DC LAW QUIZ

Who may keep keys for a pharmacy? I. a licensed pharmacist II. a proprietor of the pharmacy III. a registered pharmacy-intern a. I only b. I and II only c. II and III only d. All

*b. I and II only* [D.C. Code Title 47-2885.09(c)(4)]. (c)(1). If only part of an establishment or institution is used as the pharmacy and if the pharmacy is not open to the public at the times when the rest of the establishment is open to the public, the pharmacy shall be securely enclosed so as to prevent unauthorized access to pharmacy areas and to prevent the diversion of drugs stored in pharmacy areas. (2). The pharmacy and any storage areas for prescription drugs outside of the pharmacy shall be substantially constructed. (3). All doors shall be capable of being securely locked, and access shall be restricted to pharmacists, the proprietor of the pharmacy, or persons authorized by a pharmacist with the consent of the proprietor. (4). The key or keys to areas are to be under the control or in the possession of the pharmacist on duty or the proprietor of the pharmacy.

The *filled out DEA 222 order forms* must be kept available for inspection for how many years? 1 year 4 years 2 years 6 months

2 years, [DCMR Title 22 Chapter 15-1504, 1504.1 and 1505.1] The filled out DEA 222 order forms must be kept available for inspection for a period of 2 years. Controlled Substances in Schedule I or II shall be distributed by a registrant to another registrant only pursuant to an order form. Compliance with the provisions of federal law and regulations respecting order forms shall be deemed compliance with this chapter. All records required by this chapter shall be retained for a period of at least two (2) years.

The records regarding the automated medication dispensing system can be maintained to off site where the automated medication dispensing system is NOT located, if the records can be retrieved within three (3) business days of a request. True False

Answer: (b) False, [D.C. Official Code Title 22, Chapter 19 Section 1915.8]. The records regarding the automated medication dispensing system *shall be stored on site* where the automated medication dispensing system is located.

In District of Columbia, the controlled drugs prescriptions must be kept on file for at least: a. 5 years from the date last refilled. b. 6 months from the date last refilled. c. 2 years from the date last refilled. d. 1 year from the date last refilled.

Answer: (a) *5 years from the date of last refilled,* [DCMR Title 22 Chapter 19-1913.2, 1913.4 and 1913.7]. A pharmacy shall maintain on a current basis a complete and accurate record of all prescription drugs and devices received, sold, compounded, dispensed, or otherwise disposed of by the pharmacy for a period of five (5) years. The requirement may be met by maintaining the most recent two years of records on site and the remaining three years of records off site as long as the records can be retrieved within three (3) business days of a request. A pharmacy shall keep a chronological record, for a period of five (5) years from the date of first dispensing, of each prescription that is filled or refilled including the following information: (a). The name and address of the patient; (b). The name and address of the prescriber and date prescribed; (c). The name, strength, dosage form, and quantity of the drug prescribed, and quantity dispensed if different from the quantity prescribed; (d). The name and manufacturer of the drug if it is a substitute or generic drug for the drug actually prescribed or filled initially; (e). Directions for use; (f). The date the prescription was compounded, dispensed, or refilled; (g). The name or initials of the pharmacist responsible for final verification of the prescription order; (h). The prescriber's Drug Enforcement Administration (DEA) number and District of Columbia Controlled Substances number when required by law or regulation; (i). The expiration date of the drug dispensed; (j). Any change or alteration made to the prescription dispensed based on contact with the practitioner to show a clear audit trail. This shall include, a change in quantity, directions, number of refills, or authorization to substitute a drug; and (k). Any other information required by District of Columbia or federal law or regulations.

At the time of closing or discontinuing of business, the District of Columbia certificate of registration shall be returned to the: a. Director b. District of Columbia State Pharmacy Board c. DEA d. FDA

Answer: (a) *The Director,* [DCMR Title 22 Chapter 13 Sections 1322.1, 1322.2]. A registrant desiring to discontinue business activities altogether or with respect to controlled substances (without transferring such business activities to another person) shall: (a). Return for cancellation his or her District of Columbia certificate of registration to the Director; (b). Return for cancellation his or her federal registration certificate and any unexecuted order forms in his or her possession to the DEA; and (c). Dispose of any controlled substances in his or her possession in accordance with 21 CFR § 1307.21. A registrant desiring to discontinue business activities altogether or with respect to controlled substances (by transferring those business activities to another person) shall submit in person or by registered or certified mail, return receipt requested, to the Director, at least fourteen (14) days before the date of the proposed transfer (unless the director waives this time limitation in individual instances) the following information: (a). The name, address, controlled substance registration number(s), and authorized business activity of the registrant discontinuing the business (registrant-transferor); (b). The name, address, controlled substance registration number(s), and authorized business activity of the person acquiring the business (registrant transferee); (c). Whether the business activities will be continued at the location registered by the person discontinuing the business, or moved to another location (if the latter, the address of the new location shall be listed); and (d). The date on which the transfer of controlled substances will occur.

After dispensing an emergency oral Schedule II controlled drug, the pharmacist shall contact whom upon not receiving the written prescription from the prescriber within 7 days? I. The Director II. The District of Columbia State Board of Pharmacy III. The patient a. I only b. I and II only c. II and III only d. All

Answer: (a) *The director, * The Director of DC Department of Health [DCMR Title 22 Chapter 13-1306.5(d)(2)]. Within seven (7) days after authorizing an emergency oral prescription, the practitioner shall cause a written prescription for the emergency quantity prescribed to be delivered to the dispensing pharmacist. The pharmacist shall notify, in writing, *the Director* if the prescribing individual practitioner fails to deliver a written prescription to him or her. Failure of the pharmacist to notify the Director shall void the authority conferred by this section to dispense without a written prescription of a prescribing practitioner.

A provider pharmacy shall notify the Director in writing within 15 days of a change of location, discontinuance of service, or closure of a remote site or remote pharmacy service. True False

Answer: (b) False, [D.C. Official Code Title 22, Chapter 19 Section 1916.4]. A provider pharmacy shall notify the Director in writing *within 10 days* of a change of location, discontinuance of service, or closure of a remote site or remote pharmacy service.

Under D.C. State Pharmacy Law, a pharmacy engages in dispensing activities must require a set of prescription balances sensitive to:

Answer: (a) 15 mg, [D.C. Official Code Title 22, Chapter 19 Section 1909.2 (b)]. The equipment and references requirements under the law shall apply to all pharmacies. The pharmacist-in-charge shall be responsible for maintaining the following: (a). Current dispensing information reference source consistent with the scope of pharmacy practice at the location of the permitted pharmacy; (b). A set of prescription balances, sensitive to 15 milligrams, and weights or an electronic scale if the pharmacy engages in dispensing activities that require the weighing of components. A pharmacy may apply to the Director for a waiver of any of the equipment required under the law where the equipment would be inapplicable to the services provided by the pharmacy.

According to District of Columbia Pharmacy Law, a pharmacy shall prepare a log of drugs that have been compounded, repackaged, or prepackaged under a pharmacist's supervision. The pharmacy shall maintain this log for:

Answer: (a) 5 years from the date of packaging, [DCMR Title 22 Chapter 19 Section 1911.10]. A pharmacy shall keep a log of drugs that have been compounded, repackaged, or prepackaged under a pharmacist's supervision. The log must contain the following information: (a). The name of the drug; (b). The name of the manufacturer or distributor; (c). The manufacturer or distributor's lot or control number of the drug; (d). The strength of the drug; (e). The expiration date; (f). The date of prepackaging or repackaging; (g). The quantity of drugs prepared; and (h). The name or initials of the pharmacist supervising the packaging. A pharmacy shall keep this log for five (5) years from the date of packaging. Records that are more than two (2) years old may be stored offsite as long as they can be retrieved within three (3) business days of a request.

In the event the actual number of remaining authorized refills cannot be determined due to dysfunctioning of the Automatic Data Processing System, and the pharmacist is unable to contact the prescribing provider for a new prescription, the pharmacist shall dispense not more than a: a. 7-day supply to cover or prevent a medical emergency. b. 3-day supply to cover or prevent a medical emergency. c. 24-hour supply to cover or prevent a medical emergency. d. 48-hour supply to cover or prevent a medical emergency.

Answer: (a) 7-day supply, [DCMR Title 22 Chapter 19 Section 1914.9] A pharmacy shall have an auxiliary system or procedures in place to ensure that all refills are authorized and that the maximum number of refills is not exceeded, if the automated data processing system is inoperative for any reason. In the event the actual number of remaining authorized refills cannot be determined and the pharmacist is unable to contact the prescribing provider for a new prescription, the pharmacist may use his or her professional judgment to dispense not more than a seven-day supply to cover or prevent a medical emergency.

A 45-year-old patient comes to the pharmacy and presents a prescription for Ambien written by his podiatrist. A pharmacist shall: a. not fill the prescription. b. fill the prescription. c. ask the patient to get a new prescription from an authorized prescriber. d. fill Ambien only after filling out a DEA 222 order form.

Answer: (a) A pharmacist shall *not* fill the prescription, [DCMR Title 22 Chapter 13-1305.2 and 1305.6]. For a controlled substance prescription drug order to be legal, it must be issued for a *legitimate medical purpose* by an authorized individual practitioner acting in the usual course of his or her professional practice. The responsibility for the proper prescribing of controlled substances is upon the prescribing practitioner, but the pharmacist is responsible for the proper filling of the prescription drug order. A registered physician, dentist, veterinarian, or podiatrist authorized by this state to prescribe controlled substances can issue a prescription for controlled substances *only in the usual course of his or her professional practice*. Therefore, a *pharmacist shall question the prescription for sleeping pill (Ambien) prescribed by a registered podiatrist.*

A pharmacist has substituted generic Azithromycin (Mfg: Teva) for brand prescribed Zithromax (Mfg: Glaxo). Which of the following shall be placed on dispensing label? ************** a. Azithromycin, (Teva) b. Azithromycin, Zithromax (Teva) c. Azithromycin, (a generic for Zithromax) d. Zithromax (Glaxo), Azithromycin

Answer: (a) Azithromycin, (Teva), [DCMR Title 22 Chapter 13 Section 1325.10]. The *name of the drug* or the *name and manufacturer* of the substituted drug if different than the originally prescribed or filled drug.

Which of the following requires a DEA 222 form for purchase? a. Hashish b. Pentazocine c. Modafinil d. Meprobamate

Answer: (a) Hashish is classified as Schedule II controlled drug, [D.C. Code Title 48-902.06(F),(G) and DC Title 22 Chapter 12 Section 22-1202.1 (6)]. It requires a DEA 222 order form for purchase, [D.C. Code Title 48-903.07 and DC Title 22 Chapter 15 Section 22-1504.1].

Dr DJ prescribed Ultram to AB for his dental pain on 06/01/2019 with 3 refills. After taking the medication for a month, he didn't take the drug for a while. On 02/19/2020, he had severe dental pain and went to the pharmacy to get a few weeks supply of the drug on the original prescription. The pharmacist most likely will say: a. I cannot refill the prescription. b. I can only fill if physician says okay to fill remaining. c. I can only fill a 3-day supply. d. You have to pay in cash for this prescription.

Answer: (a) I cannot refill the prescription, [DCMR Title 22 Chapter 13 Sections 1310.1 and 1310.2]. The prescriptions for Schedule III, IV and V controlled drugs should not be filled after six month from the date of issued or refilled more than 5 times within a 6-month period. *Ultram (Tramadol) is classified as a Schedule IV controlled substance*, pharmacist cannot fill the prescription since it is more than six months old, [D.C. Code Title 48-902.10].

An oral emergency prescription for a Schedule II controlled drug order conveyed by a practitioner's designated agent may be filled by a pharmacist. a. True b. False

Answer: (a) True, [DC Code Title 22 Chapter 13 Section 1302.2]. An *oral emergency prescription for a Schedule II controlled drug order* from a *practitioner* or a *practitioner's designated agent* shall: (a). *Only be received by a pharmacist*; and (b). Be immediately reduced to writing. In addition to conforming to all applicable federal and District requirements, an oral prescription drug order shall contain the following: (a). The full name, address, and telephone number of the practitioner; (b). The date of issuance; (c). The full name and address of the patient; (d). The name, strength, and quantity of the drug, directions for use, and number of refills, when applicable; and (e). The *name of the practitioner's designated agent* authorized to orally communicate the prescription to the pharmacist.

Which of the following is/are *NOT * TRUE about dispensing Schedule V OTC controlled drugs? I. The purchaser should be at least 21 years of age. II. Dispensing should be done by a registered pharmacist. III. A record of dispensing must be entered in a Schedule V bound book.

Answer: (a) I is not true, [DCMR Title 22 Chapter 13 Section 1314.1(c)]. A controlled substance listed in Schedule II, III, IV or V, which is not a prescription drug as determined under the Federal Food, Drug, and Cosmetic Act, may be dispensed by a pharmacist without a prescription to a purchaser at retail, provided that the following occurs: (a). The dispensing is made only by a pharmacist (as defined in 21 CRF, § 1306.02(d)), and not by a non-pharmacist employee even if under the supervision of a pharmacist (although after the pharmacist has fulfilled his or her professional and legal responsibilities set forth in this section, the actual cash, credit transaction, or delivery may be completed by a non-pharmacist); (b). Not more than 240 cc. (8 ounces) of any controlled substance containing opium, nor more than 120 cc. (4 ounces) of any other controlled substance, nor more than forty-eight (48) dosage units of any controlled substance containing opium, nor more than twenty-four (24) dosage units of any other controlled substance may be dispensed at retail to the same purchaser in any given forty-eight (48) hour period, except pursuant to a written or oral prescription of a duly licensed practitioner in possession of a Federal Controlled Substances Registration number; (c). The purchaser is at least *eighteen (18) years of age;* (d). The pharmacist requires every purchaser of a controlled substance under this section not known to him or her to furnish suitable identification (including proof of age where appropriate); (e). A bound record book for dispensing of controlled substances under this section is maintained by the pharmacist, which book shall contain the name and address of the purchaser, the name and quantity of controlled substance purchased, the date of each purchase, and the name or initials of the pharmacist who dispensed the substance to the purchaser (the book shall be maintained in accordance with the record-keeping requirement of 21 CFR, § 1304.04)

Which of the following information regarding Controlled Substance registration is/are TRUE? I. Applications to renew a registration must be filed in a timely manner, not less than 60 days prior to the expiration of the registration. II. Every person who manufactures, distributes, or dispenses any controlled substance within the District of Columbia must obtain an annual registration. III. The controlled substance registration shall be issued by the Department of Human Services. a. I only b. I and II only c. II and III only d. All

Answer: (a) I only, [DC Official Code Title 22 Chapter 10 Section 1002.1 and 1003.4]. Every person who manufactures, distributes, dispenses, or conducts research with any controlled substance, or who proposes to engage in the manufacture, distribution, dispensing, or conducting of research with any controlled substance within the District of Columbia shall obtain *biennially* and maintain current registration issued by the Director of the Department of Health. Applications to renew a registration must be filed in a timely manner, not less than 60 days prior to the expiration of the registration, or the registration shall abate.

Any authorized transfer of original prescription information between non-linked pharmacy systems for the purpose of refill dispensing shall be communicated directly between: I. two licensed pharmacists II. a licensed pharmacist and a registered pharmacy-intern III. two registered pharmacy-interns

Answer: (a) I only, [D.C. Official Code Title 22, Chapter 13 Section 1316.3]. Any authorized transfer of original prescription information between non-linked pharmacy systems for the purpose of refill dispensing shall be subject to the following requirements: (a). The transfer shall be communicated directly between two licensed Pharmacists; (b). The transferring pharmacist shall record on the invalidated prescription, in hardcopy or electronically, the following information: (1). The words "VOID" and "TRANSFER"; (2). The name, address, and telephone number of the pharmacy to which it was transferred; (3). The name of the pharmacist receiving the prescription information; (4). For controlled substances, the DEA registration number of the prescriber and of the pharmacy to which the prescription is being transferred and the District of Columbia Controlled Substances registration number, if applicable, of the prescriber and of the pharmacy to which the prescription is being transferred; and (5). The date of the transfer and the name of the pharmacist transferring the information; (c). The pharmacist receiving the transferred prescription information shall reduce to writing the following information: (1). Write the word "TRANSFER" on the face of the transferred prescription; (2). All information required to be on a prescription pursuant to 21 CFR 1306.05 and this chapter; (3). Date of issuance of original prescription; (4). Original number of refills authorized on original prescription; (5). Date of original dispensing; (6). Number of valid refills remaining; (7). The transferring pharmacy's name, address, and telephone number; (8). Name of pharmacist who transferred the prescription; and (9). For controlled substances, the DEA registration number of the prescriber and the pharmacy from which the prescription was transferred, and the District of Columbia Controlled Substances registration number, if applicable, of the prescriber and of the pharmacy from which the prescription information was transferred.

Who shall be authorized to *fill* an *automated dispensing system* under the District of Columbia State Pharmacy Law? ********** I. Licensed pharmacist II. Licensed pharmacy-intern III. Certified pharmacy technician

Answer: (a) I only, [DCMR Title 22 Chapter 19 Section 1915.13 and 1915.15]. According to District of Columbia State Pharmacy Law, *only a licensed pharmacist* may *fill* an automated medication dispensing system unless otherwise specifically permitted by the law. Also, *only a licensed pharmacist* may *return* medication to the automated medication dispensing system.

Who may counsel a patient under the Washington DC State Pharmacy Law? I. a licensed pharmacist II. a registered pharmacist-intern III. a certified pharmacy technician.

Answer: (a) I only, [DCMR Title 22 Chapter 19 Section 1919.6]. Only a pharmacist may counsel a patient or the patient's agent and answer questions concerning prescription drugs or devices.

A recall communication can be accomplished by telegrams, mailgrams, or first class letters conspicuously marked, preferably in bold red type, on the letter and the envelope: "drug recall". a. True b. False

Answer: (a) True, [21CFR 7.49]. (a). General. A recalling firm is responsible for promptly notifying each of its affected direct accounts about the recall. The format, content, and extent of a recall communication should be commensurate with the hazard of the product being recalled and the strategy developed for that recall. In general terms, the purpose of a recall communication is to convey: (1). That the product in question is subject to a recall. (2). That further distribution or use of any remaining product should cease immediately. (3). Where appropriate, that the direct account should in turn notify its customers who received the product about the recall. (4). Instructions regarding what to do with the product. (b). Implementation. A recall communication can be accomplished by telegrams, mailgrams, or first class letters conspicuously marked, preferably in bold red type, on the letter and the envelope: "drug [or food, biologic, etc.] recall [or correction]". The letter and the envelope should be also marked: "urgent" for class I and class II recalls and, when appropriate, for class III recalls. Telephone calls or other personal contacts should ordinarily be confirmed by one of the above methods and/or documented in an appropriate manner. (c). Contents. (1) A recall communication should be written in accordance with the following guidelines: (i). Be brief and to the point; (ii). Identify clearly the product, size, lot number(s), code(s) or serial number(s) and any other pertinent descriptive information to enable accurate and immediate identification of the product; (iii). Explain concisely the reason for the recall and the hazard involved, if any; (iv). Provide specific instructions on what should be done with respect to the recalled products; and (v). Provide a ready means for the recipient of the communication to report to the recalling firm whether it has any of the product, e.g., by sending a postage-paid, self-addressed postcard or by allowing the recipient to place a collect call to the recalling firm. (2). The recall communication should not contain irrelevant qualifications, promotional materials, or any other statement that may detract from the message. Where necessary, followup communications should be sent to those who fail to respond to the initial recall communication. (d). Responsibility of recipient. Consignees that receive a recall communication should immediately carry out the instructions set forth by the recalling firm and, where necessary, extend the recall to its consignees in accordance with paragraphs (b) and (c) of this section.

