MPJE Prescription Dispensing Requirements 3 — Questions and Answers
Question 1: A prescription for amoxicillin 500 mg is written for 'qty: 30 capsules, no refills.' Three weeks later the patient calls requesting a refill. What should the pharmacist do?
- Dispense a one-time courtesy refill as amoxicillin is not a controlled substance
- Contact the prescriber for a new prescription or refill authorization before dispensing (Correct answer)
- Dispense up to a 72-hour emergency supply and notify the prescriber
- Refuse any dispensing as the prescription is expired
Correct answer: Contact the prescriber for a new prescription or refill authorization before dispensing
When a prescription has no refills authorized, the pharmacist must obtain a new prescription or authorization from the prescriber before dispensing additional medication.
Question 2: Which scenario represents a valid emergency oral prescription for a Schedule II controlled substance?
- A patient calls the pharmacy directly to request their own controlled substance prescription
- A prescriber calls in morphine for a terminally ill patient with a bona fide emergency and provides a written prescription within 7 days (Correct answer)
- A nurse practitioner's receptionist calls in oxycodone for a non-emergency chronic pain patient
- A pharmacist dispenses a 30-day supply based on a previous refillable Schedule II prescription
Correct answer: A prescriber calls in morphine for a terminally ill patient with a bona fide emergency and provides a written prescription within 7 days
Federal law permits oral Schedule II prescriptions only in genuine emergencies, provided the prescriber submits a written prescription within 7 days and the quantity is limited to the emergency period.
Question 3: A pharmacist suspects that a prescription for oxycodone was forged. Which action is most appropriate?
- Dispense the prescription if the patient has a valid ID and appears legitimate
- Refuse to dispense, retain the prescription if safe to do so, and notify law enforcement or the prescriber (Correct answer)
- Dispense a partial quantity while verifying the prescription's authenticity
- Return the prescription to the patient and advise them to see another pharmacy
Correct answer: Refuse to dispense, retain the prescription if safe to do so, and notify law enforcement or the prescriber
When a controlled substance prescription is suspected to be forged, the pharmacist should refuse to fill it, retain the prescription if possible, and report to the prescriber and/or law enforcement.
Question 4: A prescription reads 'Metformin 500 mg – dispense as written.' The pharmacist's wholesaler only has the generic in stock. What is the pharmacist's obligation?
- Dispense the generic, as DAW instructions on non-controlled drugs are unenforceable
- Contact the prescriber to discuss alternatives before dispensing the generic
- Dispense the brand name by ordering it specifically to fulfill the DAW instruction (Correct answer)
- Refuse to fill the prescription until the brand name is available
Correct answer: Dispense the brand name by ordering it specifically to fulfill the DAW instruction
A 'dispense as written' (DAW) instruction requires the pharmacist to dispense the brand-name product, which may require special ordering.
Question 5: Under federal law, which of the following is NOT a required element of a valid controlled substance prescription?
- Patient's full name and address
- Prescriber's NPI number (Correct answer)
- Date the prescription was issued
- Prescriber's signature
Correct answer: Prescriber's NPI number
Federal DEA requirements for controlled substance prescriptions do not include the prescriber's NPI number; required elements include patient name/address, date, drug, quantity, and prescriber signature/DEA number.
Question 6: A pharmacist receives a prescription for testosterone gel (Schedule III). The prescription was written 7 months ago. Under federal law, what is the dispensing status?
- It may be dispensed because Schedule III prescriptions are valid for 12 months
- It may not be dispensed because Schedule III prescriptions are only valid for 6 months from the date issued (Correct answer)
- It may be dispensed for the original fill only, not refills
- It may be dispensed as long as the prescriber confirms it is still valid
Correct answer: It may not be dispensed because Schedule III prescriptions are only valid for 6 months from the date issued
Federal law limits Schedule III–V prescriptions to 6 months from the date issued, so a 7-month-old prescription may not be dispensed.
Question 7: Which of the following statements about transferring a Schedule III controlled substance prescription between pharmacies is correct?
- Schedule III prescriptions may be transferred only once between pharmacies (Correct answer)
- Schedule III prescriptions may never be transferred between pharmacies
- Schedule III prescriptions may be transferred an unlimited number of times within the authorized refills
- Schedule III prescriptions may be transferred only within the same pharmacy chain
Correct answer: Schedule III prescriptions may be transferred only once between pharmacies
Federal law allows Schedule III–V prescriptions to be transferred between pharmacies only once, unless the pharmacies share a real-time electronic database allowing multiple transfers.
MPJE Prescription Dispensing Requirements 3
A prescription for amoxicillin 500 mg is written for 'qty: 30 capsules, no refills.' Three weeks later the patient calls requesting a refill.
What should the pharmacist do?