Skills- Writing Prescriptions
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Questions and Answers

What is a controlled substance

  • Not accepted medical use in treatment in the US
  • Unlikely abuse potential
  • OTC medications that can lead to illness
  • Has a likelihood of causing dependence when abused (correct)

    • What is a scheduled one controlled substance?

  • Substances in this schedule have a high potential for abuse, have no currently accepted medical use in treatment in the United States (correct)
  • Substances in this schedule have a high potential for abuse which may lead to severe psychological or physical dependence
  • Substances in this schedule have a potential for abuse less than other substances
  • None of the above

    • What is a schedule two controlled substance?

  • high potential for abuse which may lead to severe psychological or physical dependence (correct)
  • Substances in this schedule have a high potential for abuse, have no currently accepted medical use in treatment in the United States
  • Substances in this schedule have a potential for abuse less than other substances
  • Very low abuse potential

    • products containing less than 90mg of codeine per dosing unit (such as Tylenol with codeine), is an example of:

    <p>Class III</p> Signup and view all the answers

    Low potential for abuse relative to substances such as alprazolam, is a schedule:

    <p>Class IV</p> Signup and view all the answers

    Drugs generally used for antitussive, antidiarrheal, and analgesic purposes fall under:

    <p>Class V</p> Signup and view all the answers

    Controlled substances can be sent electronically (2-step authentication) if meets it DEA requirements.

    <p>True</p> Signup and view all the answers

    What is NOT a requirement for using non-electronic Rx for controlled substances?

    <p>Rx may be typed, in ink, or indelible pencil</p> Signup and view all the answers

    Written Rx signed by provider must be provided for schedule ____ (In NC, cannot be faxed or verbal)

    <p>2</p> Signup and view all the answers

    Schedule III-V can be given verbally, written, or by fax. These (can/cannot) include refills

    <p>can</p> Signup and view all the answers

    You cannot include refills for Schedule II!

    <p>True</p> Signup and view all the answers

    Always make sure to spell out the number dispensed when using a hand written script!

    <p>True</p> Signup and view all the answers

    PA’s can prescribe schedule II-V in state of NC.

    <p>True</p> Signup and view all the answers

    PA cannot prescribed controlled substances to...

    <p>ALL of the above</p> Signup and view all the answers

    When sending rx for controlled substances, rx must include Supervising Physician’s name and telephone # (in addition to prescriber’s information).

    <p>True</p> Signup and view all the answers

    Must document Rx in patient’s record, including all of the following, EXCEPT:

    <p>pharmacy name</p> Signup and view all the answers

    The NC STOP act does not require e-scripts for class II and III.

    <p>False</p> Signup and view all the answers

    In order to prescribe controlled substances class II and III, PA/NP in pain clinic are required to have supervising physician consultation!

    <p>True</p> Signup and view all the answers

    The NC STOP Act includes Mandatory use of NC controlled Substances database

    <p>True</p> Signup and view all the answers

    If you are prescribing less than 1 milligram write in _______

    <p>micrograms</p> Signup and view all the answers

    Abbreviations

    <p>ac = before meals bid = twice a day gtt = drops (as in #) hs = at bedtime</p> Signup and view all the answers

    Abbreviations

    <p>od = right eye os = left eye po = by mouth pc = after meals</p> Signup and view all the answers

    Abbreviations

    <p>prn = as needed qd = every day, daily qid = four times a day tid = three times a day</p> Signup and view all the answers

    You must be sure to circle printed name of prescribing provider if multiple names are on the prescription

    <p>True</p> Signup and view all the answers

    License number AND DEA number should be included on the script.

    <p>True</p> Signup and view all the answers

    You should leave out the Supervising Physician name and telephone number for that provider.

    <p>False</p> Signup and view all the answers

    What is NOT true when it comes to listing the drug and strength on a prescription

    <p>Abbreviate the drug name only if it is a common one</p> Signup and view all the answers

    What must be included in the sig (directions)?