The transfer of original prescription information for a controlled substance listed in Schedules III, IV, or V for the purpose of refill dispensing may be transferred up to the maximum number of refills permitted by law if pharmacies utilize a linked pharmacy system. True False

Answer: (a) True, [D.C. Official Code Title 22, Chapter 13 Section 1316.1]. The transfer of original prescription information for a controlled substance listed in Schedules III, IV, or V for the purpose of refill dispensing is permissible, subject to the requirements of § 1316.3 of this chapter, between pharmacies on a one-time basis only. However, pharmacies utilizing a linked pharmacy system may transfer up to the maximum number of refills permitted by law.

A practitioner who is authorized to dispense a controlled substance may distribute, without being registered to distribute, a quantity of the substance to another practitioner, for the purpose of general dispensing by the practitioner to his or her patients. a. True b. False

Answer: (a) True, [DCMR Title 22 Chapter 13-1320.1(d)]. According to Washington DC State Pharmacy Law, a practitioner who is authorized to dispense a controlled substance (e.g. pharmacist) may distribute (without being registered to distribute) a quantity of the substance to another practitioner, for the purpose of general dispensing by the practitioner to his or her patients, provided that the following conditions are satisfied: (a). The practitioner to whom the controlled substance is to be distributed is registered appropriately to dispense that controlled substance; (b). If the substance is listed in Schedule I or II, an order form is used as required by the federal regulations; and (c). The total number of dosage units of all controlled substances distributed by the practitioner pursuant to this section during the twelve (12) month period in which the practitioner is registered to dispense does not exceed 5% of the total number of dosage units of all controlled dangerous substances distributed and dispensed by the practitioner during the twelve (12) month period. If at any time during the twelve (12) month period during which the practitioner is registered to dispense, the practitioner has reason to believe that the total number of dosage units of all controlled substances which will be distributed by him or her to another practitioner pursuant to this section will exceed 5% of the total number of dosage units of all controlled substances distributed and dispensed by him or her during the twelve (12) month period, the practitioner shall obtain a registration to distribute controlled substances.

As part of the application for registration or renewal of registration, a nonresident pharmacy shall be able to provide to the Department a record of a prescription order dispensed to a resident of the District of Columbia *not later than three (3) business days* after the time the Department requests the record. a. True b. False

Answer: (a) True, [DCMR Title 22 Chapter 19 Section 1903.8(g)]. As part of the application for registration or renewal of registration, a nonresident pharmacy shall: (a). Submit evidence to the Department that the nonresident pharmacy holds a pharmacy license, registration, or permit, in good standing, issued by the state in which the pharmacy is located; (b). Submit evidence to the Department that the nonresident pharmacy holds a valid DEA registration number, if the pharmacy dispenses prescription controlled substances listed in any Schedule into the District of Columbia; (c). Submit evidence that the pharmacist-in-charge holds a valid license in good standing in the state in which the nonresident pharmacy is located; (d). Provide the name, address, and title of its: (1). Owner or proprietor; (2). Pharmacist-in-charge, along with his or her license number and state of licensure; (3). Principal corporate officers; (4). Pharmacists who are dispensing prescription drugs or medical devices to citizens of the District of Columbia, along with their license numbers and state of licensure; and (5). Resident agent located within the District of Columbia designated to accept service of process; (e). Submit a copy of the most recent inspection report resulting from an inspection conducted by the regulatory or licensing agent of the state in which the nonresident pharmacy is located; (f). Submit an affidavit by the pharmacist-in-charge certifying that the pharmacist-in-charge has read and understands the pharmacy and drug laws and regulations of the District of Columbia, and that the pharmacist-in-charge has made the pharmacy and drug laws and regulations of the District of Columbia available to all pharmacists working in the nonresident pharmacy; (g). Provide evidence of the nonresident pharmacy's ability to provide to the Department a record of a prescription order dispensed to a resident of the District of Columbia not later than three (3) business days after the time the Department requests the record.

A *patient record* shall be maintained for a period of not less than five (5) years from the date of the last entry in the profile record. a. True b. False

Answer: (a) True, [DCMR Title 22 Chapter 19-1913.11(e), 1913.12]. A pharmacy shall maintain a *patient record* system in an automated data processing system or manual record system which shall provide for the immediate retrieval of patient information during the pharmacy's normal operating hours which may include: (a). Full name of the patient for whom the drug is intended; (b). Street address and telephone number of the patient; (c). Patient's age or date of birth; (d). Patient's gender, height and weight; (e). A list of all prescription drug orders obtained by the patient at the pharmacy maintaining the patient record during the (5) years immediately preceding the most recent entry showing the name of the drug, prescription number, name and strength of the drug, the quantity and date received, and the name of the practitioner; (f). The pharmacist comments relevant to the individual's drug therapy, including any other information peculiar to the specific patient or drug; (g). Patient allergies, drug reactions, current medications and relevant prior medications including non-prescription medications and relevant devices, or medication conditions which are communicated by the patient or the patient's agent; and (h). Any other information which the pharmacist, in his or her professional judgment, deems appropriate. A patient record shall be maintained for a period of not less than five (5) years from the date of the last entry in the profile record. This record may be a hard copy or a computerized form.

According to Washington DC State Pharmacy Law, a drug which has been returned after being taken out of the pharmacy shall not be placed in stock for reuse or resale, except manufacturer packaged unit dose or unit of use drugs that have been unopened and unaltered. a. True b. False

Answer: (a) True, [D.C. Code Title 47-2885.13(c)]. A drug which has been returned after leaving the pharmacy shall not be placed in stock for reuse or resale, except manufacturer packaged unit dose or unit of use drugs which have been unopened and unaltered.

A prescription issued by an individual practitioner may be communicated to a pharmacist by an employee or agent of the individual practitioner. True False

Answer: (a) True, [D.C. Official Code Title 22, Chapter 13 Section 1300.4]. A prescription issued by an individual practitioner may be communicated to a pharmacist by an employee or agent of the individual practitioner only pursuant to the directions and order of the practitioner, and in conformance with the applicable federal and District of Columbia laws and regulations, and this chapter.

For any person who is exempted from registration under federal or District of Columbia statute, the pharmacist shall include on all prescriptions for controlled substances issued by the exempted practitioner the registration number of the hospital or other institution where he/she works. a. True b. False

Answer: (a) True, [D.C. Official Code Title 22, Chapter 13 Section 1302.7]. For any person who is exempted from registration under federal or District of Columbia statute, the pharmacist shall include on all prescriptions for controlled substances issued by the exempted practitioner the registration number of the hospital or other institution and the special internal code number assigned to him or her by the hospital or other institution as provided in the Act, in lieu of the registration number of the practitioner required by D.C. State Pharmacy Law.

For a schedule III, IV or V controlled substance, if a pharmacist merely initials and dates the back of the prescription, he or she shall be deemed to have dispensed a refill for the full face amount of the prescription. True False

Answer: (a) True, [D.C. Official Code Title 22, Chapter 13 Section 1310.5]. For a schedule III, IV or V controlled substance, if a pharmacist merely initials and dates the back of the prescription, he or she shall be deemed to have dispensed a refill for the full face amount of the prescription.

According to District of Columbia State Pharmacy Law, a written prescription for any drug, including over-the counter drugs, for a Medicaid beneficiary shall only be written on tamper resistant prescription pads contain one or more industry-recognized features designed to prevent unauthorized copying of a completed or blank prescription form. True False

Answer: (a) True, [D.C. Official Code Title 22, Chapter 13 Section 1333.2, 1333.3 to 1333.7]. Beginning April 1, 2009, a written prescription for any drug, including over-the counter drugs, for a Medicaid beneficiary shall only be written on tamper resistant prescription pads meeting all of the following characteristics: (a). The prescription pad contains one or more industry-recognized features designed to prevent unauthorized copying of a completed or blank prescription form; (b). The prescription pad contains one or more industry-recognized features designed to prevent erasure or modification of information written on the prescription by the prescriber; and (c). The prescription pad contains one or more industry-recognized features designed to prevent the use of counterfeit prescription forms. The following are exempt from this requirement: 1. Prescription orders transmitted to a pharmacy via telephone, telephone facsimile, or electronic prescription order are exempt from the tamper resistant requirements. 2. The tamper resistant requirements of this chapter do not apply to refill prescriptions of an original written prescription that was presented to a pharmacy before April 1, 2008. In the event a prescription is not submitted on a tamper resistant prescription form meeting the requirements set forth in §§ 1331.1 and 1333.2, a pharmacy may fill the prescription in full as written on an emergency basis as long as the pharmacy receives a verbal, telephone facsimile, electronic, or compliant written prescription within seventy-two (72) hours after the date on which the prescription was filled.

A non-resident pharmacy shall be operated only by pharmacist holding a valid license in the state in which the pharmacy is physically located. True False

Answer: (a) True, [D.C. Official Code Title 22, Chapter 19 Section 1901.1]. A pharmacy shall be operated only by pharmacist holding a valid license in the District of Columbia to practice pharmacy or, if a non-resident pharmacy, a valid license in the state in which the pharmacy is physically located.

The Director may issue a license to a new proprietor of a pre-existing licensed pharmacy without a pre-licensure inspection if the new proprietor certifies in the application for a new license that the pharmacy will not undergo substantial physical or operational changes in the first year of licensure. True False

Answer: (a) True, [D.C. Official Code Title 22, Chapter 19 Section 1905 and 1905.6]. 1. A proprietor desiring to change the name of a pharmacy shall apply to the Director on a form prescribed by the Director and pay the required fee. 2. A proprietor desiring to change the location of a pharmacy within the District shall apply for a new license. 3. If the change of name or location is approved, the Director shall issue a new license indicating the new name or location. The licensee is not permitted to use the new name or location until it has received official notification from the Director of approval of the change. 4. A proprietor desiring to change the proprietorship of a pharmacy shall notify the Director at least sixty (60) days prior to the date of the change. The prospective proprietor shall apply for a new license. 5. When a pharmacy changes proprietorship, the license shall become void and shall be surrendered promptly to the Director, and a license shall be obtained by the new proprietor whether or not there is any change in the name of the pharmacy. 6. The Director may issue a license to a new proprietor of a pre-existing licensed pharmacy without a pre-licensure inspection as required by the law, provided the new proprietor certifies in the application for a new license that the pharmacy will not undergo substantial physical or operational changes in the first year of licensure.

A pharmacy that dispenses prescription drugs shall, at least 15 days prior to the closing date of the pharmacy, post a closing notice sign in a conspicuous place in the front of the prescription department and at all public entrance doors to the pharmacy. True False

Answer: (a) True, [D.C. Official Code Title 22, Chapter 19 Section 1906.2]. A pharmacy that dispenses prescription drugs shall, *at least fifteen (15) days prior to the closing date* of the pharmacy, *post a closing notice sign* in a conspicuous place in the front of the prescription department and at all public entrance doors to the pharmacy. The closing notice sign shall contain the following information: (a). The date of closing; and (b). The name, address, and telephone number of the pharmacy acquiring the prescription drug orders, refill information, and patient medication records of the pharmacy. On the date of closing, the pharmacy shall, in addition to complying with all other District and federal requirements: (a). Transfer the prescription drug files, refill information, and patient medication records to a licensed pharmacy within a reasonable distance of the closing pharmacy. The pharmacy shall be the same pharmacy which was identified in the closing notice sign; and (b). Remove all signs and symbols indicating the presence of a pharmacy, or any representation that would tend to mislead the public that pharmacy is located at the address.

The automated data processing system shall have the capability to print all information entered into the system on paper *within three (3) business days.* True False

Answer: (a) True, [D.C. Official Code Title 22, Chapter 19 Section 1914.2, 1914.5 and 1914.6]. The automated data processing system shall have the capability of producing: a. A refill-by-refill audit trail for any specified strength and dosage form of any drug. The audit trail shall be by printout, and include the name of the prescribing practitioner, name and location of the patient, quantity dispensed on each refill, dispensing date of each refill, name or identification code of the pharmacist performing the final verification, and unique identifier of the prescription drug order. b. *The capability to print all information entered into the system on paper within three (3) business days.* c. The pharmacist-in-charge shall maintain a record keeping system in which each pharmacist involved in dispensing shall sign a statement each day attesting to the fact that the prescription information entered into the computer that day has been reviewed and is correct as shown. The log book or file shall be maintained at the pharmacy for a period of five (5) years from the date of dispensing. Records which are more than two (2) years old may be stored offsite as long as they can be retrieved within three (3) business days of a request. d. Any facility maintaining centralized prescription records shall be capable of sending a requested printout to the Pharmacy within seventy-two (72) hours.

Medication which is returned to an automated medication dispensing system may be used for subsequent administration. a. True b. False

Answer: (a) True, [D.C. Official Code Title 22, Chapter 19 Section 1915.17]. Medication which is returned to an automated medication dispensing system may be used for subsequent administration provided that: (a). The drugs are in sealed, tamper evident packaging which has not been opened; (b). The medication is in an unadulterated form; (c). If in a unit of use package, the medication is in the intact package that the medication was in when initially removed from the system; (d). The return of medication is documented within the system or in other records maintained by a licensed pharmacist; and (e). The return of medication is conducted in accordance with written procedures.

In a pharmacy employing the telepharmacy service, the counseling to the patient may be performed by using telephone, email, video conferencing, or webcam. True False

Answer: (a) True, [D.C. Official Code Title 22, Chapter 19 Section 1917.7(g)]. A provider pharmacy may provide remote pharmacy services directly, or through the use of a Director-approved subcontractor, using a telepharmacy system to a health care facility or other appropriate facility located in the District of Columbia if: (a). The provider pharmacy submits an application to the Director for permission to provide remote pharmacy services using a telepharmacy system. The application shall include: (1). The name, address, and license number of the provider pharmacy; (2). The name and address of the facility where the remote pharmacy services will be provided; (3). The name and address of the subcontractor who will provide after-hours remote pharmacy services. The following duties shall be performed only by a licensed pharmacist at the provider pharmacy: (a). Receiving an oral prescription drug order; (b). Interpreting the prescription drug order; (c). Verifying the accuracy of the prescription data entry; (d). Interpreting the patient's medication records and conducting a drug regimen review; (e). Authorizing the telepharmacy system to print a prescription label at the remote site; (f). Performing the final check of the dispensed prescription to ensure that the prescription drug order has been dispensed accurately as prescribed. The final check shall be accomplished through a visual check using electronic methods; and (g). Counseling the patient. This counseling may be performed using electronic methods such as telephone, email, video conferencing, and webcam.

A pharmacist shall not be required to counsel a patient or caregiver when the patient or caregiver refuses consultation. True False

Answer: (a) True, [D.C. Official Code Title 22, Chapter 19 Section 1919.8]. When the patient or patient's agent is not present, as in the case of prescription deliveries, the pharmacist shall ensure that the patient receives written notice: (a). Of his or her right to request consultation; and (b). A telephone number from which the patient may obtain oral consultation from a pharmacist who has ready access to the patient's record. Only a pharmacist may counsel a patient or the patient's agent and answer questions concerning prescription drugs or devices. A pharmacist shall assess to the best of his or her ability that the patient or agent understands the counseling information provided. A pharmacist shall not be required to counsel a patient or caregiver when the patient or caregiver refuses consultation. The pharmacist shall document such refusal for consultation. A pharmacist shall not be required to counsel an inpatient of a health care facility, where other licensed health care professionals are authorized to administer drugs, except upon request.

An applicant for renewal of a license shall have completed a minimum of forty (40) contact hours of continuing education credit in approved programs, which shall include at least two (2) hours in Human Immunodeficiency Virus (HIV) training and at least two (2) hours in medication/dispensing errors training during the two (2) year period preceding the date the license expires. True False

Answer: (a) True, [DCMR Title 17 Chapter 65 Section 6513.4(a)]. An applicant for renewal of a license shall have completed a minimum of forty (40) contact hours of continuing education credit in approved programs, which shall include at least two (2) hours in Human Immunodeficiency Virus (HIV) training and at least two (2) hours in medication/dispensing errors training during the two (2) year period preceding the date the license expires. Beginning with the renewal period ending February 28, 2019, two (2) hours of continuing education on cultural competency or specialized clinical training focusing on patients or clients who identify as lesbian, gay, bisexual, transgender, gender nonconforming, queer, or question their sexual orientation or gender identity and expression ("LGBTQ"), meeting the requirements of D.C. Official Code. Not more than thirty (30) contact hours of continuing education credit (of the required forty hours) may be accepted in any renewal period, or for reinstatement or reactivation of a license for approved home study or other mediated instruction continuing education courses. A minimum of ten (10) contact hours of the required forty (40) continuing education credits shall be obtained by attendance at live continuing education programs.

A prescription for a *Schedule II* controlled substance may be transmitted by the *practitioner or the practitioner's agent* to a pharmacy via *telephone facsimile equipment*, provided that the original written, signed prescription is presented to the pharmacist for review prior to issuance of the controlled substance to the patient or the patient's representative. ******* True False

Answer: (a) True, [DCMR Title 22 Chapter 13 Section 1306.4]. A prescription for a *Schedule II* controlled substance may be transmitted by the *practitioner* or *the practitioner's agent* to a pharmacy via telephone facsimile equipment, provided that the original written, signed prescription is presented to the pharmacist for review prior to issuance of the controlled substance to the patient or the patient's representative.

It shall be unlawful for any licensed pharmacist to accept any unused prescription or drug, in whole or part, after it has been dispensed or sold, for the purpose of redispensing or resale to any person. a. True b. False

Answer: (a) True, [DCMR Title 22 Chapter 13 Section 1329.1]. In the interest of the public health of the District of Columbia and the possible adverse effects which the resale of drugs may have upon the health of the public, it shall be unlawful for any licensed pharmacist to accept any unused prescription or drug, in whole or part, after it has been dispensed or sold, for the purpose of redispensing or resale to any person.

According to Washington DC State Pharmacy Law, a physician or authorized hospital staff may administer or dispense controlled substances in a hospital to maintain or detoxify a person, without being registered to the narcotic treatment program, who has been admitted to hospital for knee surgery. a. True b. False

Answer: (a) True, [DCMR Title 22 Chapter 13-1317.3]. A physician or authorized hospital staff may administer or dispense controlled substances in a hospital to maintain or detoxify a person as an incidental adjunct to medical or surgical treatment of conditions other than addiction, or to administer or dispense controlled substances to persons with intractable pain in which no relief or cure is possible or none has been found after reasonable efforts.

A prescription for a non-controlled substance shall not be filled if presented for dispensing more than 2 years after the date on which the prescription was issued. True False

Answer: (b) False, [D.C. Official Code Title 22, Chapter 13 Section 1325.8] A prescription for a non-controlled substance shall not be filled if presented for dispensing more than one (1) year after the date on which the prescription was issued. The total amount dispensed under one prescription order for a non-controlled substance, including refills, shall be limited to a one (1) year supply, not to exceed other applicable federal or District laws.

