Quiz 1

c. ii & iii only A caregiver must: 1. Not be a qualified physician and not be employed by or have an economic interest in a medical marijuana treatment center or a marijuana testing laboratory. 2. Be 21 years of age or older and a resident of this state. 3. Agree in writing to assist with the qualified patient's medical use of marijuana. 4. Be registered in the medical marijuana use registry as a caregiver for no more than one qualified patient, except as provided in this paragraph. 5. Successfully complete a caregiver certification course developed and administered by the department or its designee, which must be renewed biennially. The price of the course may not exceed $100. 6. Pass a background screening pursuant to subsection (9), unless the patient is a close relative of the caregiver. A qualified patient may designate no more than one caregiver to assist with the qualified patient's medical use of marijuana, unless: 1. The qualified patient is a minor and the designated caregivers are parents or legal guardians of the qualified patient; 2. The qualified patient is an adult who has an intellectual or developmental disability that prevents the patient from being able to protect or care for himself or herself without assistance or supervision and the designated caregivers are the parents or legal guardians of the qualified patient; 3. The qualified patient is admitted to a hospice program; or 4. The qualified patient is participating in a research program in a teaching nursing home. A caregiver may be registered in the medical marijuana use registry as a designated caregiver for no more than one qualified patient, unless: 1. The caregiver is a parent or legal guardian of more than one minor who is a qualified patient; 2. The caregiver is a parent or legal guardian of more than one adult who is a qualified patient and who has an intellectual or developmental disability that prevents the patient from being able to protect or care for himself or herself without assistance or supervision; 3. All qualified patients the caregiver has agreed to assist are admitted to a hospice program and have requested the assistance of that caregiver with the medical use of marijuana; the caregiver is an employee of the hospice; and the caregiver provides personal care or other services directly to clients of the hospice in the scope of that employment; or 4. All qualified patients the caregiver has agreed to assist are participating in a research program in a teaching nursing home.

A caregiver on the medical marijuana use registry must: i. be 18 years of age or older and a resident of this state. ii. agree in writing to assist with the qualified patient's medical use of marijuana. iii. be registered in the medical marijuana use registry as a caregiver for no more than one qualified patient a. i only b. i & ii only c. ii & iii only d. all

d. All The term "originating pharmacy" means a pharmacy wherein the Rx which will be filled by the central fill pharmacy is initially presented The term "central fill pharmacy" means a pharmacy which performs centralized Rx filling, delivering, and returning for one or more originating pharmacies Rxs may be transmitted electronically from an originating pharmacy to a central fill pharmacy including via facsimile. The originating pharmacy transmitting the prescription information must maintain the original prescription for a period of four (4) years from the date the prescription was last filled. Every inventory or record required by this chapter, including prescription records, shall be maintained: (a). Separately from all other records of the registrant, or (b). Alternatively, in the case of C III, IV, or V controlled substances, in such form that information it is readily retrievable from the ordinary business records of the registrant. In either case, the records described in this subsection shall be kept and made available for a period of at least 2 years for inspection and copying by law enforcement officers whose duty it is to enforce the CS laws. The central fill pharmacy receiving the transmitted prescription must: 1. Keep a copy of the prescription if sent via facsimile, or an electronic record of all the information transmitted by the originating pharmacy, including the name, address, and DEA registration number, if a controlled substance, of the originating pharmacy transmitting the prescription. 2. Keep a record of the date of receipt of the transmitted prescription, the name of the licensed pharmacist filling the prescription, and dates of filling or refilling of the prescription. 3. Keep a record of the date the filled prescription was delivered to the originating pharmacy and the method of delivery (private, common or contract carrier). 4. A central fill pharmacy's pharmacist filling a written or emergency oral prescription for a controlled substance listed in Schedule II shall affix to the package a label showing: a). the date of filling, b). the originating pharmacy's name and address, c). a unique identifier (i.e. the central fill pharmacy's DEA registration number) indicating the prescription was filled at the central fill pharmacy, d). the serial number of the prescription, e). the name of the patient, the name of the prescribing practitioner, and directions for use and cautionary statements, if any, contained in such prescription or required by law. *Central fill pharmacies shall not be authorized to prepare prescriptions for a CII upon receiving an oral authorization from a retail pharmacist or an individual practitioner.*

A central fill pharm's pharmD filling a written or emergency oral Rx for a CII shall affix to the package a label showing: i. originating pharm name and address ii. name of Rxing practitioner iii. central fill pharm DEA registration # a. i only b. i & ii only c. ii & iii only d. All

d. All (1). Digitoxin. (2). Conjugated Estrogen. (3). Dicumarol. (4). Chlorpromazine/ thorazine (Solid Oral Dosage Forms). (5). Theophylline/ Uniphyl (Controlled Release). (6). Pancrelipase/ Creon, Zenpep (Oral Dosage Forms). -Substitution by a dispensing pharmacist of Rx written for any brand name equivalent of a generic named drug product listed is strictly prohibited. -If an Rx is written for a drug listed on the negative drug formulary but a brand name equivalent is not specified by the prescriber, the drug dispensed must be one obtained from a manufacturer or distributor holding an approved new drug application or abbreviated new drug application issued by the FDA, US DOH and Welfare permitting that manufacturer or distributor to market those medicinal drugs or when the former is non-applicable, those manufacturers or distributors supplying such medicinal drugs must show compliance with other applicable FDA marketing requirements.

