Controlled Substance Law -- ILE 5 (Psychiatry)

what criteria must be met for a nurse practitioner of physician assistance to write a control II prescription?

-must be registered with AL board of medical examiners

-must have DEA #

-must have the practice registration amended to include CIIs

-must have an active qualified AL controlled substance certificate (QACSC) that allows the practitioner to prescribe CIII-CV controlled substances

-must have an active LPSP (Limited purpose schedule II permit)

-must have a current collaborative practice agreement with a physician who provides oversight of all NP or PA prescribing

-CII must be in the prescriber's scope of practice

can dentists prescribe amphetamines?

no

what is LPSP (limited purpose schedule II permit)

a QACSC extension that allows prescribing of certain-specific CIIs

can physicians, dentists, podiatrist, or veterinarians write prescriptions for controlled substances?

yes

should an alabama pharmacy honor a CII prescription from an out-of-state nurse practitioner?

yes

is this DEA # for Scott Henry, PA, legit? MH6125341

yes

for a DEA #, what is the first letter for

the registrant type

for a DEA #, what is the second letter for

first letter of prescribers last name

requirements for a control substance prescription

-date of issue

-patients name and address

-practitioner's name, address and DEA #

-drug name and strength

-dosage form

-quantity

-directions for use

-number of refills (if any)

-manual signature of prescriber

what should always be done as a pharmacist accepting a controlled substance prescription

double check

what can a pharmacist change on a prescription with verbal okay from prescriber

-dosage form

-strength

-quantity

-directions

-issue date

what can NOT be changed verbally by a pharmacist

-drug name

-patient name

-prescriber name

-DO NOT fill before date

are refills allowed for CII substances

no

is there an expiration date for CII prescriptions

no

can a CII be partially filled

may be if the pharmacy does not have the full supply in stock at the time that the original, valid, signed CII prescription is presented by the patient for fulfillment

what does the comprehensive addiction and recovery act allow for partial fills of CII prescriptions

within 30 days of the date of issue

what is the exception for partial fills of CII prescriptionsq

terminally ill patients can be partially filled for up to 60 days

when there is not enough supply, when can the remaining portion be filled

within 72 hours of first partial fill

can multiple prescription be written for a single patient to receive the same CII medicated for a 90 day supply

yes

what does alabama law say about receipt of CII medications

all receipts shall be reviewed and approved by pharmacist and should be documented by the signature of pharmacist employed by pharmacy permit holder on the supplier's invoice or other similar document

what are the two methods for storing controlled substances?

-lock all substances in safe

-conceal all substances by dispersing them throughout inventory but CII but be separated

when does the annual inventory occur

january 15th

does inventory just occur for CII substances

no all controls

what has to happen for inventory of controlled II substances

exact count

what has to happen for inventory of controlled III-V substances

estimated count unless the container holds more than 1000 in which case an exact count needs to happen

what DEA form is the report of theft

106

how many copies are made of the theft report

4

where do the 4 copies of the theft report go

pharmacy keeps one and two (original and duplicate) to the Field Division Office of DEA and one duplicate copy to ALBOP

does a police report get sent to ALBOP for theft

yes

describe diversion according to the DEA's pharmacist's manual

pharmacists are responsible for protecting their practices against drug diversion

ways to decrease diversion

-think of manufacturing, storage, distribution, administration and disposal avenues

-restrict access of non-authorized personnel to controlled substances

-reconciliation of drugs from wholesaler

-watch distribution of drugs

-audits of drugs in automated controlled drug cabinets

-monitor compounded records and documentation of waste

-blank prescription pads, paper, DEA ordering forms must be secured

-physician can spell out number of units or refills on prescription

ways to prevent internal diversion

-conduct routine audits

-create a checks and balance system

-develop policy

-have different individuals receive orders

-keep unnecessary personnel from behind counter

-limit individuals with authority

-keep receipts

-monitor inventory

-perform criminal background checks

-require access before entering

-store controlled substances in secured area

-keep video archive

-supervise individuals

-use pre-employment drug testing

-use tamper-resistance packaging

list behavioral indicators of employee drug use or diversion

-changes in usage patterns of drugs that are commonly abused

-changes in work habits, behaviors and/or physical appearance of employees

-computer inventory thats off

-prescription with fake patient names

-an employee that appears tired all the time and has problems keeping their balance or has slurred speech

-personnel who regularly appear before their shift, staying late, showing up on off days

-missing bottles

-heavy 'wastage' of drugs

-sloppy record keeping, suspect ledger entries and drug shortages

-inappropriate prescriptions for large narcotic doses

-personnel found "in the wrong place" without a good reason

-suspicious activity

-unexplained absences from work that occur on a regular basis

how to dispose of medications in household trash

-mix medicines with an unpalatable substance such as dirt, cat litter, or used coffee grounds

-place mixture in container such as sealer plastic bag

-throw the container in your household trash

-scratch out all personal information