According to District of Columbia State Pharmacy Law, all prescription drug order information shall be entered into the automated data processing system not more than ninety-six (96) hours after the automated data processing system is again operational.************** True False

Answer: (a) True, [DCMR Title 22 Chapter 19 Section 1914.11]. According to District of Columbia State Pharmacy Law, *all prescription drug order information* shall be entered into the automated data processing system *not more than ninety-six (96) hours after* the automated data processing system is again operational. ****************** In addition, a pharmacy shall implement routine backup files and file maintenance procedures to prevent loss of patient data. A pharmacy shall notify the Board of Pharmacy of a permanent loss of prescription drug order information or patient information due to a system failure, not more than twenty-four (24) hours after the discovery.

Where a decentralized automated medication dispensing system is being used, a licensed pharmacist shall perform a review of each order for medication before the medication is removed from the system, except if the order is for a starter dose. True False

Answer: (a) True, [DCMR Title 22 Chapter 19 Section 1915.12]. Where a decentralized automated medication dispensing system is being used: (a). A licensed pharmacist shall perform a review of each order for medication before the medication is removed from the system, except if the order is for a starter dose; and (b). A licensed pharmacist shall perform a review of each order for a starter dose *within twenty-four (24) hours of removal of the starter does* from the remote or decentralized automated medication system, if the patient is still under the care of the facility when the review is to be performed.

According to District of Columbia State Pharmacy Law, whenever an emergency kit is opened, the provider pharmacist shall be notified and the pharmacist shall restock and reseal the kit as soon as possible, but not more than seventy-two (72) hours after notification. True False

Answer: (a) True, [DCMR Title 22 Chapter 19 Section 1921.22(g)]. For an institutional facility that does not have an institutional pharmacy, drugs may be provided for use by authorized personnel by emergency kits located at the facility, provided the following requirements are met: (1). The pharmacist-in-charge at the provider pharmacy shall determine, in consultation with the medical and nursing staff of the facility, which drugs and what quantity of those drugs should be included in the emergency kit, and prepare the kit for use only by those persons licensed or authorized to administer drugs; (2). The emergency kit shall be sealed with a tamper evident seal, and stored in a secured area to prevent unauthorized access by force or otherwise, and to ensure a proper environment for preservation of the drugs inside the kit; (3). The exterior of the emergency kit shall be labeled so as to clearly indicate that it is an emergency drug kit and that it is for use in emergencies only. The label shall contain a listing of the drugs contained in the kit, including the name, strength, quantity, and expiration date of the contents, and the name, address, and telephone number of the pharmacy that prepared the kit; (4). Drugs shall be removed from emergency kits only pursuant to a valid written or verbal order by an authorized prescriber; (5). Whenever an emergency kit is opened, the provider pharmacist shall be notified and the pharmacist shall restock and reseal the kit as soon as possible, but not more than seventy-two (72) hours after notification; and (6). The expiration date of an emergency kit shall be the earliest date of expiration of any drug supplied in the kit.

The required *prescription monitoring data* shall be transmitted electronically to the Program within ___________ of dispensing. a. 24 hours of dispensing. b. 7 days of dispensing. c. 15 days of dispensing. d. 72 hours of dispensing.

Answer: (a) Within 24 hours of dispensing, [DCMR Title 17 Section 10303.1]. The required *prescription monitoring data* shall be transmitted electronically to the Program: (a). *Within twenty-four (24) hours of dispensing;* (b). In the format provided in the Electronic Reporting Standard for Prescription Monitoring Programs of the *American Society for Automation in Pharmacy (ASAP);* (c). Shall be consecutive and include any covered substances dispensed after the last date and time reporting information was submitted.

The dispensing container shall bear a label with all of the following EXCEPT: a. name, address and phone number of the manufacturer. b. unique identification number of the prescription. c. name of the prescribing practitioner. d. initials or an identification code of the dispensing pharmacist.

Answer: (a) name, address and phone number of the manufacturer, [D.C. Code Title 47-2885.14 and Section 48-903.08(e)]: (1). name, address and phone number of the pharmacy (not the manufacturer); (2). unique identification number of the prescription; (3). date the prescription is dispensed; (4). initials or an identification code of the dispensing pharmacist; (5). name of the prescribing practitioner; (6). name of the patient or if such drug was prescribed for an animal, the species of the animal and the name of the owner; (7). instructions for use; (8). quantity dispensed; (9). appropriate ancillary instructions such as storage instructions or cautionary statements such as warnings of potential harmful effects of combining the drug product with any product containing alcohol; (10). if the prescription is for a Schedule II - IV controlled substance, the statement "Caution: Federal law prohibits the transfer of this drug to any person other than the patient for whom it was prescribed"; (11). if the pharmacist has selected a generically equivalent drug pursuant to the provisions of the Act, the statement "Substituted for Brand Prescribed" or "Substituted for 'Brand Name'" where "Brand Name" is the actual name of the brand name product prescribed; (12). the name of the advanced practice nurse or physician assistant, if the prescription is carried out or signed by an advanced practice nurse or physician assistant in compliance; (13). the name and strength of the actual drug product dispensed, unless otherwise directed by the prescribing practitioner.

Whenever a pharmacy plans to discontinue operation, the proprietor shall notify the Director of the closing of the pharmacy not later than:************************* a. 30 days prior to the anticipated date of closing. b. 15 days prior to the anticipated date of closing. c. 45 days prior to the anticipated date of closing. d. 60 days prior to the anticipated date of closing.

Answer: (b) *15 days prior to the anticipated date of closing,* [D.C. Official Code Title 22, Chapter 19 Section 1906.1]. Whenever a pharmacy plans to *discontinue* operation, the proprietor shall notify the *Director* of the closing of the pharmacy not later than *fifteen (15) days prior to* the anticipated date of closing. The notice shall be submitted to the Director in writing and shall contain the following information: (a). The date the pharmacy will close; (b). The names, addresses, and telephone numbers of the persons who shall have custody of the prescription files, the bulk compounding records, the repackaging records, all drugs including the controlled substances, and inventory records of the pharmacy to be closed; and (c). The names, addresses, DEA registration numbers, and District registration numbers of any persons who will acquire any of the drugs and controlled substances from the pharmacy to be closed, if known at the time the notification is filed.

The prescription area of a retail pharmacy in District of Columbia must be minimum of: a. 50 square feet. b. 150 square feet. c. 250 square feet. d. 500 square feet

Answer: (b) *150 square feet*, [D.C. Official Code Title 22, Chapter 19 Section 1907.4]. The prescription drug compounding and dispensing area shall: (a). Be a minimum of one hundred fifty (150) square feet in area, except that a pharmacy licensed prior to the effective date of these rules may be of a lesser square footage as approved by the Director; (b). Have a minimum of ten (10) square feet of counter space for the pharmacist-in-charge, with additional space for each additional pharmacist on duty, to compound and dispense drugs safely and efficiently, except that a pharmacy licensed prior to the effective date of this chapter may be of lesser square footage of counter space as approved by the Director; (c). Shall contain an area which is suitable for confidential patient counseling, if the pharmacy serves the public; (d). Be separated from other areas by a barrier which renders the area inaccessible to unauthorized persons.

A pharmacist receives a new prescription for *Depakote*. Could a pharmacist substitute this drug for a generic *Valproic acid* if it were NOT written with a word similar to "DAW" or "Brand Necessary"? ******************************** a. Yes b. No

Answer: (b) *No*, [D.C. Official Code Title 22, 1327.1]. A pharmacist may dispense a *dosage form* of a drug product different from that prescribed, such as a tablet instead of a capsule or liquid instead of tablets, provided that: (a). The pharmacist *notifies the patient* of the dosage form substitution prior to filling the prescription; (b). The pharmacist *documents* the substitution on the prescription record; (c). The pharmacist *notifies the practitioner* of the dosage form substitution prior to dispensing or as soon as is reasonably possible thereafter; and (d). The dosage form dispensed contains the identical amount of the active ingredients as the dosage prescribed for the patients, is not an enteric-coated, delayed release tablet (as in case of Depakote) or time release product; and does not alter desired clinical outcomes.

A pharmacist is adding 1000 mg of pure codeine powder to 100 cc of Tylenol with codeine Elixir (120 mg/12 mg/5 cc). The resultant mixture should be classified as: a. Schedule II b. Schedule III c. Schedule IV d. Schedule V

Answer: (b) *Schedule III* The compounded mixture should be classified as a Schedule III controlled drug. The amount of Codeine present in the final mixture is 1.24 gms (1000 mg + 240 mg), [D.C. Code Title 48-902.08(4),(B)]. It has been stated under CSA that if a mixture contains less than 1.8 gms of Codeine per 100 cc, it should be classified as a Schedule III controlled substance. List of Schedule III controlled drugs: ----------------------------------------------------------- Cannabis (Only under Washington DC Law Title 22 Chapter 12 Section 22-1203.1(8) ) Amobarbital and noncontrolled active ingredients Amobarbital suppository dosage form Anabolic steroids Barbituric acid derivative Benzphetamine (Didrex, Inapetyl) Buprenorphine (Buprenex, Temgesic) Butabarbital (Butisol, Butibel) Butalbital (Fiorinal, Butalbital with aspirin) Codeine and isoquinoline alkaloid (Codeine with papaverine or noscapine) Codeine combination product (Empirin, Fiorinal, Tylenol, ASA or APAP w/codeine) Dronabinol in sesame oil in soft gelatin capsule (Marinol) Gamma-hydroxybutyric acid Ketamine Lysergic acid Lysergic acid amide Methyltestosterone (Android, Oreton, Testred, Virilon) Nalorphine (Nalline) Nandrolone (Deca-Durabolin, Durabolin, Durabolin-50) Norethandrolone(Nilevar, Solevar) Opium combination product (Paregoric) Pentobarbital and noncontrolled active ingredients Pentobarbital suppository dosage form Phendimetrazine (Bontril) Secobarbital and noncontrolled active ingredients Secobarbital suppository dosage form Sodium oxybate (Xyrem) Testosterone (Android-T, Androlan, Depotest, Delatestryl) Thiopental (Pentothal)

A patient brings a new prescription for Alprazolam with 5 eligible refills. The prescription is written on April 1, 2019. The prescription reads: Alprazolam 1 mg: 1 tablet by mouth at bed time x 30 days. Refills: 5 times A patient has requested medication to be partially filled. Below is the list of partially filled transactions: 1. 04/04/2019: 20 tablets 2. 05/05/2019: 40 tablets 3. 05/25/2019: 18 tablets 4. 06/09/2019: 23 tablets 5. 06/21/2019: 5 tablets 6. 08/11/2019: 35 tablets 7. 09/05/2019: 11 tablets 8. 10/11/2019: 36 tablets 9. 10/28/2019: 21 tablets 10. 11/05/2019: 6 tablets Based on above information what shall be the dispensed quantities (legally)?

Answer: (b) 152 tablets, [http://www.deadiversion.usdoj.gov/faq/general.htm]. Partial refills of schedules III and IV controlled substance prescriptions are permissible under federal regulations provided that each partial filling is dispensed and recorded in the same manner as a refilling (i.e., date refilled, amount dispensed, initials of dispensing pharmacist, etc.), the total quantity dispensed in all partial fillings does not exceed the total quantity prescribed, and no dispensing occurs after six months past the date of issue. In above example, the prescription expires on 10/01/2019 (six months from an issue date of 04/01/2019). Therefore, all partial filling before this date should be considered legal. The second thing the pharmacist has to observe that the total quantity dispensed in all partial fillings shall not exceed the total quantity prescribed. The prescription is written for 180 tablets, 1 tablet by mouth qd x 30 days with additional 5 refills. When adding all the partial filling starting from 04/04/2019 to 09/05/2019, the total quantities that the pharmacist can dispense legally come about 152 tablets.

In District of Columbia, the inventory of controlled substances should be done every: a. Year b. Two years c. Three years d. Five years

Answer: (b) 2 years, [DCMR Title 22 Chapter 15-1502.1 and D.C. Code Title 48-903.06] In District of Columbia, the inventory of controlled substances should be done every two years. Section 48-903.06: Persons registered to manufacture, distribute, or dispense controlled substances under this chapter shall follow inventory requirements of federal law.

The term of a pharmacy license issued or renewed shall expire on Jan 31 of each odd numbered year regardless of the issuance date. True False

Answer: (b) False, [D.C. Official Code Title 22, Chapter 19 Section 1902.17]. The term of a license issued or renewed pursuant to 1902.17 is two (2) years and shall expire on *May 31* of each odd numbered year regardless of the issuance date.

A proprietor desiring to change the location of a pharmacy within the District of Columbia may request the Director to amend an existing pharmacy license. True False

Answer: (b) False, [D.C. Official Code Title 22, Chapter 19 Section 1905.2]. A proprietor desiring to change the location of a pharmacy within the District of Columbia shall apply for a *new license.*

According to District of Columbia State Pharmacy Law, the prescription record should be kept on file for: a. Two years from the date of dispensing. b. Five years from the date of dispensing. c. Three years from the date of dispensing. d. A year from the date of dispensing.

Answer: (b) 5 years, [DCMR Title 22 Chapter 19-1913.2 and D.C. Code 47-2885.15(a)] According to District of Columbia State Pharmacy Law Rule-1913.2, a pharmacy shall maintain on a current basis a complete and accurate record of all prescription drugs and devices received, sold, compounded, dispensed, or otherwise disposed of by the pharmacy for a period of *five (5) years.* This requirement may be met by maintaining the most recent *two years of records on site* and the remaining *three years of records off site* as long as the records can be retrieved *within three (3) business days* of a request. A pharmacy shall keep a chronological record, for a period of five (5) years from the date of first dispensing, of each prescription that is filled or refilled. **Conflict Information D.C. Code 47-2885.15: (a). There shall be maintained in every pharmacy, or in the establishment or institution where a pharmacy is located, a suitable book, file, or other easily retrievable record, in which shall be preserved for a period of not less than 2 years every prescription compounded or dispensed at said pharmacy.

An emergency oral prescription for Schedule II controlled drugs must be mailed to dispensing pharmacy by an authorized prescriber within: a. 48 hours after an oral authorization. b. 7 days after an oral authorization. c. 10 days after an oral authorization. d. 72 hours after an oral authorization.

Answer: (b) 7 days after an oral authorization, [DCMR Title 22 Chapter 13-1306.5(d)]. In emergency situations, a pharmacist may dispense Schedule II drugs upon the oral prescription of a practitioner. (a). The quantity prescribed and dispensed is limited to no more than a seven (7) day supply to treat the patient during the emergency period (dispensing beyond the emergency period shall be pursuant to a written prescription signed by the prescribing individual practitioner); (b). The prescription shall be immediately reduced to writing by the pharmacist and shall contain all information required by District and federal law; (c). If the prescribing practitioner is not known to the pharmacist, the pharmacist shall make a reasonable effort to determine that the oral authorization came from a registered practitioner, which may include a call back to the prescribing practitioner using the practitioner's phone number as listed in the telephone directory or other good faith efforts to insure the practitioner's identity; and (d). Within seven (7) days after authorizing an emergency oral prescription, the practitioner shall cause a written prescription for the emergency quantity prescribed to be delivered to the dispensing pharmacist. In addition to conforming to the requirements of § 1301 of this chapter, the prescription shall: (1). Have written on its face "Authorization for Emergency Dispensing," and the date of the oral order; and (2). The written prescription shall be delivered to the pharmacist in person or by mail, but if delivered by mail, it must be postmarked within the seven (7) day period. Upon receipt, the dispensing pharmacist shall attach the written prescription to the oral emergency prescription which was previously reduced to writing.

What is the maximum amount of Robitussin A/C that can be dispensed to a given purchaser within a 48-hour period? a. 240 cc b. 120 cc c. 60 cc d. 480 cc

Answer: (b) According to District of Columbia Pharmacy Law, not more than a *4 ounce* over-the-counter preparation containing Codeine can be dispensed to a given purchaser *within a 48-hour* period, [DCMR Title 22 Chapter 13 Section 1314.1(b)].

Who is authorized to enter controlled premises and conduct administrative and non-administrative inspections under Washington D.C. Pharmacy Law? ********************* a. Agent designated by the Board b. Chief Pharmaceutical Control Officer c. Director of the Health d. Superintendent of Police

Answer: (b) Chief Pharmaceutical Control Officer, [D.C. Official Code Title 22, Chapter 15 Section 1500.1 to 1500.4]. In carrying out its functions under the Act, the Chief Pharmaceutical Control Officer and his or her designee, is authorized to enter controlled premises and conduct administrative and non-administrative inspections thereof, for the purpose of doing the following: (a). Inspecting, copying, and verifying the correctness of records, reports, or other documents required to be kept or made under the Act and this chapter including, but not limited to, (i). inventory and other records required, (ii). prescription and distribution records, (iii). shipping records identifying the name of each carrier used and the date and quantity of each shipment, and (iv). storage records identifying the name of each warehouse used and the date and quantity of each storage; (b). Inspecting within reasonable limits and in a reasonable manner all pertinent equipment, finished and unfinished controlled substances and other substances or materials, containers, and labeling found at the controlled premises relating to the Act; (c). Making a physical inventory of all controlled substances on hand at the premises; (d). Collecting samples of controlled substances or precursors (e). Checking records and information on distribution of controlled substances by the registrant as they relate to total distribution of the registrant (i.e., has the distribution in controlled substances increased markedly within the past year, and if so why). An inspection authorized by this section shall not extend to financial data, sales data, other than shipment data, or pricing data unless the owner, operator, or agent in charge of the controlled premises consents in writing.

The application for a pharmacy license shall include the name and license number of the licensed pharmacist who shall be responsible for ensuring that the pharmacy complies with all applicable laws and regulations pertaining to the operation of the respective pharmacy and practice of pharmacy. For an institutional pharmacy, this pharmacist shall be known as: a. Pharmacist-In-Charge b. Director of Pharmacy c. Responsible Nuclear Pharmacist d. None of the above

Answer: (b) Director of Pharmacy, [D.C. Official Code Title 22, Chapter 19 Section 1902.7]. The application for a pharmacy license shall include the name and license number of the licensed pharmacist who shall be responsible for ensuring that the pharmacy complies with all applicable laws and regulations pertaining to the operation of the respective pharmacy and practice of pharmacy. The pharmacist shall be known as: (a). The "pharmacist-in-charge" for a retail/community pharmacy, special or limited use pharmacy, or non-resident pharmacy; (b). The "Director of Pharmacy" for an institutional pharmacy; and (c). The "Responsible Nuclear Pharmacist" for a nuclear pharmacy.

