Hawaii MPJE Prep

MD

doctor of medicine

"Marijuana" means:

I. The seeds of plant of the genus Cannabis.

II. The resin extracted from plant of the genus Cannabis.

III. The mature stems of the plant of the genus Cannabis.

A. I only

B. I and II only

C. II and III only

D. all

B. I and II only

A patient comes to your pharmacy and presents the following prescription. The prescription reads: Metoprolol 50 mg 1 tab po b.i.d. qty: 120 Refill: 3 times Which of the following is TRUE?

A. Shall not fill more than 60 tablets.

B. Shall only fill 30 tablets.

C. Shall not fill more than 360 tablets in a single filling.

D. Shall fill 120 tablets as indicated.

A. Shall not fill more than 60 tablets.

A patient brings a new prescription for Zoloft. The prescription reads: Zoloft 25 mg, take 1 tablet by mouth every day for 30 days x 5 refills. The patient requests to fill the whole prescription, for 180 tablets, in a single filling. Which of the following would be the most appropriate action by the pharmacist under North Carolina Pharmacy Law?

A. Obtain the authorization from the prescribing physician.

B. Tell the patient that law does not permit to fill the whole supply.

C. Fill only 30-day supply.

D. Fill the requested amount.

A. Obtain the authorization from the prescribing physician

A Long Term Care Facility (LTCF) can be any of the followings EXCEPT:

A. A facility which provides extended health care to resident patients

B. A retirement care

C. A nursing home

D. A mental care

A. A facility which provides extended health care to resident patients

A licensee shall keep and make available for inspection all records for controlled substances, including:

I. Invoices

II. Acquisition records.

III. Sales receipts

A. I only

B. I and II only

C. II and III only

D. all

B. I and II only

A licensed physician may prescribe marijuana for the treatment(s) of:

I. Glaucoma

II. Side effects resulting from the administration of chemotherapy cancer treatment

III. Spastic quadriplegia

A. I only

B. I and II only

C. II and III only

D. all

D. all

True or False: A hospital provides outpatient pharmacy services may use the same pharmacy license it used for the hospital inpatient pharmacy.

False

True or False: A hard copy of an electronic data prescription drug order for any Schedule II controlled substance that is given directly to the patient shall NOT be REQUIRED on security paper approved by the board.

FALSE

True of False: A drug order is an order written in a hospital or healthcare institution which is signed by a legal recognized practitioner and is reduced to writing. A drug order is the same as a prescription.

False

A drug is found to be under-strength, although it is not used to treat a life-threatening disease. What type of recall will be required?

A. Class I

B. Class II

C. Class III

D. Class IV

B. Class II

OD

doctor of optometry

DO

doctor of osteopathy

DMD

doctor of dental medicine

DDS

doctor of dental surgery

DC

doctor of chiropractic

DPM

doctor of podiatric medicine

DVM

doctor of vet medicine

PA

physician assistant

NP

nurse practitioner

LPN

licensed practical nurse

Which practitioners have the broadest spectrum of prescribing ability?

MD and DO

Hawaii Chapter 328

Food, Drugs and Cosmetics

certificate of medical necessity

DHS Health Care Financing Admin's FORM HCFA 484

How do I apply to administer immunizations to people 14-17 years old?

Submit completion of ACPE immunization training course. Name, address and pharmacy permit number where you will be administering. Submit to BOP

How often do you renew to immunize people 14-17 years old?

once every 3 years (every other biennium)

Does the BOP accept non-ACPE training for immunizations of 14-17 year olds?

No. Only ACPE

Is a script required to immunize a minor (14-17 years old)?

Yes

Do you have to notify the medical home after immunizing a minor (14-17 years old)?

Yes, withing 72 hours. Name of vaccine, manufacturer, lot#, expiration, route of admin, site of admin.

Do you need to notify anyone else besides the medical home after immunizing a minor (14-17 years old)?

Yes, DOH Immunization Registry within 5 business days.

What does Act 165 (CE Law) require?

Hawaii Rph's must complete 30 hours of approved CE each biennium and prior to Dec 31 of every odd numbered year.

When do Rph's renew their license in Hawaii?

Prior to Dec 31st of every odd numbered year

What courses qualify as CE?

All ACPE approved courses are acceptable towards the CE requirement (30 hours).

What are exceptions for not completing the CE requirement?

illness

military service

lack of access to CE (geographically isolated area)

Inability to take CE (incapacity, hardship)

What happens if you renew your Rph license without completing CE requirements?

Your license is subject to disciplinary action.

Do you need to submit proof of CE at license renewal?

No. When you renew, you will be able to sign an attestation that you completed the CE requirement.

Random audit - those selected must submit proof of CE within 60 days of the notification

If you fail, disciplinary action will be taken against your license (can result in fine, revocation, suspension, etc).

How soon must you send in proof of CE if you are selected in the BOP random audit?

within 60 days

Title 21, CFR Section 1306.04. and HRS states that "a prescription for controlled substances to be effective must be..."

"issued for a legitimate medical purpose by an individual practitioner acting in the usual course of his professional practice"

Legitimate medical purpose and also in the practitioner's scope of practice!

The Holy Trinity

Soma + Xanax + Oxy

Carisoprodol + Alprazolam + Oxycodone

Dangerous drug combo in elderly patients (not the holy trinity)

tramadol

zolpidem

trazodone

When should a Rph report questionable scripts for controlled substances and who shall they report it to?

Communicate with the prescribe. If the Rph is unable to resolve any discrepancies after talking with the prescribe, contact NED!

APRN

advanced practice registered nurse

NED

National Enforcement Division (state)

DEA

Drug Enforcement Agency (federal)

Chapter 436B

Professional and Vocational Licensing Act

difference between a reinstated license vs a restored license

reinstated - license was suspended

restored - license was forfeited

How often does the licensing board meet annually?

at least 2x/year

What is an abandoned application?

