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Controlled substance
| Question | Answer |
|---|---|
| Orange book | Approved drug products with therapeutic equivalence evaluations |
| Red book | Drug prices |
| State board of Pharmacy | Each state has it's own board of pharmacy that is responsible for protecting the health, safety and welfare |
| Food and Drug Administration (FDA) | Enforces drug manufacturing laws and regulates prescription drug advertising |
| Drug Enforcement Administration (DEA) | Enforces the federal controlled substance act (CSA) and makes decisions the classification of certain drugs as controlled substances |
| Occupational Safety and Health Administration (OSHA) | Enforces occupational health and safety laws |
| Federal Trade Commission (FTC) | Regulates advertising for over-the-counter drugs (OTC), medical devices, cosmetics, food products |
| 1 section of NDC #s | Manufacturer |
| 2 set of NDC #s | Drug (strength and form) |
| 3rd set of NDC #s | Packaging size |
| Schedule 1 | Not accepted medically Not legal High potential for abuse |
| Schedule 2 | Accepted medically Rx only High potential for abuse |
| Schedule 3 | Accepted medically Rx only Moderate potential for abuse |
| Schedule 4 | Accepted medically Rx only Mild potential for abuse |
| Schedule 5 | Accepted medically Rx, limited OTC in some states Low potential for abuse |
| Schedule 1 | Heroin, LSD, marijuana |
| Schedule 2 | Methadone (Dolophine), oxycodone (oxycontin), cocaine, Adderall (amphetamine/dextroamphetamine) |
| Schedule 3 | Burprenorphine (buprenex), codeine (tylenol ll3), benzphetamine (didrex), testosterone (androgen testim, axiron) |
| Schedule 4 | Xanax (alprazolam), ambien (zolpidem), tramadol (ultram) |
| Schedule 5 | Pregabalin (lyrica), robitussin (codeine w/gualfenesin) |
| Controlled substance prescription | Pt's name and address Prescribers name, work address and DEA # Drug name, date, and dosage form Quantity, directions and # of refills l |
| Pseudoephedrine 30 day limit | 9 for 30 days 7.5 mail order 3.6 daily |
| Controlled substances | Keep all records for 2 years Faxed c-ll rx's are valid for home Infusions, long-term care, and hospice pts Verbal c-ll rx's are valid as long as the prescribing MD provides a hard copy in 7 days |
| Refills | C-ll refills not permitted C-lll to lV 5 refills for 6 months C-V refills premitted, no max |
| DEA 41 | Reporting destruction of controlled substance |
| DEA 104 | Reporting a pharm closure or surrender of a pharm permit |
| DEA 106 | reporting loss or theft of controlled substances |
| DEA 222 | ordering schedule 2 controlled substances |
| DEA 224 | Applying for a DEA registration # |
| DEA 222 form 1st page | Brown (original) Retained by drug supplier |
| DEA 222 form 2nd page | Green (1st carbon copy) Forwarded to DEA by drug supplier |
| DEA 222 form 3rd page | Blue (2nd carbon copy) Retained by pharamacy |
| DEA # | Prescriber identification #. Required by practitioners who prescribe controlled substances |
| NPI # | National provider identifier #, 10 digit # |
| Poison Prevention Packaging Act 1970 | Requires child resistant packaging. Nitroglycerin and birth control are exempt because it restores blood flow to the heart, and could cause someone having a heart attack to struggle with packaging. Difficult to open for pts under 5. |
| Omnibus Budget Reconciliation Act of 1990 | Requires drug utilization reviews (DUR) and pharmaceutical care for Medicaid pts. Offers counseling to make sure all pts were receiving same level of service |
| Health Insurance Portabilty and Accountability Act 1996 (HIPPA) | To protect the privacy of individual health info, PHI. |
| Combat Methamphetamine Epidemic Act of 2005 (CMEA) | The reason pseudoephedrine is stored behind the counter. Info must be recorded when buying: product name, quantity, name and address of pt, date and time, signature of pt |
| Safety Data sheets (SDS) | OSHA requires by manufacturers |
| Kefauver-Harris Admendment | Requires manufacturers to provide proof of safety and effectiveness. Requires manufacturers to provide accurate info of side effects |
| Durham-Humphrey Amendment | Requires any drugs habit forming, be prescribed under supervision of licensed practitioner |
| Fair packaging and Labeling Act | Requires drugs to be labeled: The identity of product Name of distributor The net quantity of drug |
| IPledge | REMS program: ensuring pts who begin Isotretinoin are not pregnant and preventing pregnancy in pts recieving treatment |
| T.I.P.S | REMS program designed to communicate the risk of cardiac arrhythmia associated with Tikosyn |
| Clozaril National Registry | A database for recording and referencing the white blood cell count of pts who recieved clozapine |
| Clinical trial phase 1 | Small study 20-80 of healthy male volunteers Low doses are tested |
| Clinical trials phase 2 | Study involving 40-300 pts with the disease of interest Minimum effect dose and max toxic dose determined |
| Clinical trial phase 3 | Study involving 300-3000 pts of various gender, race, lifestyle and age Risks and benefits using the drug Drug formulation refined Placebo studies are conducted |
| FDA recall class 1 | Serious adverse health consequences |
| FDA recall class 2 | Temp or medically reversible adverse health consequences |
| FDA recall class 3 | Products unlikely to have adverse health consequences |
| Prescription Drug Marketing Act 1987 | Requires whole distributors to be licensed |
| Drug Listings Act 1972 | |
| Established rules for all drug manufacturers to supply a current drug list to FDA | |
| Prescription Drug Marketing Act 1987 | Requires wholesale distributors to be licensed |
| How to get DEA # | 2nd letter is dm's last name. 1st+3rd+5th, and get the sum. 2nd+4th+6th and get the sum then times by 2. Last digit of DEA # is the last digit in the sum of both numbers |