According to DC Pharmacy Law, a health care facility may dispose of any pharmaceutical product, used or unused, by flushing the product down a drain. a. True b. False

Answer: (b) False, [D.C. Code Title 22B Chapter 5 Section -500.1 and 500.2]. Effective July 1, 2013, unless authorized by this chapter, a health care facility that is determined to have disposed of a pharmaceutical product by flushing the product down a drain or by any other method that utilizes the public sewer system, shall be: (a). Subject to a civil fine of up to one thousand dollars ($1,000) per occurrence; and (b). Required to submit to the Board of Pharmacy, or its designee, a mitigation plan designed to prevent further such occurrences within thirty (30) days of receipt of a request for the mitigation plan. When absent of any additional additives, the following pharmaceutical products may be disposed of by flushing the product down the drain or by another method that uses the sewer system: (a). Sterile Water; (b). Dextrose solutions such as five percent (5%) dextrose in water (D5W); (c). Saline solutions such as nine tenths of a percent of sodium chloride (0.9% NaCl); (d). Lactated Ringers; (e). Potassium salts such as potassium chloride (KCl); (f). Calcium salts such as calcium chloride (CaCl) and Calcium Gluconate; and (g). Magnesium salts such as magnesium sulfate (MgSo4). A healthcare facility shall maintain a complete and accurate record of its pharmaceutical waste disposal, for a period of three (3) years from the date of disposal.

Persons designated by the Board of Pharmacy shall be permitted, after presenting proper identification, to enter at reasonable times any pharmacy or drug outlet for the purpose of making inspections to determine compliance with this part or with other laws or regulations applicable to the practice of pharmacy. a. True b. False

Answer: (b) False, [D.C. Official Code Title 47, 47-2885.16(a), (b)]. (a). *Persons designated by the Mayor* (Not by the Board of Pharmacy) shall be permitted, after presenting proper identification, to enter at reasonable times any pharmacy or drug outlet for the purpose of making inspections to determine compliance with this part or with other laws or regulations applicable to the practice of pharmacy. Persons designated by the Mayor shall be pharmacists for the purpose of making inspections to determine compliance with those sections of this part and other applicable laws and regulations regarding the practice of pharmacy as defined within this part. (b). This inspection may include, but shall not be limited to, the examination of the pharmacy's records, including prescriptions, and the obtaining of information and samples pertaining to drugs on hand or dispensed.

A prescription for a controlled substance may be issued to an individual practitioner for the general dispensing purpose. True False

Answer: (b) False, [DCMR Title 22 Chapter 13 Section 1305.3]. A prescription for a controlled substance shall *NOT* be issued to an individual practitioner for the general dispensing purpose.

A registrant desiring to discontinue business activities with respect to controlled substances shall submit in person or by registered or certified mail, return receipt requested, to the Director, at least six months before the date of the proposed transfer. a. True b. False

Answer: (b) False, [DCMR Title 22 Chapter 13 Section 1322.2]. A registrant desiring to *discontinue business* activities altogether or with respect to controlled substances (by transferring those business activities to another person) shall submit in person or by registered or certified mail, return receipt requested, to the Director, *at least fourteen (14) days before* the date of the proposed transfer (unless the director waives this time limitation in individual instances) the following information: (a). The name, address, controlled substance registration number(s), and authorized business activity of the registrant discontinuing the business (registrant-transferor); (b). The name, address, controlled substance registration number(s), and authorized business activity of the person acquiring the business (registrant transferee); (c). Whether the business activities will be continued at the location registered by the person discontinuing the business, or moved to another location (if the latter, the address of the new location shall be listed); and (d). The date on which the transfer of controlled substances will occur.

A pharmacist may manufacture, without being registered to manufacture, an aqueous or oleaginous solution or solid dosage form containing a narcotic controlled substance in a proportion not exceeding 15% of the complete solution, compound, or mixture. a. True b. False

Answer: (b) False, [DCMR Title 22 Chapter 13-1323.1]. According to Washington DC State Pharmacy Law, a pharmacist may manufacture, without being registered to manufacture, an aqueous or oleaginous solution or solid dosage form containing a narcotic controlled substance in a proportion *not exceeding 20%* (NOT 15%) of the complete solution, compound, or mixture.

According to District of Columbia State Pharmacy Law, all drugs present in *night cabinets* are inventoried no less than once per month. True False

Answer: (b) False, [DCMR Title 22 Chapter 19 Section 1921.18(a),(b)(4)]. In the absence of a licensed pharmacist, drugs shall be stored in a locked cabinet or other enclosure constructed and located outside of the pharmacy area, to which only specifically authorized personnel may obtain access by key or combination, and which is sufficiently secure to deny access to unauthorized persons by force or otherwise. The Director of Pharmacy, in conjunction with the appropriate committee of the institutional facility, shall develop inventory listings of those drugs to be included in night cabinets and shall ensure that: (1). All drugs available in the cabinet or similar containers are properly stored and labeled; and (2). Only prepackaged drugs are available, in amounts sufficient for immediate therapeutic requirements; (3). Whenever access to the cabinet occurs, written practitioners' orders and proofs-of-use are provided to the pharmacist by the start of business the following business day; (4). All drugs therein are *inventoried no less than once per week* (NOT once a month); (5). A complete *audit* of all activity concerning the cabinet is conducted no less than once per *month*; and (6). Written policies and procedures are established to implement the requirements of this subsection.

According to Washington DC State Pharmacy Law, the proprietor of a pharmacy, or other appropriate individual, shall notify the Director within 5 days after a change in the pharmacist-in-charge, Director of Pharmacy, or Responsible Nuclear Pharmacist. a. True b. False

Answer: (b) False, [DCMR Title 22 Chapter 19-1902.8]. According to Washington DC State Pharmacy Law, the proprietor of a pharmacy, or other appropriate individual, shall notify the Director *within 30 days* (NOT 5 days) after a change in the pharmacist-in-charge, Director of Pharmacy, or Responsible Nuclear Pharmacist.

When a pharmacy changes proprietorship without changing the name of the pharmacy, an abbreviated permit application shall be obtained from Mayor instead of applying for a new pharmacy permit application. a. True b. False

Answer: (b) False, [D.C. Official Code Title 47, 47-2885.08(f)]. The application for a pharmacy license shall be made on a form to be prescribed by the Mayor and shall be accompanied by the required fee. (a). The license shall be valid for a period of time to be determined by the Mayor. No license fee shall be required for the operation of a pharmacy by the United States government or by the District of Columbia government. (b). Application for renewal of a pharmacy license shall be made not later than 30 days before the expiration date of the license to avoid lapse (c). Each pharmacy license issued shall apply only to the operation of the pharmacy at the location for which it is issued. (d). A pharmacy license is not transferable. (e). Whether or not the proprietor of a pharmacy is a pharmacist, the pharmacy license shall be issued in the name of the proprietor. (f). *When a pharmacy changes proprietorship, the license shall become void and shall be promptly surrendered to the Mayor, and a license shall be obtained by the new proprietor whether or not there is any change in the name of the pharmacy.*

A pharmacist may not serve as a pharmacist-in-charge for more than two pharmacies at a time. True False

Answer: (b) False, [D.C. Official Code Title 22, Chapter 19 Section 1920.2]. A pharmacist may not serve as a pharmacist-in-charge unless he is physically present in the pharmacy a sufficient amount of time to provide supervision and control. A pharmacist may not serve as a pharmacist-in-charge for more than *one (1) pharmacy* at a time except upon obtaining written permission from the Director.

According to District of Columbia State Pharmacy Law, a preceptor shall not supervise more than two pharmacy interns at one time. True False

Answer: (b) False, [DCMR Title 17 Chapter 65 Section 6511.7, 6509.7, 6510.5-to-6510.7 ]. According to District of Columbia State Pharmacy Law, a preceptor shall not supervise more than one pharmacy intern at one time while the intern is on duty and performing internship tasks without prior approval by the Board. This provision shall not apply to students who are enrolled in ACPE accredited programs while performing clerkship hours toward fulfillment of graduation requirements. A pharmacy intern shall perform pharmacy tasks only under the supervision of a pharmacist who has been approved by the Board to serve as a preceptor. A pharmacy intern shall not change preceptors without approval by the Board. A pharmacy intern shall not compound or dispense any drug by prescription except under the direct supervision of a preceptor who is physically present and guiding the action. A pharmacy intern shall not accept an oral prescription for a Schedule II controlled substance. A pharmacy intern may not perform a final review or exercise final decision making with respect to any of the following without the prior review and approval of the licensed pharmacist: drug utilization review; clinical conflict resolution, prescriber contact concerning prescription drug order clarification or therapy modification; or dispensing process validation. A registration as a pharmacy intern shall expire one (1) year from the date of its issuance. It may be renewed for successive periods of one (1) year if the pharmacy intern demonstrates due diligence in working toward completing the clinical internship requirement.

A practitioner registered with a narcotic treatment program pursuant to the *Narcotic Addict Treatment Act of 1974* may administer, dispense and prescribe scheduled narcotic drugs that are approved by the FDA for the treatment of narcotic addiction. ************ True False

Answer: (b) False, [DCMR Title 22 Chapter 13 Section 1317]. A practitioner who wants to use Schedule II narcotic drugs for maintenance and/or detoxification must obtain separate registration from DEA as a narcotic treatment program pursuant to the Narcotic Addict Treatment Act of 1974. This registration allows a practitioner to administer or dispense, but *NOT PRESCRIBE*, scheduled narcotic drugs that are approved by the United States Food and Drug Administration (FDA) for the treatment of narcotic addiction. Methadone and levo-alpha-acetyl-methadol (LAAM) are the only scheduled narcotics approved by FDA for use in maintenance and detoxification treatment. An exception to the registration requirement, known as the "three day rule" (21CFR1306.07(b)), allows a practitioner who is not separately registered as a narcotic treatment program, to administer (but not prescribe) narcotic drugs to a patient for the purpose of relieving acute withdrawal symptoms while arranging for the patient's referral for treatment, under the following conditions: 1. Not more than one day's medication may be administered or given to a patient at one time; 2. This treatment may not be carried out for more than 72 hours and; 3. This 72-hour period cannot be renewed or extended. The 72-hour exception offers an opioid dependent individual relief from experiencing acute withdrawal symptoms, while the physician arranges placement in a maintenance/detoxification treatment program. This provision was established to augment, not to circumvent, the separate registration requirement. It should be noted that although Buprenex, a Schedule III controlled substance, is currently approved for the treatment of pain, it may not be prescribed or dispensed for use in narcotic addiction treatment, including the treatment of withdrawal symptoms as provided above under the three-day rule.

According to District of Columbia State Pharmacy Law, a pharmacy shall maintain dispensing records for all prescription drugs or devices dispensed or distributed from the automated medication system for a period of three years. a. True b. False

Answer: (b) False, [DCMR Title 22 Chapter 19 Section 1915.7(b)]. An automated medication dispensing system is a robotic, computerized, or mechanical device and its components that distributes or dispenses medications in a licensed health care facility, or prepares medications for final dispensing by a licensed pharmacist to a patient or a patient's agent, and maintains related transaction information. The automated medication dispensing system shall be used only in settings where there is an established program of pharmaceutical care that ensures prescription orders are reviewed by a pharmacist in accordance with established policies and procedures and good pharmacy practice. A pharmacy shall provide the Director written notice of the installation of an automated medication dispensing system prior to utilizing an automated medication dispensing system. The notice shall include: (a). The name and address of the pharmacy; (b). The location of the automated equipment; (c). The identification of the responsible pharmacist; and (d). The type of system, manufacturer's name, make, and model. A pharmacy shall maintain dispensing records for all prescription drugs or devices dispensed or distributed from the automated medication system for a period of *five years* (NOT three years). The records shall include: (1). Identity of the system accessed; (2). Identification of the individual accessing the system; (3). Date of transaction; (4). Name, strength, dosage form, and quantity of drug accessed; and (5). Name of the patient for whom the drug was accessed.

Which of the following information regarding *Renewal of Pharmacy License* is/are NOT TRUE? *************** I. The Director shall mail a renewal notice to a licensee by first class mail to the licensee's last known address on file with the Director at least 90 days prior to the expiration of the license. II. If the Director does not receive the application for renewal of a license at least 60 days prior to the expiration date, the license shall lapse on the expiration date. II. A licensee applying for renewal of a license shall submit the application for renewal not less than 30 days prior to its expiration, to avoid lapse.

Answer: (b) I and II are not true, [D.C. Official Code Title 22, Chapter 19 Section 1904]. The Director shall mail a renewal notice to a licensee by first class mail to the licensee's last known address on file with the Director at least sixty (60) days (Not 90 days) prior to the expiration of the license. The failure of a licensee to receive the renewal notice required by this section does not relieve the licensee of the responsibility of renewing the license by the expiration of the existing license. A licensee applying for renewal of a license shall submit the application for renewal not less than thirty (30) days prior to its expiration, to avoid lapse. If the Director does not receive the application for renewal of a license at least thirty (30) days (Not 60 days) prior to the expiration date, the license shall lapse on the expiration date. The licensee may be reinstated within thirty (30) days of expiration upon receipt of a completed renewal application and the payment of a late fee. Upon receipt of the required late fee and final processing of the renewal application, the licensee shall be deemed to have possessed a valid license during the period between the expiration of the license and the reinstatement date. Reinstatement of a license that has been expired for over thirty (30) days shall be at the discretion of the Director. Otherwise, a licensee that fails to submit the completed renewal application or required late fee within thirty (30) days after the expiration of the applicant's license shall be required to apply for new licensure pursuant to 1902 of this chapter.

Which of the following information is/are TRUE under the Washington DC State Pharmacy Law? I. A pharmacy shall dispense drugs or medical devices in new and clean containers or in the manufacturer's original container or package. II. A pharmacy shall obtain only drugs that are in the original manufacturer's or distributor's container. III. A pharmacy may reuse a manufacturer's bottle or container. a. I only b. I and II only c. II and III only d. All

Answer: (b) I and II are true, [DCMR Title 22 Chapter 19 Section 1911.7]. A pharmacy shall dispense drugs or medical devices in new and clean containers or in the manufacturer's original container or package. A pharmacy shall dispense drugs in child-resistant containers unless there is written documentation that the patient has requested drugs in regular containers. A pharmacy *shall not reuse a manufacturer's bottle or container* A pharmacy shall obtain only drugs that are in the original manufacturer's or distributor's container.

As part of the application for registration or renewal of registration, a nonresident pharmacy shall:*********** I. Submit evidence to the Department that the nonresident pharmacy holds a pharmacy license, registration, or permit, in good standing, issued by the state in which the pharmacy is located. II. Submit evidence to the Department that the nonresident pharmacy holds a valid DEA registration number. III. Submit evidence that the pharmacist in charge holds a valid license in good standing in the District of Columbia.

Answer: (b) I and II are true, [D.C. Official Code Title 22, Chapter 19 Section 1903.8 (a) to (d)]. As part of the application for registration or renewal of registration, a nonresident pharmacy shall: (a). Submit evidence to the Department that the nonresident pharmacy holds a pharmacy license, registration, or permit, in good standing, issued by the state in which the pharmacy is located; (b). Submit evidence to the Department that the nonresident pharmacy holds a valid DEA registration number, if the pharmacy dispenses prescription controlled substances listed in any Schedule into the District of Columbia; (c). *Submit evidence that the pharmacist in charge holds a valid license in good standing in the state (NOT D.C. license) in which the nonresident pharmacy is located;*************** (d). Provide the name, address, and title of its: (1). Owner or proprietor; (2). Pharmacist-in-charge, along with his or her license number and state of licensure; (3). Principal corporate officers; (4). Pharmacists who are dispensing prescription drugs or medical devices to citizens of the District of Columbia, along with their license numbers and state of licensure; and (5). Resident agent located within the District of Columbia designated to accept service of process.

Which of the following information about Plan-B One Step is/are TRUE? I. It is intended to prevent pregnancy after known or suspected contraceptive failure or unprotected intercourse. II. With Plan B One-Step, a patient has up to 72 hours to prevent a pregnancy. III. If a patient is 15 or older, Plan B One-Step is available ONLY through a prescription. a. I only b. I and II only c. II and III only d. All

Answer: (b) I and II are true. *Plan B One-Step* is a backup plan that helps prevent pregnancy after birth control failure. The sooner a patient takes an emergency contraception, the better it works. Plan B One-Step requires just *one pill*. Other emergency contraception requires two pills, 12 hours apart. With Plan B One-Step, a patient has up to 72 hours (3 days) to prevent a pregnancy. It is not the abortion pill and it isn't a substitute for routine birth control. *Plan B is available to all Over-The-Counter without the prescription or presenting an id.* A patient is required to take a single pill, as soon as possible within 72 hours, after an unprotected intercourse or a contraceptive failure.

Where a centralized automated medication dispensing system is being used, a licensed pharmacist shall perform a final check of each medication that is removed from the system prior to distribution or dispensing, unless: I. A licensed pharmacist utilizing a centralized automated medication dispensing system distributes patient specific medications within the licensed health care facility and the medication is distributed for subsequent administration by a health care professional permitted by law to administer medication. II. A licensed pharmacist performs a daily quality assurance check of the integrity of the system that includes random sampling of the output. III. Under no circumstances, distribution or dispensing of drugs shall be done without the prior checking by a licensed pharmacist. a. I only b. I and II only c. III only d. None of the above

Answer: (b) I and II only, [DCMR Title 22 Chapter 19 Section 1915.11]. Where a centralized automated medication dispensing system is being used, a *licensed pharmacist shall perform a final check of each medication* that is removed from the system prior to distribution or dispensing, unless: I. A licensed pharmacist utilizing a centralized automated medication dispensing system distributes patient specific medications within the licensed health care facility and the medication is distributed for subsequent administration by a health care professional permitted by law to administer medication. II. A licensed pharmacist performs a daily quality assurance check of the integrity of the system that includes random sampling of the output.

A pharmacist certified by the Board to administer immunizations and vaccinations shall: I. Maintain current certification in cardiopulmonary resuscitation for health care providers. II. Administer vaccines and immunizations in accordance with CDC guidelines III. Complete 1-hour of continuing education each renewal period relevant to the administration of immunizations and vaccinations.

Answer: (b) I and II only, [D.C. Official Code Title 17, Chapter 65 Section 6512.3 and 6512.9 to 6512.12, 6512.21]. A pharmacist certified by the Board to administer immunizations and vaccinations shall: a. Maintain current certification in cardiopulmonary resuscitation for health care providers. b. Administer vaccines and immunizations in accordance with CDC guidelines c. Complete 2 hours (not 1 hour) of continuing education each renewal period relevant to the administration of immunizations and vaccinations. d. A pharmacist certified to administer immunizations and vaccinations may permit a pharmacy student in a pharmacy experiential program, who has successfully completed a Board-approved certification course to administer influenza vaccinations under the pharmacist's direct supervision to an individual who is eighteen (18) years of age or older. e. A pharmacist certified by the Board to administer immunizations and vaccinations shall not administer an immunization or vaccination to any individual younger than twelve (12) years old and must obtain acceptable proof of age before administration. f. A pharmacist certified by the Board to administer immunizations and vaccinations shall only administer an immunization or vaccination to an individual under the age of twelve (12) upon a referral from a physician who has an established physician-patient relationship with the patient. g. The administering pharmacist shall report any adverse event, which occurs in connection with or related to an administration to: (a). The Department of Health's Pharmaceutical Control Division within forty eight (48) hours after discovery of the occurrence; and (b). The Director of the Department of Health as required under the District's Mandatory Adverse Event Reporting law and regulations in D.C. Official.