Applicant fails to provide evidence of continued efforts to complete the licensing process for 2 consecutive years

What happens if a license is not renewed in a timely fashion?

The license is automatically forfeited

How long do you have to restore a forfeited license?

1 year

What happens if you don't restore a forfeited license within 1 year?

Applicant must re-apply for licensure as a new applicant

How do armed forces/national guard/reserves get an extension of licenses?

expires while member is on active duty or deployed

"state or national crisis"

How long do armed forces/national guard/reserves have to request restoration of their license?

<120 days

Which states do no reciprocate?

California and Florida

Reciprocity for military spouses timeframe (min and max)?

min: 1 year

max: 5 years

What is the pharmacist to technician ratio in Hawaii?

There is no set ratio!

Requirements for reciprocity?

current license

1500 hours in the past 5 years

no legal issues

not in Cali on Florida

How long do you have to provide written notice to the licensing authority of any judgment, award, disciplinary sanction, order?

<30 days

How long do you have to notify the licensing authority of a change of address?

<30 days

Nolo contendere

accepting conviction (like a guilty plea) without admitting guilt

Reasons for refusal to renew, reinstate or restore license

failure to meet requirements

fraudulent advertising

addiction to narcotics, barbiturates, amphetamine hallucinogens, opium or cocaine

practicing while impaired (alcohol, drugs or mental instability)

professional misconduct

disciplinary action in another state

criminal conviction

failure to report criminal conviction

True or False: Licensee can be denied for licensure if they do not pay child support.

True

True or False: Licensee can be denied for licensure if they default on student loans.

True

What is the max time your license can be suspended?

5 years

How long must you wait to apply after having a license revoked?

5 years

How long can the licensing authority IMMEDIATELY suspend you license?

<20 days

What is "contract price"?

total monetary consideration by the consumer for the provision of good and services

Chapter 328

Food, Drugs and Cosmetics

Federal Act

Federal Food, Drug and Cosmetic Act 1938

FDCA 1938

Another word for generic drug?

established drug

How much hours of experience are necessary to apply for pharmacist license?

1500 hours within the past 5 years

Chapter 330

Hawaii Poison Prevention Packaging Act

GMP

good manufacturing practices for drugs

CFR

code of federal regulations

Another term for OTC drugs

non-legend drugs

What does out of state practitioner mean?

Not licensed in Hawaii

Licensed in Hawaii, but practicing in another state

Definition of prescription

order or formula issued by a practitioner for the compounding or dispensing of drugs

order or formula issued by an out of state practitioner

The consumer must be notified if products contain an excess of ___ alcohol by weight.

0.5% alcohol by weight

Sale of confectionery which contains alcohol in excess of 0.5% by weight to person below the age of ___ is illegal.

21 yo

In order to determine if a food additive is safe for consumption, the director may request the following from the petitioner:

name and all pertinent info about the substance (chemical structure, composition, proposed use, directions, rec's, proposed labeling)

probable composition of any substance formed

probably consumption of substance in diet of humans and animals

safety factors

methods of analysis

proposed use of substance serving a useful purpose

What makes a drug "adulterated"?

filthy, putrid or decomposed substance

produced and packed in unsanitary conditions

does not meet current good manufacturing practices

containers is composed of poisonous substance

unsafe color additive

strength, quality or purity falls below the standard set forth in the compendium

What makes a drug "misbranded"?

labeling is false or misleading

label is missing name/address of manufacturer, weight, measure, qty of drug

label is missing "Warning-May be habit forming" if it contains any qty of narcotics or hypnotics

label is missing generic name, active ingredients, qty or proportion of alcohol

generic name is not 1/2 as big as brand name

does not specify if drug is liable to deterioration (light, heat, moisture)

imitation of another drug

dangerous to health when used at the rec'ed dosage and frequency

How large must the generic name be in comparison to the brand name?

1/2 as large

Section ___ pertains to drugs composed wholly or partly of insulins

Section 506

Section ___ pertains to drugs composed wholly or partly of any kind of penicillin, streptomycin, chlortetracycline, chloramphenicol, bacitracin or any other antibiotic.

Section 507

Prescription requirements:

name of pharmacy

address of pharmacy

phone of pharmacy

pt name

Rx #

date written

name of prescriber

drug name

strength

qty

use by date (1 year from dispensing)

refills

sig

generic name and "same as brand name"

If there are no refills indicated on the script, how many refills are there?

0

Expedited partner therapy

treating a pt and their sexual partners for STD's (chlamydia, gonorrhea)

What STD's are commonly treated with EPT?

chlamydia

gonorrhea

"as needed" or "PRN" refills may be refilled ___.

up to 12 months from the date of the original written date of script

3 month grace period after 12 months are up (30 d/s, only 1 refill)

How should we designate on the script that a drug is prescription only?

"Caution: Federal law prohibits dispensing without prescription"

"Rx only"

Oral codes are issued by the ___.

DPS (Dept of Public Safety)

Does the pt have the option to include their symptom or condition on the drug label?

Yes, they can refuse to have symptom/indication displayed on drug label

What section do you need to apply for new drug applications?

Section 505

How long do you keep transfer Rx on file?

5 years

What additional information do you need for an out of state prescription?

NPI

DEA

How long do you keep Rx records on file?

5 years

How long do you have if prescription records are requested by the director or director's agent?

<48 hours

Aspects of inspection by director of public safety

enter at all reasonable hours

enter any vehicle being used to transport goods

access and copy all records

secure samples or specimens after paying or offering to pay for them

prima facie evidence

accepted correct until proved otherwise

eg. if company refuses to give sample, director believes the sample to be adulterated until it is tested and proven pure