67 Questions
What is the requirement for obtaining emergency supplies of narcotics, controlled drugs, and targeted controlled substances from another pharmacy?
A prescription for the drug is written with the pharmacy name as purchaser, signed by a staff pharmacist
How often should a Narcotic Sales report for reportable narcotics and reportable controlled drugs be printed and maintained for audit purposes?
Every two weeks
What is the requirement for filing narcotic and controlled drug prescriptions?
Narcotic and controlled drug prescriptions must be filed on a separate file exclusively for narcotics and controlled drugs
What should be done when 2 prescriptions have been written on the same prescription form, one for a narcotic or a controlled drug, and the other neither a narcotic nor controlled drug?
Both must be cross-referenced
How should emergency supplies of narcotics, controlled drugs, and targeted controlled substances be recorded by the pharmacy obtaining these drugs?
The purchase must be recorded in the appropriate section of the Narcotic and Controlled Drug Register
What is the requirement for obtaining emergency supplies from another pharmacy in terms of the pharmacist's signature?
Emergency supplies do not require a signature from the pharmacist with authorized signing authority
How should prescriptions for narcotic and controlled drugs be filed in a computerized system?
Each prescription is printed on its own hard copy and then filed in chronological order by prescription number in its appropriate file
What is the process for obtaining emergency supplies of narcotics, controlled drugs, and targeted controlled substances from another pharmacy?
A prescription for the drug is written with the pharmacy name as purchaser, signed by a staff pharmacist
Which type of order for OTC narcotics requires the signature of a pharmacist with signing authority?
Written order
What is required for a verbal or electronic order of OTC narcotics?
ID number of the pharmacist with signing authority
How long does a pharmacist have to submit a written order to the distributor after placing an electronic or verbal order for OTC narcotics?
5 working days
Which type of controlled drug may be purchased by written or electronic means?
Reportable controlled drug
What is required for a written order of reportable controlled drugs?
Prescriber's signature
What record is required for all purchases of reportable controlled drugs?
Narcotic and Controlled Drug Register
What type of prescription is required for reportable controlled drugs?
Written, verbal, or faxed
Where should all Rx’s for controlled drugs be maintained?
Narcotic and controlled drug file
Under what conditions are repeats legal for written Rx of controlled drugs?
With prescriber's indication of # of repeats and time interval
Are refills permitted for verbal Rx of controlled drugs?
No
Are transfers of authorized repeats allowed for controlled drugs?
No
Where should a record of sale for all reportable controlled drugs be maintained?
Narcotic and Controlled Drug Register
What is the duration for which prescription orders must be kept according to new legislation?
10 years
How are expired unopened bottles of narcotics, controlled drugs, and targeted controlled substances handled?
They may be returned to the manufacturer or wholesaler
What is the recommended method of denaturing controlled substances?
Adding soap solution
How often do all narcotics, controlled drugs, and targeted controlled substances need to be counted?
Twice a year
What is the requirement for witnessing the destruction of outdated stock?
Witnessed and signed by two pharmacists
Where should the list of destroyed medications be placed?
In the narcotic prescription file
What is the recommended action for destruction of denatured drugs and sharps material?
Contact the Ontario Drop Program operated by Stewardship Ontario
What is the requirement for returning full, unopened, unsealed containers of targeted controlled substances?
Returns permitted to licensed dealers only upon prior receipt of written authorization
How are expired or unserviceable drugs handled in terms of pre-authorization requests for destruction?
Pre-authorization is not required
What is the required action for destroyed drugs and the record of destruction?
Record must be entered in the Narcotic and Controlled Drug Register
What is the recommendation for disposing of denatured or destroyed products?
Dispose of them in an environmentally safe manner
What is the recommendation for handling physical inventory records of narcotics, controlled drugs, and targeted controlled substances?
Count them twice annually
Which category of narcotics must have an 'N' symbol on the label and are usually stored in a locked cabinet in the pharmacy?
Reportable narcotics
Which act is the most stringent of all acts governing pharmacy?
Controlled Drugs and Substances Act (CDSA)
What are narcotics used legitimately for?
Pain control, diarrhea, and cough
How many schedules does the CDSA have for regulating drugs?
Eight
Which type of narcotics requires a pharmacist's signature with signing authority for written orders?
Reportable narcotics
Where are reportable narcotics usually stored in a pharmacy?
Locked cabinet
What is the main purpose of the Controlled Drugs and Substances Act (CDSA)?
Regulating narcotics, controlled drugs, and targeted controlled substances
Which drugs resemble the action of opium and cause tolerance and physical and psychological dependence?
Narcotics
What are the dispensing requirements for reportable narcotics?
Patient and prescriber details, complete directions for use, price, date, and signatures of pharmacist and pharmacy technician
How can reportable narcotics be purchased?
Written or electronic means
What is required for reportable narcotics purchases?
Maintaining purchase records in the Narcotic and Controlled Drug Register
What are the prescription requirements for reportable narcotics?
Written or faxed prescriptions, with verification of the physician's signature and adherence to OCP policy for faxes
What is the maximum amount of codeine phosphate allowed per solid oral dose in OTC Narcotics?