A practitioner who is a Public Health Service employee shall include which of the following for an identification purpose when prescribing a controlled substance prescription? *********** I. His or her Social Security Number II. His or her National Provider Identifier (NPI) number III. Does not require any identification number

Answer: (b) I and II only, [D.C. Official Code Title 22, Chapter 13 Section 1301.5]. *The service identification number for a Public Health Service employee* is his or her *social security identification number* or, if applicable, his or her *National Provider Identifier (NPI) number.* Each prescription shall have the name of the individual stamped or printed on it, as well as the signature of the individual.

Which of the following is/are TRUE regarding destruction of controlled substances by using authorized reverse distributors? I. A pharmacy may at any time forward controlled substances to DEA registered reverse distributors who handle the disposal of drugs. II. When a pharmacy transfers Schedule II substances to a reverse distributor for destruction, the distributor must issue an Official Order Form (DEA Form-222) to the pharmacy. III. A DEA Form-41 along with DEA Form-222 should be used to record the transfer of controlled substances between the pharmacy and the registered reverse distributor.

Answer: (b) I and II only, [D.C. Official Code Title 22, Chapter 13 Section 1320]. A pharmacy may at any time forward controlled substances to DEA registered reverse distributors who handle the disposal of drugs. The pharmacist may contact their local DEA Diversion Field Office for an updated list of those reverse distributors in their area. When a pharmacy transfers Schedule II substances to a reverse distributor for destruction, the distributor must issue an Official Order Form (DEA Form-222) to the pharmacy. When Schedule III-V controlled substances are transferred to a reverse distributor for destruction, the pharmacy should document in writing the drug name, dosage form, strength, quantity and date transferred. The DEA registered reverse distributor who will *destroy* the controlled substances is responsible for submitting a *DEA Form-41* to the DEA when the drugs have been destroyed. A *DEA Form-41 should NOT be used to record the transfer of controlled substances between the pharmacy and the registered reverse distributor,* [21CFR1300, 1301, 1304, 1305, and 1307].

When a drug is substituted, what shall be recorded by the pharmacist on the prescription form? I. name of the substituted drug II. the manufacturer of the substituted drug III. the lot number and expiration of the substituted drug

Answer: (b) I and II only, [D.C. Official Code Title 48, 48-803.04]. When a drug is substituted, the pharmacist shall record on the prescription form the *drug substituted by name and manufacturer*, and retain the form for inspection by District officials. The pharmacist shall also label the prescription container with the *name of the drug substituted*, unless the prescribing physician writes "do not label," or words of similar import, on the prescription, or, in communicating the prescription by telephone, orders that the container not be so labeled.

To qualify to serve as a preceptor, a pharmacist shall: I. Be licensed in good standing to practice pharmacy in the District of Columbia. II. Not currently be the subject of a disciplinary sanction or investigation in any jurisdiction. III. Have been engaged in the practice of pharmacy for at least one year on a full-time basis immediately prior to serving as a preceptor.

Answer: (b) I and II only, [DCMR Code Title 17, Chapter 65, 6511.2 (a)-to-(c)]. To qualify to serve as a preceptor, a pharmacist shall: (a). Be licensed in good standing to practice pharmacy in the District of Columbia; (b). Have been engaged in the practice of pharmacy for at least *two (2) years* (NOT one year) on a full-time basis immediately prior to serving as a preceptor; and (c). Not currently be the subject of a disciplinary sanction or investigation in any jurisdiction. Prior to supervising a pharmacy intern, a preceptor shall sign the "Oath of Preceptor," which states as follows: "I submit that I shall answer all questions concerning the training of the pharmacy intern under my supervision truthfully to the best of my knowledge and belief and that the training I provide will in accordance to the requirements set forth in 17 DCMR Chapter 65 and the practice of pharmacy as required by law."

Which of the following are Board-approved continuing education providers? I. ACPE II. CME-I III. CPC

Answer: (b) I and II only, [DCMR Title 17 Chapter 65 Section 6514.3(a),(b)]. To qualify for approval by the Board, a continuing education program shall be a lecture, conference, seminar, course of instruction, or workshop, and be prepared, offered, or administered by one of the following: (a). Providers approved by the *ACPE;* (b). The Accreditation Council for Continuing Medical Education(*ACME*) (sponsored or co-sponsored) and designated as an American Medical Association Physician's Recognition Award Category 1 program by the sponsoring organization; (c). A governmental unit; (d). A health care facility; or (e). An institution of higher learning recognized by an accrediting body approved by the Secretary of the United States Department of Education.

*Parenteral cytotoxic agents* shall be compounded under: I. A Class II Type A vertical laminar flow hood with bag-in, bag-out design. II. A Class II Type B vertical laminar flow hood with bag-in, bag-out design. III. A Class II Type C vertical laminar flow hood with bag-in, bag-out design.

Answer: (b) I and II only, [DCMR Title 22 Chapter 19 Section 1921.32]. In all pharmacies preparing *parenteral cytotoxic agents*, all compounding shall be conducted within a *certified Class II Type A* or *Class II Type B* vertical laminar air flow hood with bag-in, bag-out design. The pharmacy shall ensure that contaminated air plenum that are under positive air pressure are leak tight. The hood must be certified annually in accordance with National Sanitation Foundation Standard 49 or manufacturer's specifications. *Certification records shall be retained for a minimum of five (5) years.*

An internet based or telephone consultation or questionnaire evaluation is not adequate to establish a valid patient-practitioner relationship EXCEPT: I. In the event of a documented medical emergency. II. In an on-call or cross-coverage arrangement. III. Where a patient care is rendered in consultation with another practitioner who has an ongoing relationship with the patient and who has agreed to supervise the patient's treatment, including the use of any prescribed medications. a. I only b. I and II only c. II and III only d. All

Answer: (d) All, [DC Title 22 Chapter 13 Section 1300.8]. An internet based or telephone consultation or questionnaire evaluation is not adequate to establish a valid patient-practitioner relationship EXCEPT as follows: (a). In the event of a documented medical emergency; (b). In an on-call or cross-coverage arrangement; or (c). Where patient care is rendered in consultation with another practitioner who has an ongoing relationship with the patient and who has agreed to supervise the patient's treatment, including the use of any prescribed medications.

According to District of Columbia State Pharmacy Law, which of the following mid-level practitioners may prescribe and/or dispense a Schedule II controlled substance in the course of their professional practices? ********************* I. Physician's assistant II. Nurse practitioner III. Optometrists

Answer: (b) I and II only, [http://www.deadiversion.usdoj.gov/drugreg/practioners/mlp_by_state.pdf]. Pursuant to Title 21, Code of Federal Regulations, Section 1300.01(b28), the term mid-level practitioner means an individual practitioner, other than a physician, dentist, veterinarian, or podiatrist, who is licensed, registered, or otherwise permitted by the United States or the jurisdiction in which he/she practices, to dispense a controlled substance in the course of professional practice. Examples of mid-level practitioners include, but are not limited to, health care providers such as nurse practitioners, nurse midwives, nurse anesthetists, clinical nurse specialists and physician assistants who are authorized to dispense controlled substances by the state in which they practice. 1. AMB (Ambulance Service) 2. AS (Animal Shelters) 3. DOM (Doctors of Oriental Medicine) 4. ET (Euthanasia Technicians) 5. HMD (Homeopathic Physician) 6. MP (Medical Psychologists) 7. ND (Naturopathic Physician) 8. NP (Nurse Practitioners) 9. NH (Nursing Homes) 10. OD (Optometrists) 11. PA (Physician's Assistant) 12. RPH (Registered Pharmacists) For the State of District of Columbia, only following mid-level practitioners can either prescribe or administer or both, schedule controlled substances. 1. AMB (Ambulance Service): Schedule II to V controlled substances. 2. NP (Nurse Practitioner): Can prescribe Schedule II to V controlled substances. 3. PA (Physician's assistant): Can prescribe, dispense and procure Schedule II to V controlled substances. 4. ND (Naturopathic Physician): Schedule 3N for Testosterone (Prescribe, Administer and Dispense).

Which of the following is/are correct filing method(s) for controlled substances? ******* I. One file for CII, second file for III, IV and V and a third file for non-controlled substances. II. One file for CII and a second file for III, IV, V and non-controlled substances. III. One file for controlled and a second file for non-controlled substances.

Answer: (b) I and II, [D.C. Official Code Title 22, Chapter 13 Section 1313.1 and 1313.2]. Prescription orders for controlled substances in Schedules I and II shall be maintained in a file separate from all other records of the pharmacy. Prescription orders for controlled substances in Schedules III, IV and V shall be maintained either in a separate prescription file or in such form that they are readily retrievable from the other prescription records of the pharmacy. They will be deemed readily retrievable if, at the time they are initially filed, the face of the prescription is marked in red ink in the lower right corner with the letter "C" no less than one-inch high and filed in the usual consecutively numbered prescription file for non-controlled substances.

The label of a drug listed in Schedules II, III, IV, and V shall, when dispensed to or for a patient, contain a clear, concise warning that: a. It is a habit forming. b. It is a crime to transfer the drug to any person other than the patient. c. Do not self-administer. d. May cause drowsiness.

Answer: (b) It is a crime to transfer the drug to any person other than the patient, [D.C. Official Code Title 22, Chapter 13 Section 1308.2]. The label of a drug listed in Schedules II, III, IV, and V shall, when dispensed to or for a patient, contain a clear, concise warning that it is a crime to transfer the drug to any person other than the patient. When the size of the label space requires a reduction in type, the reduction shall be made to a size no smaller than necessary and in no event to a size no smaller than six (6) point type.

A pharmacist receives a new prescription for a tablet form of Drug A which is only available in a capsule dosage form. Does the pharmacist require notifying the physician by Law for this substitution? True False

Answer: (b) No, [D.C. Official Code Title 22, Chapter 13 Section 1327.2]. The notification required in § 1327.1(c) shall not apply to those circumstances where the dosage form substitution is made in order to comply with the prescriber's intent, (i.e. physician prescribed tablets but the medication only comes in capsules.) Substitution of dosage form shall not include the substitution of a product that has been compounded by the pharmacist unless the pharmacist contacts the practitioner prior to dispensing and obtains permission to dispense the compounded product.

In no event the label of a drug listed in Schedules II, III, IV, or V shall be made to a size smaller than _______ type. a. four (4) point b. six (6) point c. three (3) point d. eight (8) point

Answer: (b) six (6) point type, [D.C. Code Title 48-902.06 and DCMR Title 22 Chapter 13-1308.2]. The label of a drug listed in Schedules II, III, IV, and V shall, when dispensed to or for a patient, contain a clear, concise warning that it is a crime to transfer the drug to any person other than the patient. When the size of the label space requires a reduction in type, the reduction shall be made to a size no smaller than necessary and in no event to a size no smaller than six (6) point type.

The labels for parenteral cytotoxic label shall include: a. Handle With Care b. Dispose of Properly c. Highly Skin Irritant d. May Cause Nausea or Vomiting

Answer: (b), [D.C. Official Code Title 22, 1921.33]. In addition to existing labeling requirements, parenteral product labels shall include: (a). Telephone number of the pharmacy; (b). Name and concentrations of all ingredients contained in the parenteral product, including primary solution; (c). Instructions for storage and handling; and (d). A label for all cytotoxic agents which shall state: "Chemotherapy - Dispose of Properly".

In *emergency situations* a pharmacist may *dispense Schedule II* drugs upon the *oral prescription* of a practitioner. The quantity prescribed and dispensed is limited to no more than a: a. 72-hour supply to treat the patient during the emergency period. b. 24-hour supply to treat the patient during the emergency period. c. 7-day supply to treat the patient during the emergency period. d. 48-hour supply to treat the patient during the emergency period.

Answer: (c) *7-day supply to treat the patient during the emergency period*, [DCMR Title 22 Chapter 13-1306.5(a)]. In emergency situations a pharmacist may dispense *Schedule II* drugs upon the oral prescription of a practitioner. The quantity prescribed and dispensed is limited to *no more than a seven (7) day supply* to treat the patient during the emergency period (dispensing beyond the emergency period shall be pursuant to a written prescription signed by the prescribing individual practitioner).

What are duties of *pharmacy clerk*? I. Bookkeeping II. Stocking III. Documenting third-party reimbursement a. I only b. I and II only c. II and III only d. All

Answer: (d) All, [DCMR Title 17 Chapter 99 Section 9911.1]. Unless otherwise authorized by the Board, an individual who works at a pharmacy and is not licensed or registered by the Board as a pharmacist or pharmacy intern or authorized to perform the services of a pharmacy technician under this chapter, may perform only ancillary pharmacy services, such as: (a). Cashiering; (b). Bookkeeping; (c). Pricing; (d). Stocking; (e). Delivering; (f). Answering nonprofessional questions and telephone inquiries; (g). Documenting third-party reimbursement; and (h). Notifying the patient or the patient's agent of the opportunity to receive an oral consultation from the pharmacist.

The dispensing label requirement for Schedule II controlled substances, for administration to an ultimate user who is institutionalized, shall be waived if the following conditions are met: I. Not more than a 14-day supply of the controlled substance listed in Schedule II is dispensed at one time. II. The controlled substance listed in Schedule II is not in the possession of the ultimate user before the administration. III. The institution maintains appropriate safeguards and records regarding the proper administration, control, dispensing, and storage of the controlled substance listed in Schedule II. a. I only b. I and II only c. II and III only d. All

Answer: (c) *II and III only,* [DCMR Title 22 Chapter 13-1308.1 and 1308.3]. The pharmacist filling a written or emergency oral prescription for a controlled substance listed in Schedule II shall affix to the package the following: (a). A label showing the date of filling; (b). The pharmacy name and address; (c). The serial number of the prescription; (d). The name of the patient; (e). The name of the prescribing practitioner; and (f). Directions for use and cautionary statements, if any, contained in the prescription or required by law. The above requirements do not apply when a controlled substance listed in Schedule II is prescribed for administration to an ultimate user who is institutionalized, if the following limitations are observed: (a). Not more than a *seven-day supply* (NOT 14-day supply) of the controlled substance listed in Schedule II is dispensed at one time; (b). The controlled substance listed in Schedule II is not in the possession of the ultimate user before the administration; (c). The institution maintains appropriate safeguards and records regarding the proper administration, control, dispensing, and storage of the controlled substance listed in Schedule II; and (d). The system employed by the pharmacist in filling a prescription is adequate to identify the supplier, the product, and the patient, and to set forth the directions for use and cautionary statements, if any, contained in the prescription or required by law.

Which of the following requires a tamper-evident packaging? a. Cold EZ lozenges b. Tolnaftate cream c. Prilosec capsules d. Sensodyne fluoride tooth paste

Answer: (c) *Prilosec capsules* Each manufacturer and packer who packages an OTC drug product (except a dermatological, dentifrice, insulin, or lozenge product) for retail sale shall package the product in a tamper-evident package, if this product is accessible to the public while held for sale. A tamper-evident package is one having one or more indicators or barriers to entry which, if breached or missing, can reasonably be expected to provide visible evidence to consumers that tampering has occurred. To reduce the likelihood of successful tampering and to increase the likelihood that consumers will discover if a product has been tampered with, the package is required to be distinctive by design or by the use of one or more indicators or barriers to entry that employ an identifying characteristic (e.g., a pattern, name, registered trademark, logo, or picture). A tamper-evident package may involve an immediate-container and closure system or secondary-container or carton system or any combination of systems intended to provide a visual indication of package integrity. The tamper-evident feature shall be designed to and shall remain intact when handled in a reasonable manner during manufacture, distribution, and retail display.

A nonresident pharmacy shall report a change in the name or address of the resident agent in writing to the Department within ___________ days after the change.

Answer: (c) A nonresident pharmacy shall report a change in the name or address of the resident agent in writing to the Department *within 30 days after the change.* A nonresident pharmacy shall report a change in the pharmacist-in-charge, or corporate officers within thirty (30) days after the change. A nonresident pharmacy which changes proprietorship or ownership, its name, or location shall notify the Department within ten (10) days after the change and apply for a new registration. A nonresident pharmacy shall notify the Department within ten (10) days after closing.

A license is the property of the District of Columbia government and shall be returned to whom immediately upon the voluntary surrender by the licensee? ************* a. Mayor b. President of Pharmacy Board c. Director of the DC Department of Health d. Superintendent of City

Answer: (c) Director of the District of Columbia Department of Health, [DCMR Title 22 Chapter 19 Section 1902.16(c)]. A license is the property of the District of Columbia government and shall be returned to the Director immediately upon the occurrence of any of the following events: (a). Suspension or revocation of the license; (b). Refusal or failure to renew the license; (c). Voluntary surrender by the licensee; (d). Change in proprietorship of the pharmacy; (e). Death of the proprietor; (f). Failure of the pharmacy to open for business within thirty (30) days after the license has been issued, except that the Director may grant an extension at his or her discretion for good cause shown; (g). Failure of the pharmacy to operate for any reason for more than ninety (90) consecutive days after it has opened for business; or (h). Closure of the pharmacy.

An individual practitioner *employed by a hospital* shall write which of the following on the controlled substance prescriptions? I. A DEA number of an individual practitioner II. The registration number of the hospital III. The special internal code number assigned to the individual practitioner by the hospital a. I only b. I and II only c. II and III only d. All

Answer: (c) II and III only, [DC Code Title 22 Chapter 13 Section 1301.3]. Any person who is exempted from registration under federal or District of Columbia statute shall include on all prescriptions for controlled substances issued by him or her the registration number of the hospital or other institution and the special internal code number assigned to him or her by the hospital or other institution as provided in the Act or this chapter, in lieu of the registration number of the practitioner required by this chapter.

The dispensing pharmacist shall document which of the following information on each prescription order that has been dispensed? I. The signature of the pharmacist who performed the final verification. II. The name or initials of the pharmacist who performed the final verification. III. Any change or alteration made to the prescription dispensed based on contact with the practitioner to show a clear audit trail. a. I and III only b. None of the above c. II and III only d. III only

Answer: (c) II and III, [D.C. Official Code Title 22, Chapter 13 Section 1301.6]. The dispensing pharmacist shall document the following information on each prescription order that has been dispensed: (a). The name or initials of the pharmacist who performed the final verification; and (b). Any change or alteration made to the prescription dispensed based on contact with the practitioner to show a clear audit trail. This shall include but not be limited to, a change in quantity, directions, or number of refills.

Who may provide the registration for pharmacy interns who obtain their practical experience outside of the District of Columbia? a. Director of pharmacy board b. Governor c. Mayor d. Healthcare administer of the state

Answer: (c) Mayor, [D.C. Official Code Title 47, 47-2885.06(b)]. (a). To register as a pharmacy intern, a person shall establish to the satisfaction of the Board of Pharmacy that the applicant: (1).. Is currently registered in and attending a duly accredited college or school of pharmacy or is a graduate of such college or school of pharmacy; and (2) Has provided such additional evidence as the Board has determined is necessary for the position of pharmacy intern; and (3). Has complied with the other standards required for registration by the Non-Health Related Professions and Occupations Licensure Act of 1998. (b). The Mayor may, by regulation, provide for the registration of pharmacy interns who obtain their practical experience outside of the District of Columbia. (c). Registration as a pharmacy intern may be renewed for successive periods of 1 year if the Mayor is satisfied that the applicant is in good faith and with reasonable diligence working toward his or her pharmaceutical degree or, if he or she has already received his or her degree, has been unable with reasonable diligence to accumulate the number of hours of service required by the Mayor.

