PHA 373 - Filling and Dispensing L5 (Part A)
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93 Terms
Who is the Pharmacist-in-Charge (PIC)?
The pharmacist whose name appears on the pharmacy license and who is responsible for all prescription-related business in a community pharmacy.
How many pharmacies can a pharmacist be PIC for?
One pharmacy at a time.
Does a PIC have to be a full-time employee?
No.
Who is the Director of Pharmacy?
The pharmacist responsible for all activities of the hospital pharmacy.
Does the Director of Pharmacy have to be a full-time employee?
Yes.
What is the Director of Pharmacy responsible for?
All activities of the hospital pharmacy.
Who may perform duties requiring professional judgment?
Only a licensed pharmacist.
What duties require professional judgment?
Patient counseling, communicating with healthcare providers, taking verbal prescriptions, and providing prescription drug information.
Where must controlled substances be purchased from or returned to?
A permitted wholesaler/distributor.
Where must controlled substances be stored?
In the prescription department accessible only to authorized personnel.
What information must a pharmacist include when signing a controlled substance invoice?
Signature, Georgia pharmacist license number, and date.
What authority does the Georgia Drugs and Narcotics Agency (GDNA) have?
To inspect, copy, and remove inventory records, invoices, and prescriptions.
Who has keys to the community pharmacy?
Only pharmacists.
Who may access the pharmacy department?
Pharmacists, pharmacy interns/externs, and registered pharmacy technicians.
What must happen if a pharmacist is absent from a community pharmacy?
The prescription department must be securely locked.
What is the 5-minute rule?
If the pharmacist leaves for longer than 5 minutes, the prescription department must close and be secured.
What sign must be displayed when the pharmacy closes?
"Prescription Department Closed" in letters at least 3 inches high.
When does the pharmacy NOT have to close if the pharmacist is away longer than 5 minutes?
When the pharmacist is still performing pharmacy duties (e.g., counseling, immunizations, MTM, OTC consultations).
What is direct supervision?
The pharmacist must be available to assist and supervise pharmacy personnel.
Where may direct patient care occur outside the dispensing area?
Consultation rooms, vaccination rooms, OTC aisles, and MTM areas.
What security requirement exists for hospital pharmacies?
The pharmacy must be locked to prevent unauthorized entry.
Must hospitals provide medications even when the pharmacy is closed?
Yes, medications must be available 24/7.
What methods allow hospitals to provide medications when the pharmacy is closed?
Remote order entry, night cabinets, limited pharmacy access, nurse supervisor access, and emergency kits/crash carts.
What is remote order entry?
A pharmacist at another location enters medication orders electronically when the hospital pharmacy is closed.
Who must approve remote order entry policies?
The Georgia Board of Pharmacy.
What is a night cabinet?
A locked metal cabinet outside the pharmacy containing prepackaged medications.
Who has access to a night cabinet?
Authorized personnel using a key, code, or combination.
How often must a night cabinet inventory be performed?
Weekly.
What documentation is required when controlled substances are removed from a night cabinet?
A written order and proof-of-use form.
What is a retrospective review?
The pharmacist reviews medication use after the pharmacy reopens.
What is an emergency kit (crash cart)?
A mobile cart containing emergency medications for urgent patient care.
When may drugs be removed from a crash cart?
Only by authorized personnel with a valid practitioner's order.
What happens after a crash cart seal is broken?
The cart must be returned to the pharmacy for restocking, counting, and resealing.
How often must crash carts be inspected?
At least every 90 days by a pharmacist.
When must the pharmacy be notified regarding a crash cart?
Whenever it is opened.
Who may enter the hospital pharmacy after hours?
One nurse supervisor per shift.
When may a nurse supervisor enter the pharmacy?
When medications are unavailable from floor stock and delaying therapy could harm the patient.
What must be available before a nurse enters the pharmacy?
An on-call pharmacist available by phone and able to come to the hospital if needed.
What must the pharmacist do the next day after limited pharmacy access?
Conduct inventory.
What is the difference between a prescription order and a hospital order?
A prescription order is used in the community; a hospital order is used for inpatients.
What information must appear on a Physician Assistant prescription?
Name, address, and telephone number of both the supervising physician and PA.
Can a Physician Assistant prescribe Schedule III-V medications?
Yes, using their own DEA number.
How long may a Physician Assistant authorize refills?
Up to 12 months.
What information must appear on an APRN prescription?
Name, address, and telephone number of both the delegating physician and APRN.
Can APRNs prescribe Schedule III-V medications?
Yes, using their own DEA number.
