Kentucky Scheduled Drugs Iii Through V Prescriptions
For Schedule III through V drugs, a DEA 222 is not necessary. 10 Upon receipt of new Schedule II drugs, the pharmacist must enter the shipment into a log in the pharmacy to ensure that shrinkage and diversion of product does not occur.
This second article of a 4-part series on key components of the Federal Controlled Substances Act will discuss the requirements for controlled substances prescriptions. For a prescription for a controlled substance to be considered valid, it must be “issued for a legitimate medical purpose by a registered practitioner acting in the usual course of sound professional practice.”1Registered practitioner refers to any health care professional who is authorized to prescribe controlled substances within the area in which he or she is licensed to practice and who is registered with the Drug Enforcement Agency (DEA) or is exempt from registration.2 All of the following must be included in a prescription for a controlled substance1:
Issue date
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Materi bahasa indonesia kelas 11 kurtilas. Name and address of patient
Name, address, and DEA registration number of practitioner
Drug name
Strength of drug
Dosage form (ie, tablet, suspension, etc)
Quantity prescribed
Directions for use
Refills (if authorized)
Manual signature of the prescriber
Schedule II prescriptions must be presented to the pharmacy in written form and signed by the prescriber.1 There are no federal quantity limits on Schedule II prescriptions.2 In addition, there is no federal time limit on when a Schedule II prescription must be filled after being signed by a prescriber. That being said, the pharmacist must ensure that the controlled substance is being prescribed for a legitimate medical purpose; the quantity of the medication prescribed and the time between signing and filling of a prescription may play a role in this decision. Note that state laws may have stricter rules.
A prescription for a Schedule II medication may be phoned into the pharmacy in an emergency situation.1 The prescriber must follow-up the phone prescription with a written prescription to the pharmacy within 7 days. Faxed Schedule II prescriptions are generally permitted, however, the pharmacist must receive the original, signed written prescription before dispensing the Schedule II controlled substance to the patient.2 There are 3 scenarios in which a facsimile Schedule II prescription may serve as an original written prescription. These include the following:
The health care provider is prescribing a Schedule II narcotic to be compounded for direct administration to a patient by intravenous, intramuscular, subcutaneous, or intraspinal infusion.
The provider is prescribing Schedule II medications to patients within a long-term care facility, which are normally filled and delivered to the patients within the facility by the pharmacy.
The provider is prescribing Schedule II medications to a patient in hospice care as certified by Medicare or licensed by the state.
Prescriptions for Schedules III to V controlled substances may be written, orally communicated, or faxed to the pharmacy.1
Not all prescriptions for controlled substances can be refilled.1 Schedule II medications may not be refilled; a new prescription must be written every time. Medications classified as Schedule III or IV controlled substances may be refilled up to 5 times in a 6-month period. Schedule V medications may be refilled as authorized by the prescriber. For refills of any controlled substance, the dispensing pharmacist’s initials, date of refill, and amount dispensed must be written on the back of the prescription.2
Kentucky Scheduled Drugs Iii Through V Prescriptions Online
One mechanism to verify the validity of a controlled substance prescription is through the DEA registration number provided by the practitioner.2 DEA registration numbers contain 2 letters followed by a computer-generated sequence of 7 numbers. The first letter in the DEA registration is generally an A, B, or M. Prior to October 1, 1985, DEA registration numbers began with the letter A. Registration numbers issued after this date start with the letter B. Mid-level practitioners, such as advanced nurse practitioners and physician assistants, have registration numbers beginning with the letter M. The second letter in the registration number is the first letter of the practitioner’s last name (ie, J for Jackson or W for White). The computer-generated sequence of numbers can be verified using the following formula: add the sum of the first, third, and fifth digits to twice the sum of the second, fourth, and sixth digits. The total should be a number whose last digit is the same as the last digit of the DEA number on the prescription.
Health care providers with prescribing authority, when acting within the usual course of business at a hospital or other health care institution, may prescribe controlled substances under the DEA registration number of the hospital or institution.2 Examples of practitioners who may use a hospital’s DEA registration number include physician interns and residents as well as medical house staff or mid-level practitioners such as physician assistants or advanced nurse practitioners. The hospital or other institution must authorize the health care provider to prescribe under its registration number. A specific internal code number must be assigned to each authorized practitioner.
