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Law Quiz 2
TTUHSC pharmacy law
81
Law
Professional
01/22/2013

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Cards

Term
T/F: The National Drug Code (NDC) is always required on all drug labeling?
Definition
False: NDC is requested on labeling but is not required
Term
The NDC code consists of ___ characters
Definition
10 characters
Term
What are parts of the NDC code?
Definition

Labeler code = 1st 5 numbers - identifies the distributor/manufacturer

 

Drug product code = middle 3 digits - identifies drug classe (unique to drug)

 

Package = last 2 digits - identifies amount in package

Term
Identify the 3 NDC segments: Benadryl® Liquid Medication 120ml NDC 0501 2050 04
Definition

Labeler code = 05012 (1st 5 digits)

 

Drug product code = 050 (6th-8th digits)

 

Package = 04  (last 2 digits)

Term
A display of written, printed or graphic matter upon the immediate container of any article; printed, written or graphic material that is literally affixed to the container of the drug
Definition
Label
Term
All labels and other written printed or graphic matters either upon any container or any of its wrappers or accompanying such article; printed, written or graphic material that is enclosed with or accompanies the drug once it enters interstate commerce and is put up for sale after shipment.
Definition
Labeling
Term
__ determines date of the prescription or the date of its filling or refill.
Definition
State law
Term
Section 503 (b)(2) of the Prescription Label Act/OBRA Act requires that prescription label have the following 6 information:
Definition

·        Name and address of the dispenser (pharmacy)

·        Serial number of the prescription

·        Date of the prescription or the date of its filling (or refilling)---state law often determines which date is to be used

·        Name of the prescriber

·        Name of the patient

·        Directions for use, including precautions, if any, as indicated on the prescription

Term
These 6 things are not required by federal law and are left to the discretion of the individual states.
Definition

·        Address of the patient

·        Initials of dispensing pharmacist

·        Telephone number of the pharmacy

·        Drug name, strength, and manufacturer’s lot number

·        Beyond-use date (if any)

·        Name of manufacturer or distributor

Term
What is the purpose of labeling of a manufacturer's container?
Definition
to inform and alert the prescriber and the dispensing pharmacist.
Term
a form which can be redeemed at no cost, or at a reduced cost for a drug bearing one of the federal legends
Definition
Drug coupons
Term

T/F: No person may sell, purchase or trade, offer to sell, purchase or trade or counterfeit a drug coupon.

 

Definition
True
Term
drugs that have the same therapeutic effect
Definition
Therapeutic Equivalence
Term
drugs that are the same molecule, dose,salt form and dosage form. They dissolve, metabolize and are eliminated the same way.
Definition
Bioequivalence
Term
refers to drug products that contain the same therapeutic moiety BUT may consist of different salts, esters or complexes, dosage forms, strengths 
Definition
Pharmaceutical equivalent
Term
T/F: Most states allow substitution between pharmaceutical alternatives.
Definition
False: Most states do NOT allow substitution between pharmaceutical alternatives
Term
Approved Drug Products with Therapeutic Equivalence Evaluations
Definition
Orange Book
Term

such products are determined to be bioequivalent and are thus "therapeutically equivalent" to the brand name or reference product.

Definition
A-rated products on Orange Book
Term
these are products that are found not to be bioequivalent
Definition
B-rated products
Term
some drug products identified by the FDA as having actual or potential bioequivalence problems, may be acceptable substitutes if the equivalency problem has been resolved by in vivo and/or in vitro studies. 
Definition
AB- products
Term
designation which signifies that the product meets "necessary bioequivalence requirements" 
Definition
AB-products on the Orange Book
Term
products not presenting bioequivalent problems in conventional dosage forms
Definition
AA
Term
Solutions and powders for aerosolization
Definition
AN
Term
Injectable products with oil solvents
Definition
AO
Term
Injectable solutions
Definition
AP
Term
Topical products
Definition
AT
Term

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).

