my uworld cpje notes

how soon to report abuse/neglect

2 working days of 36 hours of receiving info. failure to report is misdemeanor

exceptions to 3 year record keeping requirement?

hospital pharmacy chart order for controlled substances - 7 years

patient acknowledgement of hipaa - 6 years

transaction info for prescription drugs - 6 years

continuing education certificates - 4 years

patient medication profiles - 1 year

medication error/ quality assurance reports - 1 year

when to report patient harm form compounded products to FDA MedWatch

within 72 hours for nonsterile, 12 hours for sterile products. immediately for sterile products from another pharmacy

15 days for outsourcing facilities

optometrist prescribing limitations

topical and oral ok.

3 days for codeine, hydrocodone, or tramadol

no oral or topical anti-glaucoma meds or oral steroids under 18 years old

naturopath limitations

need NDF on license. independently can prescribe epi, hormones, OTC. dependently can prescribe C3-5

NO C2's

CNM, NP, PA

must be dependent authority for C2-5

what if prescriber dies?

rx still valid until expire or refills gone

out of state rx

allowed if license is equivalent to CA prescriber.

C2 must be mailed to pt home address (cannot hand to pt)

how long to keep records in hospital

3 years for noncontrolled, 7 years for controlled

when do non-controlled rx expire?

technically, never. standard of practice is 1 year

when do c2-5 rx expire

6 months

quantity limit for c3-4?

5 refills in 6 months, and max 120 day supply (whichever is less)

-C5 no refill limits

-prn refills on noncontrolled= expire in 1 year

auto refill renewal

enroll yearly

emergency refill limits

must have contacted prescriber, and lack of supply may cause adverse events

-only c3-5 and legend

-notify prescriber

-c3-5 only quantity needed to cover emergency period

-pharmacist judgment qty for legend drugs

transfer limits

c3-5 can only be transferred once (unless share database)

c2 cant be transferred

30->90 day fill

if noncontrolled and not psychiatric, and after an initial 30 day supply

-notify prescriber

where to look for therapeutic equivalence

orange book, ab1 rated.

purple book for interchangeable biologics

when unit dose packaging expire

6 months

PEP

-truvada (emtricit/TDF) + raltegravir (isentriss BID) or dolutegravir (tivicay QD).

- darunavir (prezista) and ritonavir (norvir ) QD

-Biktarvy (bictegravir/emtricit/TAF) QD

-take for 4 weeks, then get HIV test

PrEP

emtricit + TDF (truvada) or TAF (descovy)

how much pharmacy can sell to other DEA registrants

<5%

if return controlled drugs to supplier: what dea form?

dea 222 form or csos (like selling). pharmacy keep original, send copy to DEA, supplier keep copy

if dispose controlled drugs to reverse distributor

dea form 41. reverse distributor submits form to DEA

if lost dea form 222

notify dea field office immediately, with serial number or date issued

if controlled drugs lost in shipment

purchaser alert supplier, sign statement that order not received

if loss in pharmacy:

if by employee: notify ca bop in 14 days. all employee theft is significant

if insignificant, repor to CA BOP in 30 days

-if missing drugs, notify dea in 1 day and 45 days to investigate and submit form 106

if missing controlled drugs

notify dea in 1 day of discovery. then 45 days to investigate and submit dea form 106

who doesnt need dea number

practitioners at hospitals, or federal gov practitioners

dea 224 form

initial registration for pharmacy, hospital, institution, practitioners

224a

registration renewal form - done by PIC every 3 years

225

registration for manufacturers, distributors

363

narcotic treatment program registration

222

ordering, distributing, transferring schedule 1 & 2. used by dea registrant or POA.

limit of 20 items, only schedule 1 &2. (CSOS has no limit)

106

report theft

41

destroy controlled substance

actiq, fentora

fentanyl c2

hysingla ER, vicodin,

Lortab

hydrocodone, c2

dilaudid

hydromorphone

demerol

mepheridine c2

intensol, methadose

methadone c2

ms contin

morphine

oxycontin, roxicodone, xtampza er, endocet, percocet, percodan

oxycodone

tapentadol

nucynta/er c2

dynavel xr

amphetamine c2

focalin

dexmethylphenidate c2

dexedrine

dextroamphetamines

concerta, daytrana, quillichew, quillivant, ritalin, jornay

methylphenidate

other c2

dronabinol (syndros solution), cocaine for topical anesthesia, barbiturates (pentobarb, secobarb alone - c3 if suppository or if combo), codeine alone

fiorinal

butalbital/aspirin/caffeine C3

marinol

dronabinol capsules c3

fycompa

perampanel c3

xyrem

sodium oxybate c3

testosterone

c3

librium

chlordiazepoxide c4

onfi

clobazem c4

tranxene

clorazepate c4

diastat, valium

diazepam c4

versed

midazolam c4

restoril

temazepam c4

halcion

triazolam c4

belsomra

suvorexant c4

sonata

zaleplon c4

adipex

phentermine c4

qsymia

phentermine/topiramate c4

nuvigil

armodafinil c4

provigil

modafinil c4

soma

carisoprodol c4

ultracet

tramadol c4

schedule 5:

codeine cough syrup, lomotil (diphenoxylate/atropine), vimpat (lacosamide) pregablin