The health care institution must keep an up-to-date list of all internal codes with the corresponding practitioner.2 If the pharmacy has any doubt regarding a controlled substance prescription from a provider using a health care institution’s DEA number, the pharmacist may contact the institution to verify the legitimacy of the prescription. As mentioned previously, mid-level practitioners such as nurse midwives, nurse practitioners, nurse anesthetists, clinical nurse specialists, physician assistants, and optometrists may be granted DEA registration numbers and may prescribe controlled substances. However, registration is contingent upon authority granted by the state in which they are licensed. Pharmacists must be familiar with the controlled substances act in their state to determine which health care providers may or may not prescribe any controlled substances and, if so, which schedules may be prescribed.
On December 19, 2007, a DEA regulation came into effect that allows a prescriber to issue multiple prescriptions authorizing an individual patient to receive a total of up to a 90-day supply of a Schedule II controlled substance.2 However, this is allowable only under the following conditions:
Every Schedule II prescription must be written on a separate prescription blank.
Each Schedule II prescription must be written for a legitimate medical purpose by an authorized prescriber during the usual course of professional practice.
The prescriber must indicate on each prescription the earliest date on which the prescription can be filled by the pharmacy; an exception to this rule would be for the first prescription if the prescriber intends for that prescription to be filled immediately.
The prescriber must determine that providing multiple Schedule II prescriptions to the patient does not increase the risk of diversion or abuse.
State law must allow for the issuance of multiple prescriptions.
The individual prescriber must comply fully with all other applicable requirements under the Controlled Substance Act and the Code of Federal Regulations, as well as any additional requirements under state law.
The third RxLegal column in this series will discuss ordering and record-keeping requirements for controlled substances.
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In our fast-paced society, time efficiency comes at a premium and many doctors’ offices employ nurse practitioners or physicians assistants to help get patients in and out quickly. As of 2012, nearly 86 percent of nurse practitioners were women, according to the U.S. Bureau of Labor Statistics. A nurse practitioner offers the same level of service as a physician, and thanks to regulations from the Drug Enforcement Administration, they can even write prescriptions. Before signing their John Hancock to a prescription, the practitioner must register with the DEA.
Licensing
Each state sets its own licensing requirements for nurse practitioners, but all 50 require that a nurse practitioner have at least a registered nurse license. Earning an RN license means earning a bachelor’s degree in nursing and passing the National Council Licensure Examination. All states also mandate that nurse practitioners take specialized nurse practitioner courses. In 27 of the states, a nurse practitioner needs a master’s degree to practice, while in 35 states, she needs national certification. National certification comes from several industry groups and requires passing a certification exam. Some of the states that require certification mandate that the nurse practitioner receive specialized training in a certain field, such as acute care, pediatrics, oncology or family care.
Registration
Before she can write prescriptions for drugs or medical devices, the nurse practitioner must register with the DEA and receive a furnishing number. The DEA assigns the furnishing number, which gives practitioners the authority to write prescriptions after they have met the requirements. An applicant must submit an application form to the DEA that shows she has taken courses directly related to dispensing controlled substances and holds proper certification according to her state’s rules. The DEA also requires applicants to pay a fee when submitting the application.
Stipulations
Once registered with the DEA, a nurse practitioner may order, dispense or furnish prescription medicine, but only under the supervision of a practicing doctor or physician. A nurse practitioner must also sign a written agreement with her supervising physician that stipulates she is allowed to dispense and prescribe drugs and specifies what drugs that physician allows her to prescribe. Each prescription the nurse practitioner writes must include her DEA number, name, address and professional certification. The actual prescription must also have the nurse practitioner's name on it.
Types of Substances
The DEA divides drugs and medical devices into different categories, also called schedules. Nurse practitioners who work in a hospital, surgical suite or hospice care can apply for Schedules II through V. All other nurse practitioners can apply for Schedules III through V. Schedule I drugs are illegal substances such as marijuana and heroin. The schedule number increases as the abuse potential of the drug decreases. For example, Schedule II includes drugs with high chances of misuse, such as morphine and codeine, while Schedule V drugs have the lowest likelihood of people abusing them.
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References
About the Author
Lindsey Thompson began her writing career in 2001. Her work has been published in the Cincinnati Art Museum's 'Member Magazine' and 'The Ohio Journalist.' You'll also find her work on websites like Airbnb, Chron.com, and USAToday.com. Thompson holds a Bachelor of Science in journalism from the Scripps School of Journalism at Ohio University.
Photo Credits
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