care for ENTIRE person
• Can basically prescribe anything that will help the patient; even if they are specialized

May question why a specific MD/DO prescribes something but is legal tho

Question 4

What is the Scope of Practice for Dentist and how does this affects their prescribing power?

Answer 4

• Care for Mouth, Face, Jaw mainly
• Can really only prescribe for thoses areas [i.e.: pain meds for toothache, gum infections, dentail anxiety…]

WANT TO CALL TO DOUBLE CHECK

Question 5

What is the Scope of Practice for Podiatrist and how does that affect their prescribing power?

Answer 5

• Care for Feet, Ankles, maybe Hands
• Heart drug for edema??

More likely to stay in their lane

Question 6

What is the Scope of Practice for Veterinarians and how does that affect their prescribing power?

Answer 6

• ONLY for animals [tho it is human meds for animals]
• NO LIMITS just has to be for animal

HUMANS PICK THEM UP; keep in mind if filling a lot of vet stuff

Question 7

What is important to know about the prescribing power of Mid-Practioners?

Answer 7

• Narrow scope [i.e.: Optometrists]
• Broad scope: NP or PA [really prescriber under supervision]
• Just depends on what healthcare professional it is

Question 8

What is the Durham-Humphery Amendment [DHA] of 1951?

Answer 8

• Defined what a drug & prescription was and who can give them
• Allowed prescribers to CALL IN prescriptions
• Allowed refills

Question 9

What are some of the ways of accepting a prescription?

Answer 9

• Written & Orally (came from DHA)
• then Electronic & Fax came later

Question 10

What are some things that have to be on an Rx label?

Answer 10

• Name/Address of dispenser
• Rx Number
• Date of filing
• Name of Prescriber
• Patient name
• Directions
• Cautions

These are NOT always required

Question 11

Breif summarize the Refill laws in Indiana?

Non-C, C III - V, C II

Answer 11

• Non-control: refill any times upto one year
• Rx or OTC-Only & CIII, CIV, CV: refill no more than 5 times upto 6 months
• CII: NO refills but fillable upto 1 year

Question 12

What is an NDC?

Answer 12

• National Drug Code; not mandatory on bottle
• 10-digit number

Question 13

What does each part of the NDC number mean?

XXXXX - XXXX - XX

Answer 13

• First: Manufacturer [5 numbers]
• Second:Drug [4 numbers]
• Package size [2 numbers]
• i.e.: 50459-0141-30

Question 14

What does agency mean within pharmacy?

Answer 14

• When one person authorizes a second person to deal with a third person

SO stupid

Question 15

What are the parts of Agency in Pharmacy Law?

Answer 15

• “Principal” delegates to “Agent”. “Agent” completes task; “Agents” CANNOT make the decisions
• “Agents” CANNOT call in CII, but can Fax them

Question 16

What is the Omnibis Reconciliation Act of 1990 and what did it implement?

Answer 16

• Was one of the first federal laws that gave Pharmacist and Pharmacies the standards for practice
• i.e.; DURs, Conseling Requirements, Patient Profiles

Question 17

What is Drug Utilization Review [DUR] and the different types?

Answer 17

• Ongoing, systematic process designed to maintain the appropriate and effective use of medications
• Prospective & Retrospective

Question 18

What is Prospective DUR?

Answer 18

• Identifing problem BEFORE the patient gets the medications

Question 19

What is Retrospective DUR?

Answer 19

• Looking at regimens AFTER medicaitons have been dispensed

Question 20

What information does the OBRA ‘90 say must be included?

Answer 20

• written information like; name, address, phone, DoB, Gender..

Question 21

What is a MedWatch?

Answer 21

• Voluntary reporting system for adverse events with drug products, bioloigs, devices, nutirional products, cosmetices, and dietary supplements

Question 22

What is the Offical MedWatch?

Answer 22

• FDA 3500

Question 23

What type of information is required for pharmacies to give to patients in regards to MedWatch?

Answer 23

• Toll Free number with ALL new Rx and Refills

Question 24

What does the Drug Quality and Security Act [DQSA] require?

Answer 24

• Electronic tracing of products at the package level and trace certain Rx
• Help stop Counterfiets

Question 25

What is the time frame for verification of product legitmacy?

Answer 25

- Verification from place and get it back in **24 hours** - **non-rx, animal drugs, blood, radioactive drugs, biologics, imaging drugs, some IV products, gases...** are NOT covered by the DQSA

Question 26

What is the time frame for nitufying the FDA of illegitmate products in the supply chain, and who must provide the notifaction?

Answer 26

- Told to FDA within **24 hours** - By the Manufacturerm Repacker, Distributor, Dispenser

Question 27

# Practice Question 1 A surgeon is not allowed to write a prescription for a non-surgical issue. ## Footnote a. True b. False

Answer 27

- b. False

Question 28

# Practice Question 2 Which of the following is correct regarding a drug, max refills, and max prescription validity? (Select all that apply) ## Footnote a. Codeine/Acetaminophen, 5 Refills, Expires 6 months b. Codeine, 0 Refills, expires 1 year c. Gabapentin, 5 Refills, expires 6 months d. Lisinopril, unlimited refills, expires 1 year e. Sertraline, 11 refills, expires 1 year

Answer 28

- A, B, D

Question 29

# Practice Question 3 Pharmacists must determine whether an agent calling in a prescription has agency from the practitioner? ## Footnote a. True b. False

Answer 29

- b. False

Question 30

# Practice Questions 4 A prescription is present to you with the following information written on it by **Dr. Jane Doe**. Written on **02/25/2020, John Smith, Methadone 5mg, Take 1 tablet by mouth daily, may cause drowsiness**. Which of the following examples includes all information that must be on the prescription label based on the noted prescription information? ## Footnote a. Name & address of the dispensing pharmacy, Jane Doe, John Smith, Rx Number, Methasone 5mg, 02/25/2020, Take 1 tablet by mouth daily, may cause drowsiness b. Name & address of the dispensing pharmacy, Jane Doe, Rx Number, Methadone 5mg, Take 1 tablet by mouth daily. c. John Smith, Rx number, 02/25/2020, Methadone 5mg, Take 1 tablet b y mouth daily, may cause drowsiness d. Name & address of the dispensing pharmacy, Jane Doe, Rx Number, 02/25/2020, Methadone 5mg e. Jane Doe, John Smith, Rx Number, Methadone 5mg, Take 1 tablet by mouth daily, may cause drowsiness.

Answer 30

a. Name & address of the dispensing pharmacy, Jane Doe, John Smith, Rx Number, Methasone 5mg, 02/25/2020, Take 1 tablet by mouth daily, may cause drowsiness