Definition
Category A
Term
Animal reproduction studies have failed to demonstrate a risk to the fetus and there are no adequate and well-controlled studies in pregnant women.
Definition
Category B
Term
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.
Definition
category C
Term
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.
Definition
Category D
Term

 Studies in animals or humans have demonstrated fetal abnormalities and/or there is positive evidence of human fetal risk based on adverse reaction data from investigational or marketing experience, and the risks involved in use of the drug in pregnant women clearly outweigh potential benefits.

Definition
Category X
Term
 Orange Book is updated ___
Definition
Monthly
Term
Established five schedules of controlled substances;  the schedules reflect the relative potential for abuse.
Definition
Controlled Substance Act of 1970
Term
Drugs in these schedule are not to be prescribed since they dont have any accepted medical use.
Definition
Schedule I
Term

Drugs in this schedule have currently accepted medical use in treatment in the United States or a currently accepted medical use with severe restrictions 

* abuse of the drug or other substance may lead to severe psychologic or physical dependence 

Definition
Schedule II
Term
abuse may lead to moderate or low physical dependence or high psychologic dependence. 
Definition
Schedule III
Term
The authority to decide in which schedule a drug is placed is vested in the ___ 
Definition
U.S Atoorney General
Term
What is considered a narcotic?
Definition
Drugs derived from opium
Term
T/F: All controlled substances are considered narcotics.
Definition
False: all narcotics are controlled substances, but not all controlled substances are narcotics.
Term
Every person or firm who manufactures, distributes, or dispenses any controlled substances or who proposes to engage in the same must register with the ____
Definition
DEA or DPS (in Texas)
Term
T/F: A pharmacy may be registered to dispense controlled substances to other registrants, for example, to physicians for their office use.
Definition
True
Term
      • New Application for Retail Pharmacy, Hospital/Clinic, Practitioner, Teaching Institution, or Mid-Level Practitioner. 
Definition
DEA form 224
Term
      • New Application for Manufacturer, Distributor, Researcher, Analytical Laboratory, Importer, Exporter 
Definition
DEA form 225
Term
New Application for Narcotic Treatment Programs
Definition
DEA form 363
Term
      • New Application for Domestic Chemical  
Definition
DEA form 510
Term
DEA registration numbers consist of ___ characters
Definition
9  (2 letters and 7 numbers)
Term

What does this DEA registration letters mean when it is the 1st letter of the DEA number?

 

A, B, M, F, P

Definition

A - dispenser

B- dispenser

M- midlevel practitioner

F - dispenser

P - distributor

Term
When selling controlled substances from one pharmacy to another, if the total amount of such sales to practitioners exceeds ____  distributed and dispensed during any 12-month period, the pharmacy must register as a ____ as well.  
Definition

5% of the total dosage units


distributor

Term
T/F: A practitioner who compounds a mixture containing a controlled substance and administers it to a patient pursuant to a valid prescription is required to register as a manufacturer.
Definition
False: a practitioner who compounds a mixture containing a controlled substance and administers it to a patient pursuant to a valid prescription is not required to register as a manufacturer.
Term
The DEA can get any record from a pharmacy except these 3 records without permission of the registrant.
Definition

1. Financial record

2. Sales record

3. Pricing record

Term
Acquisition and transfer of Schedule I & II drugs between two institutions require a ___ which is a triplicate form 
Definition
DEA form 222
Term
Name the 3 common mistakes made on DEA 222 form.
Definition

1. Form is used to order non-CIIs (only C-I & IIs can be ordered using form 222)

2. Ordering more than 10 scheduled drugs on form 222

3. Erasing errors, instead of crossing them out

Term
What type of DEA forms are used for CIII-V?
Definition
No DEA form needed - these drugs are considered not to be as dangerous.
Term
In case of theft of controlled substance, what should you the Texas pharmacist do?
Definition