A pharmacist may dispense a generically equivalent drug product if the substituted generic drug product is in list of:

Answer: (c) Orange book, [DCMR Title 22 Chapter 13 Section 1326.1]. A pharmacist may dispense a generically equivalent drug product if: (a). The generic product costs the patient less than the prescribed drug product; (b). The patient does not refuse the substitution; and (c). The prescribing practitioner does not indicate on the written, facsimile, or electronic prescription form that the specific prescribed brand is to be dispensed by marking "DISPENSE AS WRITTEN," "BRAND NECESSARY," "NO SUBSTITUTION," or other similar language. If a prescription is transmitted orally, the prescribing practitioner or the practitioner's authorized agent shall prohibit substitution by specifying "BRAND NECESSARY," "NO SUBSTITUTION," or other similar language. The formulary of drug products for the District of Columbia shall be the chemical and generic drugs contained in the publication, "Approved Drug Products with Therapeutic Equivalence Evaluations (also known as the Orange Book)", and its monthly updates. This drug formulary is incorporated by reference as a part of this chapter.

Vimpat is classified as a: a. Schedule II b. Schedule III c. Schedule IV d. Schedule V

Answer: (d) *Vimpat* is classified as a Schedule V controlled drug, [D.C. Code Title 48-902.12 and DC Code Title 22 Chapter 12 Section 22-1205(b)]. List of Schedule V controlled drugs: ------------------------------------------------------------ Codeine preparations - Not more than 200 mg per 100 ml or 100 gm (Robitussin AC, Phenergan with Codeine). Difenoxin preparations - Not more than 0.5 mg Difenoxin + 25mcg Atropine sulfate (Motofen). Dihydrocodeine preparations - Not more than 100 mg per 100 ml or 100 gm. Diphenoxylate preparations- Not more than 2.5 mg Diphenoxylate + 25mcg Atropine sulfate (Lomotil, Logen). Ethylmorphine preparations - Not more than 100 mg per 100 ml or 100 gm. Opium preparations - Not more than 100 mg per 100 ml or 100 gm (Parepectolin, Kapectolin PG, Kaolin Pectin P.G.). Lyrica - Pregabalin Vimpat - Lacosamide Potiga - Ezogabine

In District of Columbia, inventory records of institutional pharmacies must be maintained for a period of at least: a. 1 year b. 2 years c. 3 years d. 5 years

Answer: (d) 5 years, [DCMR Title 22 Chapter 19-1921.5] According to District of Columbia State Pharmacy Law, inventory records of institutional pharmacies must be maintained for a period of at least five years from the date of such inventory or record. The Director of Pharmacy shall maintain the following records for a period of five (5) years: (a). Physician's orders; (b). Proofs of use of Schedule II controlled substances and any other drugs requested or required; (c). Reports of suspected adverse drug reactions; (d). Drug distribution records from night cabinets, automated medication dispensing systems, emergency kits, and similar systems; (e). Inventories of the pharmacy; (f). Inventories of controlled substances; (g). Alcohol and flammable reports; and (h). Any other records and reports as may be required by federal or District of Columbia law and regulations.

Which of the following is/are classified as Schedule II controlled drug(s)? I. Diphenoxylate II. Fentanyl III. Lisdexamfetamine a. I only b. I and II only c. II and III only d. All

Answer: (d) All are classified as Schedule II controlled drugs, [D.C. Code Title 48-902.06]. List of Schedule II controlled drugs: -------------------------------------------------------- Hashish Alfentanil (Alfenta) Amobarbital (Amytal, Tuinal) Amphetamine (Dexedrine, Biphetamine) Lisdexamfetamine (Vyvanse) Coca Leaves Cocaine Codeine Dextropropoxyphene, bulk (non-dosage forms) Dihydrocodeine (Didrate, Parzone) *Diphenoxylate* Diprenorphine Ecgonine (Cocaine precursor, in Coca leaves) Ethylmorphine (Dionin) Fentanyl (Innovar, Sublimaze, Duragesic) Glutethimide (Doriden, Dorimide) Hydrocodone (dihydrocodeinone) Hydrocodone and isoquinoline alkaloid Hydrocodone combination product (Tussionex, Tussend, Lortab, Vicodin, Hycodan, Anexsia) Hydromorphone (Dilaudid, dihydromorphinone) Levo-Alphacetylmethadol (LAAM, long acting methadone, levomethadyl acetate) Meperidine (Demerol, Mepergan, pethidine) Methadone (Dolophine, Methadose, Amidone) Methamphetamine (Desoxyn, D-desoxyephedrine, ICE, Crank, Speed) Methylphenidate (Ritalin) Morphine (MS Contin, Roxanol, Duramorph, RMS, MSIR) Opium poppy Opium tincture Opium, granulated Opium, powdered Opium, raw Oxycodone (OxyContin, Percocet, Tylox, Roxicodone, Roxicet) Oxymorphone (Numorphan) Pentobarbital (Nembutal) Poppy Straw Concentrate Remifentanil (Ultiva) Secobarbital (Seconal, Tuinal) Sufentanil (Sufenta) Tapentadol (Nucynta)

When should a pharmacist offer patient counseling? I. Whenever a new prescription drug or device is dispensed to a patient. II. Whenever a prescription drug or device has not previously been dispensed to a patient in the same dosage form or dose. III. Once yearly on maintenance medications.

Answer: (d) All, [D.C. Official Code Title 22, Chapter 19 Section 1919.1]. Following review of a patient's medical record and prior to dispensing a drug or medical device, a pharmacist shall make a verbal offer to counsel, or his designee shall notify the patient or the patient's agent of the opportunity to receive an oral consultation from the pharmacist: (a). Whenever a prescription drug or device has not previously been dispensed to a patient; (b). Whenever a prescription drug or device has not previously been dispensed to a patient in the same dosage form, strength, or with the same written directions; (c). Once yearly on maintenance medications; or (d). Whenever the pharmacist deems it warranted in the exercise of his or her professional judgment.

Which of the following is/are classified as Schedule IV controlled drug(s)? I. Carisoprodol II. Tramadol III. Clorazepate a. I only b. I and II only c. II and III only d. All

Answer: (d) All, [D.C. Code Title 48-902.10]. List of Schedule IV controlled drugs: ------------------------------------------------------------ Carisoprodol (Soma) Tramadol (Ultram) Alprazolam (Xanax) Barbital (Barbitone) Butorphanol (Stadol, Stadol NS, Torbugesic, Torbutrol) Chloral hydrate (Noctec) Chlordiazepoxide (Librium, Libritabs, Limbitrol, SK-Lygen) Clonazepam (Klonopin, Clonopin) Clorazepate(Tranxene) Dexfenfluramine (Redux) Diazepam (Valium, Valrelease) Dichloralphenazone (Midrin) Difenoxin 1 mg/ Atropine 25 mcg (Motofen) Estazolam (ProSom, Domnamid, Eurodin, Nuctalon) Ethchlorvynol (Placidyl) Fenfluramine (Pondimin, Ponderal) Flurazepam (Dalmane) Fospropofol (Lusedra) Lorazepam (Ativan) Mazindol (Sanorex, Mazanor) Meprobamate (Miltown, Equanil, Deprol, Equagesic, Meprospan) Midazolam (Versed) Modafinil (Provigil) Oxazepam (Serax, Serenid-D) Pemoline (Cylert) Pentazocine (Talwin, Talwin NX, Talacen, Talwin Compound) Phenobarbital (Luminal, Donnatal, Bellergal-S) Phentermine (Ionamin, Fastin, Adipex-P, Obe-Nix, Zantryl) Prazepam (Centrax) Propofol (Diprivan) Propoxyphene dosage forms with other ingredients Quazepam (Doral, Dormalin) Sibutramine (Meridia) Temazepam (Restoril) Triazolam (Halcion) Zaleplon (Sonata) Zolpidem (Ambien) Zopiclone (Imovane) Eszopiclone (Lunesta)

The dispensing container label shall meet which of the following requirement(s)? I. The letter height or type size for all labeling information, headings, and subheadings must be a minimum of 8 points. II. The identifying information must be presented in bold print and must precede the heading or subheading by at least two square em's. III. Each section heading must be in bold print whereas each subheading within a section must be indented and not bolded. a. I only b. I and II only c. II and III only d. All

Answer: (d) All, [D.C. Official Code Title 47, 47-2885.14 and 21CFR201 Section 201.57]. (d). Format requirements: All labeling information must be printed in accordance with the following specifications: (1). All headings and subheadings must be highlighted by bold type that prominently distinguishes the headings and subheadings from other labeling information. Reverse type is not permitted as a form of highlighting. (2). A horizontal line must separate the information. (3). The headings section must be presented in the center of a horizontal line. (4). If there are multiple subheadings listed under paragraphs, each subheading must be preceded by a bullet point. (5). The labeling information must be in bold print. (6). The letter height or type size for all labeling information, headings, and subheadings must be a minimum of 8 points, except for labeling information that is on or within the package from which the drug is to be dispensed, which must be a minimum of 6 points. (7). The identifying information must be presented in bold print and must precede the heading or subheading by at least two square em's (i.e., two squares of the size of the letter "m" in 8 point type). (8). The information must be limited in length to an amount that, if printed in 2 columns on a standard sized piece of typing paper (8 1/2 by 11 inches), single spaced, in 8 point type with 1/2-inch margins on all sides and between columns, would fit on one-half of the page. (9). Sections or subsections of labeling that are identified as containing recent major changes must be highlighted in the full prescribing information by the inclusion of a vertical line on the left edge of the new or modified text. (10). Each section heading must be in bold print. Each subheading within a section must be indented and not bolded.

*Thirty days prior* to each issue date, the Department of Human Services shall furnish to the Office of Consumer Protection a list of the *100 most commonly used prescription drugs*. This list shall include which of the following? I. name of the drug II. two commonly prescribed quantities of the drug III. the current selling price of each quantity a. I only b. I and II only c. II and III only d. All

Answer: (d) All, [D.C. Official Code Title 48, 48-801.01 and .02]. *Thirty days prior to each issue date*, the Department of Human Services shall furnish to the Office of Consumer Protection a list of the *100 most commonly used prescription drugs.* *Ten days prior to each issue date*, the Office of Consumer Protection shall furnish to each pharmacy in the District a *poster* suitable for display of a *type style* and *size* so as to be easily readable at a reasonable distance, which: (1). Lists the *100 most commonly used prescription drugs* in *2 commonly prescribed quantities*, with space for the *current selling price of each quantity*; (2). Lists professional and convenience services, with space for each pharmacy to indicate: (A). Whether it offers each service; and (B). The additional charge, if any, for that service; (3). Contains a heading stating "*OUR CURRENT PRESCRIPTION PRICES*" and containing spaces for the insertion of the name and address of each pharmacy; (4). Indicates in simple language that: (A). The price of a prescription drug is often different at different pharmacies, and that the consumer may want to make a comparison on the cost of a prescription; (B). The pharmacy may be able to substitute a less expensive drug which is therapeutically equivalent to the one prescribed by the consumer's doctor, unless the consumer does not approve; and (C). The consumer has the right to know the exact price of a prescription before it is filled; and (5). Provides space for each pharmacy to indicate the eligibility and terms of any discount it offers on legend drugs.

The pharmacist shall not dispense an equivalent drug product if: I. The person purchasing the drug product or the patient for whom it is intended indicates a preference for the drug product actually prescribed. II. The prescriber, in the case of a written prescription order signed by the prescriber, writes in the prescriber's own handwriting "dispense as written" or "D.A.W." III. The prescriber, in the case of a prescription communicated by telephone, expressly indicates the prescription is to be dispensed as communicated.

Answer: (d) All, [D.C. Official Code Title 48, 48-803.03]. The pharmacist shall not dispense an equivalent drug product if: (1). The person purchasing the drug product or the patient for whom it is intended indicates a preference for the drug product actually prescribed; (2). The prescriber, in the case of a written prescription order signed by the prescriber, writes in the prescriber's own handwriting "dispense as written" or "D.A.W." or a similar notation. A procedure for checking or initialing a box, preprinted or stamped on a prescription form, will not constitute an acceptable notation; (3). The prescriber, in the case of a prescription communicated by telephone, expressly indicates the prescription is to be dispensed as communicated, and this indication is noted in the pharmacist's own handwriting on the orally transcribe prescription form.**** ???????????

The dispensing pharmacist shall document which of the following information on the written record of each prescription order that has been dispensed? I. The name or initials of the pharmacist who performed the final verification. II. Any change or alteration made to the prescription dispensed based on contact with the practitioner to show a clear audit trail. III. Authorization obtained from the practitioner to substitute a drug. a. I only b. I and II only c. II and III only d. All

Answer: (d) All, [DC Code Title 22 Chapter 13 Section 1302.5 and 1302.6]. The dispensing pharmacist shall document the following information on the written record of each prescription order that has been dispensed: (a). The name or initials of the pharmacist who performed the final verification; and (b). Any change or alteration made to the prescription dispensed based on contact with the practitioner to show a clear audit trail. This shall include, but not be limited to, a change in quantity, directions, or number of refills. Authorization obtained from the practitioner to substitute a drug, shall be documented on the prescription order, except in the case of an institutional pharmacy which maintains readily retrievable, written, documented policies authorizing such substitution.

In which of the following instance(s) shall the reporting requirements to Prescription Monitoring Program not apply to the dispensing of covered substances? I. Administering covered substances. II. Dispensing covered substances to inpatients in hospitals. III. Dispensing covered substances for substance abuse treatment program. a. I only b. I and II only c. II and III only d. All

Answer: (d) All, [DCMR Title 17 Section 10301.5 and 10304.1]. The reporting requirements to *Prescription Monitoring Program* shall *not* apply to the dispensing of covered substances when the dispensing is limited to the following: (a). Administering covered substances; (b). Dispensing covered substances within an appropriately *licensed narcotic maintenance program*, such as a methadone treatment program or substance abuse treatment program; (c). Dispensing covered substances to inpatients in hospitals or nursing facilities licensed by the Department or facilities that are otherwise authorized by law to operate as hospitals or nursing homes in the District; or (d). Dispensing covered substances to inpatients in hospices licensed or certified by the Department. A dispenser that dispenses no covered substances within a twenty-four (24) hour reporting period shall submit a report documenting that zero covered substances were dispensed during that twenty-four (24) hour reporting period.

Which of the following drug(s) shall be reported to *Prescription Data Monitoring Program*? I. Cyclobenzaprine II. Hydrocodone III. Butalbital a. I only b. I and II only c. II and III only d. All

Answer: (d) All, [DCMR Title 17 Section 10302.1]. Covered substance: ************ a. All controlled substances included in Schedules II, III, IV, and V. b. All drug products containing Cyclobenzaprine. c. All drug products containing Butalbital.

Which of the following is/are TRUE about Telephone Facsimile prescription order? I. A practitioner shall not transmit a prescription via telephone facsimile without a patient's consent. II. A telephone facsimile prescription shall be transmitted only by a practitioner or a practitioner's designated agent directly from the practitioner's office. III. The pharmacy shall implement and maintain procedures to verify the authenticity of the telephone facsimile transmission and its source of origin. a. I only b. I and II only c. II and III only d. All

Answer: (d) All, [DCMR Title 22 Chapter 13 Section 1303.1 to 1303.5]. A practitioner shall *not* transmit a prescription via telephone facsimile if in doing so it would interfere with a patient's freedom to choose a pharmacy, or without a patient's consent. A telephone facsimile prescription shall be transmitted only by a practitioner or a practitioner's designated agent directly from the practitioner's office or a health care facility to the pharmacy with no intervening person having access to the prescription drug order. The pharmacy and the practitioner shall both have adequate security and system safeguards designed to prevent and detect unauthorized access, modification, or manipulation of patient records and telephone facsimile transmissions. The pharmacy shall implement and maintain procedures to verify the authenticity of the telephone facsimile transmission and its source of origin which may include: (a). Maintenance of a practitioner's telephone facsimile number reference; (b). Verification of the telephone number of the originating telephone facsimile equipment; and (c). Telephone verification with the practitioner's office that the prescription as transmitted via telephone facsimile contains the same exact information it contained when originated by the practitioner and contains no alterations by any intervening parties.

Faxing a prescription for Schedule II controlled drugs may serve as the original prescription only if: I. A licensed practitioner prescribes the Schedule II controlled substances for a patient undergoing home infusion/IV pain therapy. II. A licensed practitioner prescribes the Schedule II controlled substances for a patient living in an LTCF. III. A licensed practitioner prescribes the Schedule II controlled substances for a patient living in hospice care as certified by Medicare.

Answer: (d) All, [DCMR Title 22 Chapter 13-1306.7 and 21CFR1306.11 (e),(f) and (g)]. Normally, a C-II prescription drug order may be transmitted by the practitioner or the practitioner's agent, but not the patient or patient's agent, to a pharmacy via facsimile machine or equipment. The original written, signed prescription drug order must be presented by the patient to the pharmacist prior to the actual dispensing of the schedule II (C-II) drug. Faxing a prescription for Schedule II controlled drugs may serve as the original prescription only if: 1. A licensed practitioner prescribes the Schedule II controlled substances for a patient undergoing home infusion/IV pain therapy. 2. A licensed practitioner prescribes the Schedule II controlled substances for a patient residing in a LTCF. 3. A licensed practitioner prescribes the Schedule II controlled substances for a patient residing in hospice care as certified by Medicare under Title XVIII. 4. A licensed practitioner prescribes the Schedule II controlled substances for the direct administration to a patient by parenteral, intravenous, intramuscular, subcutaneous, or intraspinal infusion route.

Which of the following is/are duties of the Mayor? I. Administer and enforce the provisions of the state pharmacy law. II. Establishment of minimum standards for the operation of pharmacies. III. The establishment of various classifications of pharmacies. a. I only b. I and II only c. II and III only d. All

Answer: (d) All, [D.C. Code 47-2885.18(a)]. The Mayor shall: (1). Administer and enforce the provisions of the law; (2). The establishment of various classifications of pharmacies, including, but not limited to, retail, institutional, radio, or nuclear pharmacies; (3). Establishment of minimum standards for the operation of pharmacies, including the minimum requirements for technical equipment and professional reference materials; (4). The safe and proper storage, and maintenance of drugs, and the disposal of drugs; (5). The requirements to assure that pharmacies shall be clean, in good repair, well ventilated and illuminated, and equipped with the necessary dispensing facilities,and adequate facilities for the purposes of cleansing hands, equipment and utensils, and the premises therein; such facilities may be located in areas adjacent to the pharmacy where only part of an establishment or institution is used as the pharmacy;and (6). The establishment of regulations covering the storage and dispensing of radiopharmaceuticals.