    <p>All of the above</p> Signup and view all the answers

    Always spell out the # dispensed to avoid changes to prescription

    <p>True</p> Signup and view all the answers

    Refills can be no more than:

    <p>12 months</p> Signup and view all the answers

    What is another word for Sig

    <p>Directions</p> Signup and view all the answers

    It is generally recommended to avoid abbreviations (especially with med names) when writing prescriptions

    <p>True</p> Signup and view all the answers

    It is OK to write "as directed" on a prescription

    <p>False</p> Signup and view all the answers

    Avoid writing just "PRN"

    <p>True</p> Signup and view all the answers

    What pregnancy category is this?

    <p>Adequate and well-controlled studies have failed to demonstrate a risk to the fetus in the first trimester of pregnancy (and there is no evidence of risk in later trimesters) = Category A Animal reproduction studies have failed to demonstrate a risk to the fetus and there are no adequate and well-controlled studies in pregnant women = Category B Animal reproduction studies have shown an adverse effect on the fetus and there are no adequate and well-controlled studies in humans, but potential benefits may warrant use of the drug in pregnant women despite potential risks = Category C There is positive evidence of human fetal risk based on adverse reaction data from investigational or marketing experience or studies in humans, but potential benefits may warrant use of the drug in pregnant women despite potential risks = Category D</p> Signup and view all the answers

    It is OK to use LEADING zeros (0.5), but NOT trailing zeros (5.0)

    <p>True</p> Signup and view all the answers

    Study Notes

    Controlled Substances

    • A controlled substance is a drug or substance whose manufacture, distribution, and possession are regulated by the government.
    • A scheduled controlled substance is a drug or substance classified into one of five schedules (I-V) based on its potential for abuse, currently accepted medical use, and safety under medical supervision.

    Scheduling of Controlled Substances

    • Schedule I: high potential for abuse, no currently accepted medical use, and lack of accepted safety for use under medical supervision.
    • Schedule II: high potential for abuse, currently accepted medical use, but with severe restrictions, and abuse may lead to severe psychological or physical dependence.
    • Schedule III: moderate to low potential for abuse, currently accepted medical use, and abuse may lead to moderate or low physical dependence and high psychological dependence.
    • Schedule IV: low potential for abuse, currently accepted medical use, and abuse may lead to limited physical dependence and psychological dependence.
    • Schedule V: low potential for abuse, currently accepted medical use, and abuse may lead to limited physical dependence and psychological dependence.

    Examples of Scheduled Controlled Substances

    • Products containing less than 90mg of codeine per dosing unit (e.g., Tylenol with codeine) are classified as Schedule III.
    • Substances with low potential for abuse relative to substances like alprazolam are classified as Schedule IV.

    Prescribing and Dispensing Controlled Substances

    • Controlled substances can be sent electronically (with 2-step authentication) if they meet DEA requirements.
    • Written Rx signed by the provider must be provided for Schedule II substances (in NC, cannot be faxed or verbal).
    • Schedule III-V substances can be given verbally, in writing, or by fax.
    • Refills are not allowed for Schedule II substances.
    • When sending Rx for controlled substances, the Rx must include the Supervising Physician's name and telephone number (in addition to the prescriber's information).
    • The Rx must be documented in the patient's record, including the date, patient's name, medication, dosage, and quantity.

    PA and NP Prescribing

    • PA's can prescribe Schedule II-V substances in the state of NC.
    • PA cannot prescribe controlled substances to patients in a hospital or nursing home setting.
    • When sending Rx for controlled substances, PA/NP in pain clinics are required to have supervising physician consultation.

    NC STOP Act

    • The NC STOP Act does not require e-scripts for Class II and III substances.
    • The NC STOP Act includes Mandatory use of NC controlled Substances database.
    • To prescribe controlled substances Class II and III, PA/NP in pain clinics are required to have supervising physician consultation.

    Prescription Writing

    • When prescribing less than 1 milligram, write in micrograms (mcg).
    • Spell out the number dispensed to avoid changes to the prescription.
    • Refills can be no more than 5 times within 6 months.
    • The sig (directions) must include the dosage, frequency, and duration.
    • "Sig" is another word for "directions".
    • It is generally recommended to avoid abbreviations (especially with medication names) when writing prescriptions.
    • Avoid writing "as directed" or "PRN" on a prescription.
    • Pregnancy category should be included on the prescription.
    • It is OK to use leading zeros (0.5), but not trailing zeros (5.0).

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