Oregon MPJE Questions and Answers Already Passed

Oregon MPJE Questions and Answers Already Passed Is a pharmacist's signature required on hardcopies or will initials suffice? It is acceptable to either sign, initial, or utilize an electronic record identifying the verifying pharmacist. Can a pharmacist change the date-to-fill after talking to the prescribing doctor on a CII? The date-to-fill is part of the directions written on the script therefore it would be allowed to change after speaking with the prescribing doctor. How are outdated CIIs destroyed? See 21 CFR 1307.21and OAR (reverse distributor, DEA, Board approved Plan). Can physician assistants and naturopaths prescribe CII medications? Yes, check the formulary at current DEA registration for CII medication. Does a pharmacist need to cancel a CII prescription across its face and sign? No What is the law for selling a controlled substance for office use? CII? CIII-V? A prescription cannot be written to provide medical offices medications. If the office wants CII medications a DEA 222 form must be used to transfer the CII stock. For all other medications, an invoice must be utilized. Does post-dating the prescription for a CII by the prescriber void the prescription? The prescription must have the date it was written on the hard copy. For more information call the DEA office at . Is a typed CII prescription with an electronically signed signature a valid prescription? No. The prescription needs to be hand signed by the prescriber. Is a CII perpetual inventory required in all practice settings? No, it has been required in hospitals for a long time (monthly reconciliation). A quarterly reconciliation is required for retail pharmacies but not a perpetual inventory. Does the CII annual inventory have to be separated from the CIII-V inventory? Yes, they can be on the same report as long as listed out separately. How long do we need to keep CII inventory records? 3 years. What is required of drug outlets electronically ordering CIIs? The pharmacist must be able to retrieve the electronic DEA 222 from their ordering system for review by Board inspectors. This electronic form must contain the date and quantity of each controlled substance received. In which cases are partial fills on CII prescriptions allowed? Partial fills are allowed on CII prescriptions when: 1)The pharmacist is unable to fill the entire amount and the remaining balance is dispensed within 72 hours. If the remainder is not filled within that timeframe, then the remainder is lost and the prescriber should be notified of the actual quantity filled. 2)For patients that are residing in a long term care facility or community based care facility or diagnosed with a terminal illness in which scripts are good for 60 days from the date the prescription was written. What information must be documented on the original hardcopy or electronic record (a single screen) each time you partial fill a CII for hospice/terminally ill patients, long term care or community based care patients? The date dispensed, quantity dispensed each time, amount remaining after each fill and pharmacist who dispensed it. Can a CII prescription be changed from a capsule to a tablet or liquid form of the same medication? Yes, if you contact the prescriber and they authorize the change. If the prescriber is not reasonably available for consultation and the prescribed drug does not utilize a unique delivery system technoloy, an oral tablet, capsule or liquid form of the prescribed drug so long as the form dispensed or administered has the same strength, dose and dose schedule, and is therapuetically equivalent to the drug prescribed. Per If a CII medication is written with only the first or last name of patient, can a pharmacist call the prescriber to clarify it and then fill the prescription? Yes. What changes can a pharmacist make to a CII prescription after speaking to the prescriber over the phone? A pharmacist CAN change the drug strength, dosage form, drug quantity, and the directions. Changes that cannot be made are the patient's name, controlled substance prescribed, and the addition of a prescriber's signature (the prescription must be hand signed). In which situations can a faxed CII prescription serve as an original prescription? A faxed prescription can serve as an original for patients in a long term care facility , community based care, enrolled in hospice, or receiving home infusion/IV pain management therapy. The prescription must be manually signed by the prescriber prior to faxing. Is it legal to write/fill a CII prescription on the same page as a second prescription? Yes, but the prescriptions must be correctly filed and cross-referenced. The original must be filed under the highest controlled prescription. If a prescriber writes for a quantity of a CII that is greater than the amount the patient's insurance will pay for, can the prescription be split into two prescriptions, one for insurance and one for cash? Yes. Both prescriptions must be filled and dispensed/sold at the same time. Can a prescriber write multiple prescriptions for a CII on the same day to be filled on different dates? Yes, as long as the total quantity does not exceed a 90 day supply and each subsequent prescription states the earliest date it can be filled and the practitioner provides written instructions on each written prescription. [CFR 1306.12(b((ii)] Can prescribers post date CII prescriptions? No, the prescription must have the date that the prescription is actually written and a fill date can be designated in the instructions to the pharmacist. Does a limit exist on the quantity of CII medication that can be dispensed from a single prescription? No, but use professional judgment. Is it ok to fill a CII from a state that is not contiguous? Yes, but use professional judgement and make certain the prescription is valid. ORS 689.525(1)(2) For drug recalls on a CII, can good drug be exchanged for the recalled drug? Yes, it can be exchanged without a new prescription, but you need to document on the hardcopy what was taken back and the quantity replaced. If there is a shortage of a CII such as oxycodone, can the RPh change the drug to oxycodone/APAP after consulting