In addition to conforming to all applicable federal and District requirements, a *telephone facsimile prescription* drug order shall contain which of the following at the time it is transmitted? I. The signature of the practitioner. II. The full name and address of the patient. III. A statement that indicates that the prescription was transmitted via telephone facsimile. a. I only b. I and II only c. II and III only d. All

Answer: (d) All, [DCMR Title 22 Chapter 13-1303.6 and 1303.7]. The pharmacy shall implement and maintain procedures to verify the authenticity of the *telephone facsimile transmission* and its source of origin. In addition to conforming to all applicable federal and District requirements, a telephone facsimile prescription drug order shall contain the following at the time it is transmitted: (a). A prescription bearing the following information: (1). The printed or typed *full name, address, telephone number and facsimile number of the practitioner;* (2). The *signature of the practitioner;* (3). The *date of issuance;* (4). The *full name and address of the patient;* (5). The *name* and *dosage* of the drug, *directions for use*, *quantity* dispensed, and *number of refills*, when applicable; and (6). A *statement that indicates that the prescription was transmitted via telephone facsimile;* (b). Along with the prescription, the following information shall be transmitted: (1). The *name, address, and facsimile number of the pharmacy* to which the prescription was transmitted; (2). The *date the prescription was transmitted* via facsimile to the pharmacy, if the date is different from the date of issuance of the prescription; (3). If transmitted by a designated agent, the *full name of the designated agent*; and (4). A clearly legible statement that: (A). *The telephone facsimile transmission is intended only for the recipient to whom it was addressed and contains information that is confidential;* (B). The recipient is prohibited from distribution or dissemination of the information contained in the transmission unless permitted by federal or District law; and (C). If the recipient is not the intended recipient or the authorized agent of the intended recipient, the recipient should immediately notify the sender by telephone and return the original message to the sender. In addition to the requirements of 1303.6, a prescription for a *controlled substance*, when authorized by law for dispensing, shall also include the following: (a). The practitioner's federal Drug Enforcement Administration *(DEA) registration number;* (b). The *practitioner's District of Columbia Controlled Substances registration number*, if applicable; (c). Be *signed by the practitioner* in the same manner as the practitioner would sign a check or legal document (for example: " J.H. Smith " or " John H. Smith "); and (d). Any other requirements under District or federal law.

Which of the following statements is/are TRUE about transmitting an *electronic prescription* order according to Washington DC State Pharmacy Law? I. The order shall be transmitted directly to a pharmacy through a secure computer to computer transmission. II. The order shall be processed by a commercial intermediary that is duly authorized to operate in the District of Columbia, which ensures the confidentiality and security of the transmission process. III. The order shall be transmitted directly to a pharmacy through a secure computer to facsimile transmission. a. I only b. I and II only c. II and III only d. All

Answer: (d) All, [DCMR Title 22 Chapter 13-1304.3(a),(b),(c)]. According to Washington DC State Pharmacy Law, an *electronic prescription* may be transmitted only by a practitioner or a practitioner's designated agent: (a). Directly to a pharmacy through a secure computer to computer transmission; (b). Directly to a pharmacy through a secure computer to facsimile transmission; or (c). Processed by a commercial intermediary that is duly authorized to operate in the District of Columbia, if applicable, and which ensures the confidentiality and security of the transmission process. A pharmacist shall not dispense an electronic prescription for a controlled substance listed in any schedule, unless otherwise authorized or permitted by federal law or regulations.

Which of the following statements are TRUE about AccessRx programs according to District of Columbia State Pharmacy Law? I. AccessRx programs enable the District to take steps to make prescription drugs more affordable for qualified District residents. II. AccessRx programs can be integrated with any District-wide program for the uninsured. III. The intent of AccessRx programs is not to discourage employers from offering or paying for prescription drug benefits for their employees or to replace employer-sponsored prescription drug benefit plans.

Answer: (d) All, [D.C. Code Title 48-831.01(1)-to-(4)]. AccessRx enables the District to take steps to make prescription drugs more affordable for qualified District residents, thereby increasing the overall health of District residents, promoting healthy communities, and protecting the public health and welfare. AccessRx can be integrated with any District-wide program for the uninsured. The intent of AccessRx is not to discourage employers from offering or paying for prescription drug benefits for their employees or to replace employer-sponsored prescription drug benefit plans that provide benefits comparable to those made available to qualified District residents under AccessRx.

What are requirements to become a licensed pharmacy *technician*? I. Obtained a high school diploma or its equivalent. II. Obtained a current certification from The National Healthcareer Association. III. Completed a national, regional, or state accredited pharmacy technician training program recognized by the Board.

Answer: (d) All, [D.C. Official Code Title 17, Chapter 99 Section 9902.1 and 9907.6]. An applicant applying for a registration to practice as a pharmacy technician shall establish to the satisfaction of the Board that the applicant has successfully: (a). Obtained a *high school diploma* or its equivalent, or has passed a Board approved examination that proves that he or she has achieved competency in the educational skills required to perform the function of a pharmacy technician; and (b). Obtained a current certification from: (1). The Pharmacy Technician Certification Board (PTCB); (2). The National Healthcareer Association (formerly ICPT); or (3). Another state certifying organization approved by the Board; or (c). Completed one of the following types of Board approved pharmacy technician training programs, which shall include a Board-approved exam: (1). A national, regional, or state accredited pharmacy technician training program recognized by the Board; (2). A pharmacy technician program at a college or university that is accredited by an accrediting body recognized by the Secretary of the United States Department of Education or the Council on Postsecondary Accreditation; (3). An employer-based pharmacy technician training program recognized by the Board that meets the requirements of § 9903 and includes a minimum of one hundred sixty (160) hours of training within a one (1) year period, including theoretical and practical instruction; or (4). A pharmacy technician program that meets the guidelines of the American Society of Health-System Pharmacists, is licensed by the District of Columbia Educational Licensure Commission, and has certified to the Board its intent to pursue accreditation upon becoming eligible to do so. An applicant for renewal of a pharmacy technician registration shall: (a) Have completed a minimum of twenty (20) contact hours of continuing education credit in pharmacy-related subject matter, which shall include at least two (2) contact hours of continuing education credit in pharmacy law, and two (2) contact hours in medication safety, during the two (2) year period preceding the date the registration expires. Beginning with the renewal period ending February 28, 2019, two (2) hours of continuing education on cultural competency or specialized clinical training focusing on patients or clients who identify as lesbian, gay, bisexual, transgender, gender nonconforming, queer, or question their sexual orientation or gender identity and expression ("LGBTQ") meeting the requirements of D.C. Official Code.

Which of the following duties shall NOT be performed by pharmacy interns?************ I. Prescriber contact concerning prescription drug order clarification II. Prescription transfers III. Receiving refill authorizations

Answer: (d) All, [D.C. Official Code Title 22, Chapter 19 Section 1920.5(b)]. The following list of duties shall *only be performed by pharmacists* and not by pharmacy technicians or interns: (1). Drug utilization review; (2). Clinical conflict resolution; (3). Prescriber contact concerning prescription drug order clarification; (4). Patient *counseling* on prescription, over-the-counter, and herbal products; (5). Dispensing process validation; (6). *Receiving new oral prescription* drug orders, or *refill authorizations*; $$$$$$$$ (7). *Prescription transfers*; and $$$$$ (8). *Independent compounding.* $$$$$$

A written prescription drug order for a controlled substance shall contain which of the following? I. The patient's address II. The practitioner's Federal Drug Enforcement Administration (DEA) registration number III. The practitioner's District of Columbia controlled substances registration number

Answer: (d) All, [D.C. Official Code Title 22, Chapter 13 Section 1301.1 and 1301.2]. In addition to conforming to all applicable federal and District requirements, a written prescription drug order shall contain the following: (a). The printed or typed full name, address, and telephone number of the practitioner; (b). The original, legal signature of the practitioner, in ink; (c). The date of issuance; (d). The full name of the patient; (e). The name, strength and quantity of the drug prescribed, directions for use, and number of refills, when applicable; and (f). Be written in ink, indelible pencil or typewriter. In addition to the requirements of § 1301.1, a prescription drug order for a controlled substance shall also include the following: (a). The patient's address; (b). The practitioner's Federal Drug Enforcement Administration (DEA) registration number; (c). The practitioner's District of Columbia controlled substances registration number, if applicable; (d). Be signed by the practitioner in the same manner as the practitioner would sign a check or legal document (for example: "J.H. Smith" or "John H. Smith").

An oral prescription drug order may contain which of the following? I. The full name, address, and telephone number of the practitioner. II. The full name and address of the patient. III. The name of the practitioner's designated agent authorized to orally communicate the prescription. a. I only b. I and II only c. II and III only d. All

Answer: (d) All, [D.C. Official Code Title 22, Chapter 13 Section 1302.2, 1302.3 and 1302.4]. An oral prescription drug order from a practitioner or a practitioner's designated agent shall: (a). Only be received by a pharmacist; and (b). Be immediately reduced to writing. In addition to conforming to all applicable federal and District requirements, an oral prescription drug order shall contain the following: (a). The full name, address, and telephone number of the practitioner; (b). The date of issuance; (c). The full name and address of the patient; (d). The name, strength, and quantity of the drug, directions for use, and number of refills, when applicable; and (e). The name of the practitioner's designated agent authorized to orally communicate the prescription to the pharmacist. In addition to the requirements of § 1302.3, a prescription for a controlled substance, when authorized by law for dispensing, shall also include the following: (a). The practitioner's federal Drug Enforcement Administration (DEA) registration number; and (b). The practitioner's District of Columbia Controlled Substances registration number, if applicable.

A prescription medication may be delivered to: I. The patient for whom the prescription is prescribed. II. An agent authorized by the patient. III. The residence of the patient, regardless of whether the patient is present at the residence at the time of delivery.

Answer: (d) All, [D.C. Official Code Title 22, Chapter 13 Section 1315.7 and 1315.8]. A prescription medication may be delivered to: (a). The patient for whom the prescription is prescribed; (b). Wherever the patient is located; (c). An agent authorized by the patient; or (d). The residence of the patient, regardless of whether the patient is present at the residence at the time of delivery. If a patient authorizes delivery of a prescription medication or device to an agent at a location other than the pharmacy or the patient's residence, the pharmacy shall document in a readily retrievable record: (a). The patient's authorization; (b). The identity of the agent to whom the medication is sent; and (c). The date, time; and location where the medication was sent.

Which of the following information about a *pharmacy license* is/are TRUE? I. A license is valid only for the proprietor, the premises, and the pharmacy name designated on the license and the location for which it is issued. II. The pharmacy license shall be issued in the name of the proprietor whether or not the proprietor of a pharmacy is a pharmacist. III. A pharmacy license is not transferable.

Answer: (d) All, [D.C. Official Code Title 22, Chapter 19 Section 1902.13, 1902.14 and 1902.15]. A license is valid only for the proprietor, the premises, and the pharmacy name designated on the license and the location for which it is issued. The pharmacy license shall be issued in the name of the proprietor whether or not the proprietor of a pharmacy is a pharmacist. A pharmacy license is not transferable.

Not later than fifteen (15) days after the pharmacy has closed, the proprietor shall submit to the Director: I. The pharmacy license II. The District of Columbia certificate of registration III. Confirmation that the DEA registration and all unused DEA 222 forms (order forms) were returned to the DEA

Answer: (d) All, [D.C. Official Code Title 22, Chapter 19 Section 1906.4]. Not later than fifteen (15) days after the pharmacy has closed, the proprietor shall submit to the Director the following: (a). The pharmacy license; (b). The District of Columbia certificate of registration; and (c). A written statement containing the following information: (1). The actual date of closing; (2). Confirmation that all drugs have been transferred to an authorized person or persons, or destroyed. If the drugs were transferred, the names and addresses of the persons to whom they were transferred; (3). If controlled substances were transferred, a list of the names, addresses, DEA registration numbers, and District registration numbers of the persons to whom the substances were transferred, the substances transferred, the amount of each substance transferred, the date on which the transfer took place, and a copy of DEA form 222 for the transfer of Schedule II controlled substances; (4). Confirmation that the DEA registration and all unused DEA 222 forms (order forms) were returned to the DEA; (5). Confirmation that all pharmacy labels with addresses and blank prescription pads with addresses which were in the possession of the pharmacy were destroyed; (6). If controlled substances were transferred, confirmation that an inventory has been conducted; and (7). Confirmation that all signs and symbols indicating the presence of the pharmacy have been removed.

Under D.C. State Pharmacy Law, a nuclear pharmacy shall maintain which of the following items in hard copy or electronic format in its reference library? I. A reference on the safe handling of radioactive materials. II. A minimum of three texts dealing with nuclear medicine science. III. A reference on sterile product preparation.

Answer: (d) All, [D.C. Official Code Title 22, Chapter 19 Section 1909.5 (a) to (d)]. Under D.C. State Pharmacy Law, a nuclear pharmacy shall maintain the following items, in hard copy or electronic format, in its reference library: (a). A reference on the safe handling of radioactive materials; (b). A minimum of three texts dealing with nuclear medicine science; (c). A reference on sterile product preparation; and (d). Code of Federal Regulations, Title 49, Parts 106-199, with recent amendments.

A container in which a prescription drug or device is sold or dispensed for an animal must bear a label containing the following information: I. the name of the owner II. the first name of the animal III. the species of the animal

Answer: (d) All, [D.C. Official Code Title 22, Chapter 19 Section 1912.2(b) and Section 48-903.08(e)]. A container in which a prescription drug or device is sold or dispensed must bear a label containing the following information: (a). The name, address, and telephone number of the pharmacy; (b). The name of the patient, or if the ultimate user is an animal, the name of the owner, the first name of the animal, and the species of the animal; (c). The name of the prescribing practitioner; (d). The date of filling; (e). The generic, chemical, or brand name of the drug unless omission is specifically requested by the prescriber in writing; (f). The strength, dosage, and quantity of the drug dispensed; (g). The directions for use and cautionary statements; (h). The serial number of the prescription or prescription number; and (i). The expiration date of the product according to the manufacturer or one (1) year from the date the drug or medical device is dispensed, whichever comes first, subject to the discretion of the pharmacist to select an earlier date on which the life of a compounded drug product may expire. If a prescription order is for a controlled substance, the label shall also include a clear, concise warning that it is a crime to transfer the drug to any person other than the patient.

A pharmacy shall be responsible for labeling each prepackaged or repackaged container with the:********* I. The name of the manufacturer if the drug is generic. II. The manufacturer or distributor's control or lot number. III. The drug strength and quantity.

Answer: (d) All, [D.C. Official Code Title 22, Chapter 19 Section 1912.4]. A pharmacy shall be responsible for labeling each prepackaged or repackaged container with the following information: (a). The name of the drug; (b). The name of the manufacturer if the drug is generic; (c). The drug strength and quantity; (d). The manufacturer or distributor's control or lot number; and (e). The expiration date of the product according to the manufacturer or on one (1) year from the date the drug or medical device is prepackaged, whichever comes first, subject to the discretion of the pharmacist to select an earlier date on which the life of a compounded drug product may expire.

Who may have an access to the automated medication dispensing system? I. Licensed pharmacist II. Qualified pharmacy personnel III. Individuals permitted by law to administer medication

Answer: (d) All, [D.C. Official Code Title 22, Chapter 19 Section 1915.10]. Access to the automated medication dispensing system shall be limited to individuals that have completed documented training concerning the automated pharmacy system and who are one of the following: (a). Licensed pharmacist; (b). Qualified pharmacy personnel under a licensed pharmacist's supervision; or (c). Individuals permitted by law to administer medication.

Drugs shall only be dispensed at a remote site through an automated prescription medication dispensing system if: I. An original prescription drug order has been received, or reviewed electronically, by a pharmacist at the provider pharmacy. II. A pharmacist at the provider pharmacy has approved the release of the initial dose of a prescription drug order. III. A pharmacist at the provider pharmacy has conducted a drug regimen review prior to releasing a prescription drug order to the automated pharmacy system.

Answer: (d) All, [D.C. Official Code Title 22, Chapter 19 Section 1916.6, 1916.7, 1916.8]. A provider pharmacy may provide remote pharmacy services directly or through the use of a Board-approved subcontractor using an automated pharmacy system to a health care facility or other appropriate facility located in the District of Columbia if: (a). The provider pharmacy submits an application to the Director for permission to provide remote pharmacy services using an automated medication dispensing system. The application shall include: (1). The name, address, and license number of the provider pharmacy; (2). The name and address of the facility where the remote pharmacy services will be provided; (3). The name and address of the subcontractor who will provide after-hours remote pharmacy services. The following duties shall be performed only by a licensed pharmacist at the provider pharmacy: (a). Receiving an oral, facsimile, or electronic prescription drug order; (b). Interpreting the prescription drug order; (c). Verifying the accuracy of the prescription data entry; (d). Selecting the drug product; (e). Interpreting the patient's medication records and conducting a drug regimen review; (f). Authorizing the telepharmacy system to print a prescription label at the remote site; and (g). Performing the final check of the dispensed prescription to ensure that the prescription drug order has been dispensed accurately as prescribed. The final check shall be accomplished through a visual check using electronic methods. Patient counseling of an inpatient of a health care facility may be performed by either a pharmacist or a licensed health care professional authorized to administer drugs. Drugs shall only be dispensed at a remote site through an automated prescription medication dispensing system if: (a). An original prescription drug order has been received, or reviewed electronically, by a pharmacist at the provider pharmacy; (b). A pharmacist at the provider pharmacy has approved the release of the initial dose of a prescription drug order; and (c). A pharmacist at the provider pharmacy has conducted a drug regimen review prior to releasing a prescription drug order to the automated pharmacy system.

Which of the following information is/are TRUE ABOUT using the automated medication system? I. Non-sterile drugs which require reconstitution through the addition of a specified amount of water may be dispensed by the remote site only if a registered pharmacy technician reconstitutes the product. II. Subsequent doses from an approved prescription drug order may be removed from the automated medication system by, authorized personnel without the additional approval from the pharmacist. III. A provider pharmacy shall only store drugs at a remote site within an automated medication dispensing system that is locked by key or combination so as to prevent access by unauthorized personnel.

Answer: (d) All, [D.C. Official Code Title 22, Chapter 19 Section 1916.9 to 1916.11]. Non-sterile drugs which require reconstitution through the addition of a specified amount of water may be dispensed by the remote site only if a registered pharmacy technician or an authorized licensed healthcare provider reconstitutes the product. Subsequent doses from an approved prescription drug order may be removed from the automated medication system by, authorized personnel, after the initial approval. Any change made in the prescription drug order shall require a new approval by a pharmacist to release the drug. A provider pharmacy shall only store drugs at a remote site within an automated medication dispensing system that is locked by key or combination so as to prevent access by unauthorized personnel. A pharmacist from the provider pharmacy shall be accessible at all times to respond to a patient's or other health professional's questions and needs pertaining to drugs dispensed through an automated medication dispensing system at a remote site. The access may be by telephone or through a twenty-four (24) hour pager service.