1. Notify the DEA, DPS and TSBP

2. Complete DEA form 106 and mail it to the above departments and keep on for your records.

Term
The primary records of dispersals by a pharmacy are ___
Definition
prescriptions
Term
T/F: controlled substance prescriptions can be kept together with other prescriptions.
Definition
False: controlled substance prescriptions must be kept segregated from other prescriptions to make them quickly and easily identifiable
Term
What is the approved filing method allowed in Texas?
Definition
Three files method
Term
Examples of Schedule I drugs
Definition
LSD, PCP, marijuana, mescaline, heroin
Term
Valium®, Ativan®, Ambien® belong to what schedule?
Definition
Schedule IV
Term
Tylenol® with codeine #3, anabolic steroids, growth hormone belongs to what schedule?
Definition
Schedule 3
Term
What class do these belong to: cocaine, morphine, Dilaudid, fentanyl, amphetamine, secobarbital, pentobarbital, methylphenidate, Ritalin®, Tylox®, Demerol®, Mepergan Fortis®
Definition
Schedule II
Term
Add a new Subchapter H that gives DPS the authority to access administrative penalties on registrants who violate the law. The amount of the penalty my not exceed ____ for each violation/day nor exceed a total of ____
Definition

$1,000; 


$20,000

Term
When controlled substance is received from manufacturer, purchaser must record on his retained copy of the order form (DEA 222) the ___ and ___
Definition
number of bulk containers of each item and the date received. 
Term
How can a pharmacy return schedule merchandise back to manufacturer?
Definition
Pharmacist contacts distributor and request that the distributor/wholesaler issue an order form, the pharmacist "fills" the order form with the mdse. he/she is returning.  The pharmacy (acting as a distributor) would retain one copy and forward one to the DEA
Term
A supplier must complete the shipment pursuant to an order form within _____; order form is void ___ after purchaser executes form
Definition
60 days; 60 days
Term
Before using the electronic ordering 222 form a DEA registrant must appoint a ____ who will serve as that registrant’s recognized agent regarding issues pertaining to issuance of, revocation of, and changes to digital certificates issued under that registrant’s DEA registration.
Definition
CSOS coordinator
Term
T/F: A CSOS Certificate may not be installed into multiple software programs and may also be transferred to multiple ordering computers
Definition
False: A CSOS Certificate may be installed into multiple software programs and may also be transferred to multiple ordering computers
Term
Triplicate order system (DEA 222) is for ___ and ___only
Definition

C-I and C-II only 

- not for CIII to CIV due to less chance of abuse

Term
 Acquisition records of these scheduled substances consist of ____or ___ from the wholesaler/distributor/supplier
Definition
invoices  or packing slips
Term

____ must contain number of dosage units or volume dispensed, name and address of the person to whom the drug is dispensed, date, name/initials of dispensing pharmacist

Definition
Dispersal records 
Term
The primary records of dispersals by a pharmacy are ___
Definition
prescriptions
Term
Records of this 6 categories of drugs must be maintained separately including prescription files, invoices and receipts , inventories
Definition
Schedule II -V and dangerous drugs
Term

      Inventories and records are to be kept under the federal and Texas regulations for ____years from the date such inventory and records are made

Definition
two 
Term
These 2 controlled drugs can be sold without prescription. Which one is the sale prohibited in Texas?
Definition

More than 8 ounces or 48 units of opium products ex. Donnagel PG; Parepectolin, Kapectolin PG, Kaolin Pectin P.G.

 

or 

> 4 ounces or 24 units of codeine - in Tx sale is prohibited without prescription

Term
When doing inventory of the pharmacyan exact count or measure of ___ and __ is mandatory, but estimates of ___ are ok.
Definition

C1 & CII = mandatory

but an estimate for CIII-V

Term
Inventories must be kept at the registered location for ___
Definition
two years.
Term
At the time a drug is added to the list of controlled substances, the ___notice usually specifies the date when inventories must be taken.  
Definition
Federal Register 
Term

Annual inventory is required for all controlled substances plus all dosage forms of __and ___

Definition
nalbuphine (Nubain) and carisoprodol (Soma) 
Term
After inventory, the PIC must sign the inventory record within ___
Definition
72 hours or 3 working days
Term
Notify the board in writing within ___ that a change of PIC has occurred
Definition
10 days
Term
__ is required for Schedule II drugs in Class C (institutional) pharmacies only
Definition
Perpetual inventory
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