8mg
What is the requirement for part-fills of verbal Rx narcotics?
Part-fills are not permitted
What is the primary purpose of methadone as a reportable narcotic?
Both treatment of heroin addiction and relief of pain
What is the primary difference between reportable (straight) narcotics and narcotic preparations (verbal Rx narcotics)?
Sales record requirements
What is the primary distinction between reportable (straight) narcotics and narcotic preparations (verbal Rx narcotics) in terms of repeats?
Repeats not permitted for reportable narcotics
What is the prescription requirement for purchasing verbal Rx narcotics?
Rx may be verbal or electronic
What is the primary distinction between reportable (straight) narcotics and OTC narcotics in terms of sales records?
No entry is required for OTC narcotics
What is the primary distinction between reportable (straight) narcotics and OTC narcotics in terms of repeats?
Repeats not permitted for reportable narcotics
What is the primary difference between narcotic preparations (verbal Rx narcotics) and OTC narcotics in terms of purchasing?
Purchases by verbal or electronic means require a pharmacist's signature
What is the primary distinction between narcotic preparations (verbal Rx narcotics) and OTC narcotics in terms of part-fills?
Part-fills are not permitted for verbal Rx narcotics
What is the primary requirement for filing prescriptions of narcotic and controlled drugs in a computerized system?
All faxes should be verified as per OCP policy
What is the primary requirement for obtaining emergency supplies of OTC narcotics from another pharmacy?
A written order must be submitted to the distributor within 5 working days
What is the process for obtaining signing privileges for ordering narcotics, controlled drugs, and targeted controlled substances?
Pharmacists must request authorization in writing from the provincial pharmacy regulatory authority
Where are reportable narcotics usually stored in a pharmacy?
In a locked cabinet
What is required for recording emergency sales of controlled drugs from another pharmacy and sales to physicians for their office use?
A manual report
What is the main purpose of the Controlled Drugs and Substances Act (CDSA)?
To regulate the sale and conditions of drug products at the federal level
What is the requirement for obtaining emergency supplies of narcotics, controlled drugs, and targeted controlled substances from another pharmacy?
The pharmacist obtaining the drugs must sign a record of receipt
What is required for recording sales of reportable narcotics and reportable controlled drugs?
Sales entry in the Narcotic and Controlled Drug Register or computer system records
What is required for an entry in the sales records of reportable narcotics and reportable controlled drugs?
Fill date, prescription number, quantity, name of drug, strength, and manufacturer
What is the recommendation for handling physical inventory records of narcotics, controlled drugs, and targeted controlled substances?
Regularly counting all narcotics, controlled drugs, and targeted controlled substances
What is required for a record of all purchases for every category of narcotics and controlled drugs?
Date, name of drug, strength, quantity, and name and address of the supplier
What is the requirement for returning full, unopened, unsealed containers of targeted controlled substances?
Returning them to the original supplier or manufacturer
How are expired unopened bottles of narcotics, controlled drugs, and targeted controlled substances handled?
Returning them to the original supplier or manufacturer
Study Notes
Controlled Drugs and Substances Act Overview
- The Controlled Drugs and Substances Act (CDSA) is a federal act that regulates narcotics, controlled drugs, and targeted controlled substances, and it is the most stringent of all acts governing pharmacy.
- The CDSA regulates the manufacture, distribution, and record-keeping of narcotics, controlled drugs, targeted controlled substances, by wholesalers, pharmacies, and practitioners.
- Narcotics are drugs that resemble the action of opium, causing tolerance and physical and psychological dependence, and are used legitimately for pain control, diarrhea, and cough.
- The CDSA consists of seven parts, including offenses and punishments, enforcement, disposal of controlled substances, administration and compliance, and general provisions.
- The CDSA has eight schedules for regulating drugs, including narcotics, cannabis, controlled drugs, barbiturates, anabolic steroids, and others.
- There are three categories of narcotics: reportable narcotics, verbal prescription narcotics, and OTC (exempted) narcotics.
- Reportable narcotics must have an 'N' symbol on the label and are usually stored in a locked cabinet in the pharmacy.
- Examples of reportable narcotics include codeine phosphate, morphine sulfate, fentanyl, oxycodone, and pentazocine.
- Dispensing requirements for reportable narcotics include patient and prescriber details, complete directions for use, price, date, and signatures of pharmacist and pharmacy technician.
- Reportable narcotics can be purchased by written or electronic means, and purchase records must be maintained in the Narcotic and Controlled Drug Register.
- Prescription requirements for reportable narcotics include written or faxed prescriptions, with verification of the physician's signature and adherence to OCP policy for faxes.
- Reportable narcotics purchases require a pharmacist's signature with signing authority for written orders, and the pharmacist's identification number for electronic orders.
Test your knowledge of the Controlled Drugs and Substances Act (CDSA) with this quiz. Explore the regulations and requirements for narcotics, controlled drugs, and targeted controlled substances, as well as the schedules and categories involved in the act. Brush up on dispensing and prescription requirements, and enhance your understanding of the CDSA's impact on pharmacy operations.
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