Which of the following is/are elements of Prospective DUR? I. Therapeutic duplication II. Drug-disease contraindications III. Clinical abuse/misuse

Answer: (d) All, [D.C. Official Code Title 22, Chapter 19 Section 1918.1(h)]. For purposes of promoting therapeutic appropriateness, a pharmacist shall, prior to or at the time of dispensing a prescription drug order, review the patient's medication record and each prescription drug order presented for dispensing. The Prospective DUR shall include screening for the following, if available: (a). Over-utilization or under-utilization; (b). Therapeutic duplication; (c). Drug-disease contra-indications; (d). Drug-drug interactions; (e). Incorrect drug dosage or duration of drug treatment; (f). Drug-allergy interactions; (g). Reasonable dose and route of administration; (h). Clinical abuse/misuse;

Whenever any drug is not available from floor supplies, night cabinets, automated medication dispensing systems, telepharmacy systems, or by similar means, and the drug is required to treat the immediate needs of a patient whose health would otherwise be jeopardized, the drug may be obtained from the pharmacy if: I. Only one supervisory registered professional nurse in any given 8 hour shift is responsible for obtaining drugs from the pharmacy. II. Removal of any drug from the pharmacy by an authorized nurse shall be recorded on a suitable form showing the patient's name, room number, name of the drug, strength, amount, date, time and the signature of the nurse. III. The responsible nurse may, in times of emergency, delegate this duty to another licensed registered nurse.

Answer: (d) All, [D.C. Official Code Title 22, Chapter 19 Section 1921.19]. Whenever any drug is not available from floor supplies, night cabinets, automated medication dispensing systems, telepharmacy systems, or by similar means, and the drug is required to treat the immediate needs of a patient whose health would otherwise be jeopardized, the drug may be obtained from the pharmacy in accordance with the following requirements: (a). One (1) supervisory registered professional nurse, and only one (1), in any given eight (8) hour shift is responsible for obtaining drugs from the pharmacy. The responsible nurse shall be designated in writing by the appropriate committee of the institutional facility. The responsible nurse may, in times of emergency, delegate this duty to another licensed registered nurse; (b). The responsible nurse shall, prior to being permitted to obtain access to the pharmacy, receive thorough education and training in the proper methods of access, removal of drugs, and records and procedures; and (c). The Director of Pharmacy or his or her designee shall administer the education and training required in subsection (b) of this section. Removal of any drug from the pharmacy by an authorized nurse shall be recorded on a suitable form showing the patient's name, room number, name of the drug, strength, amount, date, time and the signature of the nurse. The form shall be left with the container from which the drug was removed. Investigational drugs shall be stored in and dispensed from the pharmacy only by a pharmacist. All information with respect to investigational drugs shall be maintained in the pharmacy.

The label of a single-unit package of an individual-dose shall include: I. Identification of the repackager by name II. The generic, chemical, or brand name of the drug III. The lot number and expiration date

Answer: (d) All, [D.C. Official Code Title 22, Chapter 19 Section 1921.29]. The label of a single-unit package of an individual-dose or unit-dose system of packaging of drugs shall include: (1). The generic, chemical, or brand name of the drug; (2). The route of administration, if other than oral; (3). The strength and volume, where appropriate, (4). The control number or lot number, and expiration date; (5). Identification of the repackager by name or by license number and shall be clearly distinguishable from the rest of the label; and (6). Special storage conditions, if required. (b). When a multiple-dose drug distribution system (i.e. blister cards) is utilized, including dispensing of single unit packages, the drugs shall be dispensed in a container to which is affixed a label containing the following information: (1). Identification of the dispensing pharmacy; (2). The patient's name; (3). The date of dispensing; (4). The generic, chemical, or brand name of the drug dispensed; and (5). The drug strength. All drugs dispensed to inpatients for self-administration, and all drugs dispensed to ambulatory or outpatients, shall contain a label affixed to the container indicating: (a). The name and address of the pharmacy dispensing the drug; (b). The name of the patient for whom the drug is prescribed; or, if the patient is an animal, the name of the owner, name of the animal, and the species of the animal; (c). The name of the prescribing practitioner; (d). Such directions as may be stated on the prescription drug order; (e). The date of dispensing; (f). Any cautions which may be required by federal or District of Columbia law, (g). The serial number or prescription number of the prescription drug order; (h). The name or initials of the dispensing pharmacist; (i). The generic, chemical, or brand name of the drug dispensed; (j). The strength, dosage, and quantity of the drug dispensed; (k). The name of the manufacturer or distributor of the drug; and (l). The expiration date.

Prior authorization from the D.C. Medicaid program shall be required for the dispensing of which of the following drugs to D.C. Medicaid ambulatory care patients? ************* I. Percodan II. Percocet III. Dalmane

Answer: (d) All, [D.C. Official Code Title 29, Chapter 9 Section 914.1]. Prior authorization from the D.C. Medicaid program shall be required for the dispensing of the following prescribed drugs to D.C. Medicaid ambulatory care patients: (a). Oxycodone HCl and Aspirin (more commonly known as Percodan); (b). Flurazepam (more commonly known as Dalmane); and (c). Oxycodone and Acetaminophen (more commonly known as Percocet and Tylox).

A registered pharmacy technician shall not provide services related to: I. Therapy modification II. Receiving a new prescription drug order over the telephone III. Clinical conflict resolution

Answer: (d) All, [DCMR Title 17 Chapter 99 Section 9910.3]. A registered pharmacy technician shall not provide the following services: (a). Drug regimen review; (b). Clinical conflict resolution; (c). Prescriber contact, except for receiving authorization of prescription refills; (d). Therapy modification; (e). Patient counseling; (f). Dispensing process validation; (g). Vaccination or immunization administration; (h). Receiving a new prescription drug order over the telephone; (i). Any activity required by law or regulation to be performed only by a pharmacist; or (j). Any activity for which professional pharmaceutical judgment is required.

Which of the following shall be transmitted along with the prescription information to the recipient pharmacy when the prescription is sent by a practitioner using an electronic transmission? I. The National Council on Prescription Drug Programs (NCPDP) pharmacy number of the pharmacy to which the prescription was transmitted. II. The date the prescription was transmitted to the pharmacy, if the date is different from the date of issuance of the prescription. III. If transmitted by the prescriber's designated agent, the full name of the designated agent. a. I only b. I and II only c. II and III only d. All

Answer: (d) All, [DCMR Title 22 Chapter 13-1304.8(b)(1),(2),(3)]. According to Washington DC State Pharmacy Law, along with the electronic prescription order, the following information shall be transmitted: (1). The National Council on Prescription Drug Programs (NCPDP) pharmacy number of the pharmacy to which the prescription was transmitted; (2). The date the prescription was transmitted to the pharmacy, if the date is different from the date of issuance of the prescription; and (3). If transmitted by the prescriber's designated agent, the full name of the designated agent. In addition to conforming to all applicable federal and District requirements, an electronic prescription order shall conform to federally recognized national transmission standards and contain the following information at the time it is transmitted: (a). A prescription bearing the following information: (1). The full name, address, and telephone number of the practitioner; (2). The electronic signature of the practitioner; (3). The date of issuance; (4). The full name and address of the patient; and (5). The name and dosage of the drug, directions for use, quantity dispensed, and number of refills, when applicable.

The dispensing label requirement for Xanax, for administration to an ultimate user who is institutionalized, shall be waived if the following conditions are met: I. Not more than a thirty-day supply of Xanax or one hundred (100) dosage units of Xanax, whichever is less, shall be dispensed at one time. II. Xanax shall not be in the possession of the ultimate user before administration. III. The institution maintains appropriate safeguards and records the proper administration, control, dispensing, and storage of Xanax. a. I only b. I and II only c. II and III only d. All

Answer: (d) All, [DCMR Title 22 Chapter 13-1312.2]. The dispensing label requirement for Schedule III or IV controlled substances, for administration to an ultimate user who is institutionalized, shall be waived if the following conditions are met: (a). Not more than a thirty-day supply or one hundred (100) dosage units, whichever is less, of the controlled substance listed in Schedule III, IV or V is dispensed at one time; (b). The controlled substance listed in Schedule III, IV or V is not in the possession of the ultimate user before administration; (c). The institution maintains appropriate safeguards and records the proper administration, control, dispensing, and storage of the controlled substance listed in Schedule III, IV or V; and (d). The system employed by the pharmacist in filling a prescription is adequate to identify the supplier, the product, and the patient, and to set forth the directions for use and cautionary statements, if any, contained in the prescription or required by law.

What are the requirements to be qualified as a *nuclear pharmacist* in the District of Columbia? I. A pharmacist shall submit proof, acceptable to the Board, that the individual has completed a minimum of two hundred (200) contact hours of didactic instruction in nuclear pharmacy and the safe handling and the use of radioactive material. II. A pharmacist shall submit proof, acceptable to the Board, that the individual has completed a minimum of five hundred (500) hours of supervised clinical nuclear pharmacy training under the supervision of a qualified nuclear pharmacist. III. A pharmacist shall have met the Nuclear Regulatory Commission standards of training for medically used or radioactive by-product material.

Answer: (d) All, [DCMR Title 22 Chapter 19 Section1922.3]. A qualified nuclear pharmacist shall: (a). Be a currently licensed pharmacist in the District of Columbia; (b). Have met the Nuclear Regulatory Commission standards of training for medically used or radioactive by-product material; and (c). Be currently certified as a nuclear pharmacist by a certification board recognized by the Board; or in lieu of certification: (1). Submit proof, acceptable to the Board, that the individual has completed a minimum of two hundred (200) contact hours of didactic instruction in nuclear pharmacy and the safe handling and the use of radioactive material from a program recognized by the Board; and (2). Submit proof, acceptable to the Board, that the individual has completed a minimum of five hundred (500) hours of supervised clinical nuclear pharmacy training under the supervision of a qualified nuclear pharmacist in a nuclear pharmacy providing nuclear pharmacy services or in a structured clinical nuclear pharmacy training program in an approved school of pharmacy.

Which of the following should be part of a patient's counseling? I. The name and description of the drug. II. Techniques for self-monitoring of therapy. III. Action to be taken in the event of a missed dose.

Answer: (d) All, [DCMR Title 22 Chapter 19 Sections 1919.3 and 1919.6]. To optimize drug therapy, a pharmacist shall counsel the patient or patient's agent regarding: 1. the name and description of the drug or device. 2. dosage form, dosage, route of administration, and duration of drug therapy. 3. special direction and precautions for preparation, administration, and use by the patient. 4. common severe side or adverse effects or interactions and therapeutic contraindications that may occur with the therapy. 5. techniques for self-monitoring of drug therapy. 6. proper storage of medication. 7. refill information. 8. action to be taken in the event of a missed dose. 9. pharmacist comments relevant to the individual's drug therapy, including any other information peculiar to the specific patient, drug, or device.

Under D.C. State Pharmacy Law, which of the following items shall NOT be required to post conspicuously in the vicinity of the pharmacy practice area? ********** a. Pharmacy license b. Professional licenses of pharmacists on duty c. Certificate of Occupancy Permit d. Certificates of registration of pharmacy technicians

Answer: (d) Certificates of registration of pharmacy technicians, [D.C. Official Code Title 22, Chapter 19 Section 1901.3]. The following items shall be posted conspicuously in the vicinity of the pharmacy practice area: (a). Certificate of Occupancy Permit (where applicable); (b). Pharmacy license; (c). Federal and District of Columbia Controlled Substances Registrations; (d). Professional licenses of pharmacists on duty; (e). Certificates of registration of pharmacy interns; and (f). The hours that the pharmacy is open for business.

In District of Columbia, a pharmacist should not dispense any schedule II controlled drug if the prescription is presented: a. More than 180 days after the date of issuance. b. More than 90 days after the date of issuance. c. More than 365 days after the date of issuance. d. More than 30 days after the date of issuance.

Answer: (d) More than 30 days after the date of issuance, [DCMR Title 22 Chapter 13-1306.2] According to Washington DC State Pharmacy Law, a prescription for a controlled substance listed in Schedule II shall not be filled if submitted more than thirty (30) days after the date on which the prescription was issued. A prescription for a controlled substance listed in Schedule III or IV may not be filled or refilled more than six (6) months after the date on which the prescription was issued. A pharmacist may fill a prescription for a controlled substance listed in Schedule II that was submitted to the pharmacy more than thirty (30) days after the date on which it was written, if it is clear on the face of the prescription that the individual practitioner issued multiple prescriptions authorizing the patient to receive a total of up to a ninety (90)-day supply of the Schedule II controlled substance and: (i). Each separate prescription was issued for a legitimate medical purpose by an individual practitioner acting in the usual course of professional practice; (ii). The individual practitioner provided written instructions on each prescription (other than the first prescription, if the prescribing practitioner intends for that prescription to be filled immediately) indicating the earliest date on which a pharmacy may fill each prescription; and (iii). The prescription is presented to the pharmacy for filling not more than ninety (90) days after the date on which the prescription was written.

AJ came to your pharmacy and said that he could only pay for 10 tablets of Hydrocodone. The remaining he would collect next week. The pharmacist may tell him: a. Okay, but call us before you come. b. We cannot dispense this prescription. c. You have to pay us in advance for the whole supply. d. No, you cannot do that.

Answer: (d) No - you cannot do that, [DCMR Title 22 Chapter 13 Section 1307.2]. The partial filling of a prescription for a controlled substance listed in Schedule II is permissible, *if the pharmacist is unable to supply the full quantity* for a written or emergency oral prescription and he or she makes a notation of the quantity supplied on the face of the written prescription (or written record of the emergency oral prescription). The remaining portion of the prescription may be filled within seventy-two (72) hours of the partial filling, however, if the remaining portion is not or cannot be filled within the seventy-two (72) hour period, the pharmacist shall so notify the prescribing individual practitioner. No further quantity may be supplied beyond seventy-two (72) hours without a new prescription.

The laminar air flow hood shall be certified: a. Weekly b. Biweekly c. Quarterly d. Annually

Answer: (d) The laminar air flow hood shall be certified *annually* in accordance with Federal Standard 209(b). *Certification records shall be retained for a minimum of (5) years*, [DCMR Title 22 Chapter 19 Section 1921.32].

Burglaries and damage to a pharmacy or its contents by fire, flood, or other causes shall be reported immediately to the District of Columbia State Pharmacy Board. a. True b. False

Answer: *(b) False* [D.C. Code Title 47-2885.09(d)]. Burglaries and damage to a pharmacy or its contents by fire, flood, or other causes shall be reported immediately to the *Mayor of the District of Columbia* Neither drugs nor other merchandise shall be dispensed, sold, held for sale, or given away in any pharmacy damaged by fire, flood, or other causes until the Mayor has determined that the merchandise is not adulterated or otherwise unfit for sale, use, or consumption. Damaged premises shall be inspected by the Mayor to determine their continued suitability for pharmacy operations. Conflict Information D.C. Code Title 22 Chapter 19 Section 1901.8: Burglaries, thefts, suspected diversions, significant losses of drug inventory or the inability to account for such inventory, and damage to a pharmacy or its inventory by fire, flood, or other causes shall be reported by the licensee or agent of the licensee to the Director within forty-eight (48) hours after discovery.

The partial filling of Dilaudid for terminally ill patients must be done within 72 hours from the initial filling. a. True b. False

Answer: *(b) False* [DCMR Title 22 Chapter 13 1307.1, 1307.2 and 1307.3]. A Prescription for *Schedule II* controlled substance for a patient in a *Long Term Care Facility (LTCF)* or for a patient with a medical diagnosis documenting a *terminal illness* may be filled in partial quantities to include individual dosage units and in accordance with federal law. If there is any question whether a patient may be classified as having a terminal illness, the pharmacist must contact the practitioner prior to partially filling the prescription. The pharmacist shall also observe the following: (a). Both the pharmacist and the prescribing practitioner have a corresponding responsibility to assure that the controlled substance is for a terminally ill patient; (b). The pharmacist must *record on the prescription* whether the patient is "terminally ill" or an "LTCF patient"; (c). A prescription that is partially filled and does not contain the notation "terminally ill" or "LTCF patient" shall be deemed to have been filled in violation of the federal and District law; (d). For *each* partial filling, the dispensing pharmacist shall *record on the back of the prescription* (or on another appropriate record, uniformly maintained, and readily retrievable) the *date* of the partial filling, *quantity dispensed*, *remaining quantity* authorized to be dispensed, and the *identification of the dispensing pharmacist* (e). The total quantity of Schedule II controlled substances dispensed in all partial fillings must not exceed the total quantity prescribed; and (f). Schedule II prescriptions for patients in a LTCF or patients with a medical diagnosis documenting a terminal illness shall be valid for a period not to exceed *sixty (60) days* from the issue date unless sooner terminated by the discontinuance of medication.

Who shall be responsible for publishing a formulary of drug products? a. Director of Pharmacy Board b. P and T Committee c. Department of Human Services d. Mayor of the State

Answer: *(c) Department of Human Services* [D.C. Code Title 48-803.01]. The Department of Human Services shall publish a formulary of drug products, with the chemical or generic name of each, that are determined to be therapeutically equivalent to specified brand name drug products. The Department shall determine the contents of the formulary only after recommendations are made by a committee of *9 members* appointed by the Director of that Department. The committee shall consist of *one licensed physician* and *one licensed pharmacist employed by the Department*, *2 licensed physicians* and *3 licensed pharmacists in private practice* in the District, and *2 pharmacologists on the faculty of a university in the District.* The recommendations of the committee shall require concurrence of a majority of the members of the committee. The committee's recommendations shall be published in the District of Columbia Register as proposed regulations of the Department. The committee shall review the published formulary annually, or whenever an amendment to it appears necessary.

The sale-related information of which of the following shall be included in a *bound volume*? I. Hypodermic syringes II. Diluents such as lactose III. Gelatin capsules a. I only b. I and II only c. II and III only d. All

Answer: *(d) All* [DCMR Title 22 Chapter 19-1913.10 and D.C. Code 47-2885.15(2)]. There shall be maintained a *bound volume* recording the information required by law or regulation concerning the over-the-counter sales of those drugs that are listed in *Schedule V*. There shall also be maintained a bound volume in which shall be entered similar information concerning each sale of: (A). *Hypodermic syringes, needles,* or other medical devices that may be *used in the administration of controlled substances;* (B). *Gelatin capsules* and glassine envelopes in quantities sufficient to indicate an intention to use such items in the distribution of controlled substances; and (C). *Diluents or adulterants*, such as *lactose or quinine*, in quantities sufficient to indicate an intention to use such substances for the illegal distribution or dispensing of any controlled substance. The *records required to be maintained* by this section shall be available for inspection by the Mayor/Director during regular business hours.

Who may appoint the members of the Washington D.C. State Pharmacy Board? a. Director of Pharmacy Board b. Governor c. Mayor d. Healthcare administer of the state

C. Mayor Answer: (c) Mayor, [D.C. Code Title 3 SUBCHAPTER XIII Section-1202.08]. (a). There is an established Board of Pharmacy that consists of 7 members appointed by the Mayor.(b). The Board shall regulate the practice of pharmacy.(c). Of the members of the Board, 5 shall be pharmacists licensed in the District and 2 shall be consumer members.(d). Except as provided in subsection (e) of this section, members of the Board shall be appointed for terms of 3 years.(e). Of the members initially appointed under this section, 2 shall be appointed for a term of 1 year, 2 shall be appointed for a term of 2 years, and 3 shall be appointed for a term of 3 years.

All of the following are Schedule I controlled drugs EXCEPT: a. Heroin b. Mescaline c. Hydromorphone d. Difenoxin

Hydromorphone is a Schedule II controlled drug, [D.C. Code Title 48-902.06]. List of Schedule I controlled drugs: ----------------------------------------------------------- Difenoxin (Lyspafen) Dihydromorphine Heroin (Diacetylmorphine, diamorphine) Lysergic acid diethylamide (LSD, lysergide) Mescaline Peyote