How long may APRNs authorize refills?
Up to 12 months.
For which medications may APRNs authorize refills up to 24 months?
Birth control, hormone replacement therapy, and prenatal vitamins.
What may APRNs NOT prescribe?
Medications to pharmacologically induce abortion.
What are the four methods of receiving community prescriptions?
Written, oral, fax/visual image, and electronic data transmission.
Can a patient fax or scan a prescription to the pharmacy?
No. Electronic prescriptions must come directly from the prescriber.
What information is required on all prescriptions?
Patient name and address, prescriber information, DEA number if controlled, issuance date, drug name, strength, dosage form, quantity, directions, refills, and prescriber identification/signature.
Who may accept oral prescriptions?
Only pharmacists and pharmacy interns/externs.
Can a pharmacy technician accept an oral prescription?
No.
What must happen immediately after receiving an oral prescription?
It must be reduced to writing.
What is the difference between the issuance date and the fill date?
The issuance date is when the prescription is written or transmitted; the fill date is when it is dispensed.
What information must appear on a community prescription label?
Pharmacy name, address, phone number, Rx number, fill date, patient name, prescriber name, drug name and strength, quantity, directions, cautionary statements, pharmacist initials/code, and expiration date.
When is generic substitution required?
When an equivalent generic or interchangeable biological product is available unless prohibited.
Which therapeutic equivalence ratings may be substituted?
A-rated and B-rated products.
Which therapeutic equivalence rating may NOT be substituted?
C-rated products.
What must a pharmacist dispense if a generic prescription is written?
The lowest-priced equivalent product in stock.
What must appear on the label when substitution occurs?
"Generic for…" or "Interchangeable biological product for…"
What must a prescriber write to prevent substitution?
"Brand Necessary."
Can "Brand Necessary" be preprinted or stamped?
No.
If the prescriber writes "Brand Necessary," may the pharmacist substitute a generic?
No, unless the prescriber later authorizes substitution.
Can a patient override "Brand Necessary" and request a generic?
No. The patient must contact the prescriber.
Can prescriptions be refilled without authorization?
No.
How should refills be timed?
They must not be filled earlier than appropriate based on the prescribed dosage regimen.
Where must refill records be documented?
On the original prescription or an approved electronic record.
When is a prescription invalid after the patient-provider relationship ends?
Six months after termination.
When may a pharmacist dispense an emergency supply without refills?
When unable to contact the prescriber and interruption of therapy could harm the patient.
How much medication may be dispensed in an emergency refill?
Up to a 72-hour supply.
Can controlled substances be dispensed under the emergency refill rule?
No.
How soon must the pharmacist notify the prescriber after an emergency refill?
Within 7 days.
How is an emergency refill documented?
As a new non-refillable prescription referencing the original prescription number.
What must the pharmacist document for an emergency refill?
The circumstances requiring emergency dispensing.
Can pharmacists routinely use emergency refills for the same patient and medication?
No.
What must the receiving pharmacist do during a manual prescription transfer?
Create a hard copy marked "TRANSFER" and document required transfer information.
What must the sending pharmacist do during a manual prescription transfer?
Mark the prescription "VOID" and document the transfer.
What information is documented during a prescription transfer?
Names of both pharmacies, pharmacists, transfer date, and DEA numbers if controlled.
What must happen during an electronic prescription transfer?
The original prescription is marked VOID and a hard copy is created.
Who must personally offer patient counseling?
The pharmacist.
When is counseling required?
On all new prescriptions.
Is counseling routinely required for refills?
No.
What information should counseling include?
Drug name, purpose, dosage, route, duration, directions, precautions, side effects, monitoring, storage, refill information, missed doses, and other relevant information.
When is counseling NOT required?
Hospital inpatients, inmates, Department of Public Health patients, and patients or caregivers who refuse counseling.
Can clerks perform pharmacist duties?
No. Clerks are support staff but cannot perform duties requiring professional judgment.
What is required if GDNA removes records from the pharmacy?
The pharmacist must be given a receipt.
What is the main difference between a night cabinet and a crash cart?
Night cabinets are for general after-hours medication access; crash carts/emergency kits are for urgent emergency medications.
What does it mean when an emergency kit/crash cart is sealed?
It is sealed to prevent unauthorized access.
What labeling is required on emergency kits/crash carts?
Clear exterior and interior labels.
Who exchanges a used emergency kit for a new one?
The pharmacist and nurse.
What does “Prescription Order” mean?
A medication order used in the community/outpatient setting.
What does “Hospital Order” mean?
A medication order used in the institutional/inpatient setting.