According to FL Law, which is included in a negative drug formulary? i. Theophylline (Controlled Release) ii. Conjugated estrogen iii. Dicumarol a. i only b. i & ii only c. ii & iii only d. All

c. Methylphenidate List of CI controlled drugs: Difenoxin(Lyspafen) DihydromorphineHeroin (Diacetylmorphine, diamorphine) Lysergic acid diethylamide (LSD, lysergide) Marijuana (Cannabis, marijuana) Mescaline Peyote

All of the following are CI EXCEPT: a. Heroin b. LSD c. Methylphenidate d. Marijuana

a. 2h

Before being approved as a Marijuana qualified physician a physician must successfully complete a _________ course and subsequent examination offered by the Florida Medical Association or the Florida Osteopathic Medical Association. a. 2h b. 4h c. 6h d. 8h

a. 30h within 24 month period to the exp date of license. -Upon a licensee's first renewal of licensure, the licensee must document the completion of one (1) hour of board-approved CE which includes the topics of: --HIV/AIDS --current Florida law on AIDS and its impact on testing, confidentiality of test results, and treatment of patients. --the modes of transmission, including transmission from a healthcare worker to a patient and the patient to the healthcare worker. --infection control procedures, including universal precautions. --epidemiology of the disease; related infections including tuberculosis (TB). --clinical management; prevention -In order to meet this requirement, licensees must demonstrate that the course includes information on the State of Florida law on HIV/AIDS and its impact on testing, reporting, the offering of HIV testing to pregnant women, and partner notification issues. Any HIV/AIDS CE course taken during the second or subsequent renewal of licensure may be applied to satisfy the general CE hours requirement. -The initial renewal of a pharmacist license will not require completion of courses of CE hours if the license was issued less than 12 months prior to the expiration date of the license. -If the initial renewal occurs 12 months or more after the initial licensure, then 15 hours of CE hours shall be completed prior to the renewal of the license but no earlier than the date of initial licensure. -Prior to renewal a licensee must complete, within the 24 month period prior to the expiration date of the license, a 2h CE course approved in advance by the BOP or the Accreditation Council for Pharmacy Education (ACPE) on medication errors that covers the study of: root-cause analysis, error reduction and prevention, and. patient safety. -Hours obtained pursuant to this section may be applied by the licensee to the requirements of subsection (1). -Five hours of CE in the subject area of risk management may be obtained by attending one full day or eight (8) hours of a board meeting at which disciplinary hearings are conducted by the Board of Pharmacy in compliance with the following: --1. The licensee must sign in with the Executive Director or designee of the Board before the meeting day begins. --2. The licensee must remain in continuous attendance. --3. The licensee cannot receive continuing education credit for attendance at a board meeting if required to appear before the board; and --4. The maximum continuing education hours allowable per biennium under this paragraph shall be ten (10). -Up to five hours per biennium of CE credit may be fulfilled by the performance of volunteer services to the indigent or to underserved populations, or in areas of critical need within the state where the licensee practices. -One hour credit shall be given for each two hours volunteered in the 24 months prior to the expiration date of the license. -CE credit shall be granted for completion of post-professional degree programs provided by accredited colleges or schools of pharmacy. -Credit shall be awarded at the rate of 5 hours of CE credit per semester hour completed within the 24 months prior to the expiration date of the license. -Any volunteer expert witness who is providing expert witness opinions for cases being reviewed by the DOH shall receive five (5) hours of credit in the area of risk management for each case reviewed in the 24 months prior to the expiration date of the license, up to a maximum of ten (10) hours per biennium. -The presenter of a live seminar, a live video teleconference or through an interactive computer-based application shall receive 1 credit for each course credit hour presented, however presenter will not receive additional credit for multiple same course presentations. -At least ten (10) of the required 30 hours must be obtained either at a live seminar, a live video teleconference, or through an interactive computer-based application.

How many hours of CE are required for pharmD under FL law? a. 30h b. 15h c. 20h d. 22h

d. None of the above Under no circumstances may prescription drugs, pharmaceuticals or devices which bear upon the container an expiration or beyond use date which has been reached be sold or dispensed to the public. Accordingly, all outdated, damaged, deteriorated, misbranded, or adulterated prescription drugs and pharmaceuticals shall be removed or quarantined from active stock.

How often shall a pharmD examine the stock of Rxs department of each pharm for deteriorated or expired pharmaceuticals? a. Monthly b. Biweekly c. Quarterly d. None of the above

c. ii & iii only

If the Rx is written for an animal, which of the following shall be required on the Rx.? i. name of animal ii. species of animal iii. full name and address of owner a. i only b. i & ii only c. ii & iii only d. All

c. 365d aka 1 year 1. No prescription may be filled or refilled in excess of one (1) year from the date of the original prescription was written. 2. No prescription for a controlled substance listed in CII may be refilled. 3. No prescription for a controlled substance listed in CIII, IV, or V may be filled or refilled more than five (5) times within a period of six (6) months after the date on which the prescription was written. Also, all prescription records shall be kept and made available for a period of at least 2 years for inspection and copying by law enforcement officers.

In FL, PharmD should not dispense any med/device if the Rx is presented more than ___ after the date of issuance a. 180d b. 90d c. 365d d. 30d

b. 2 years -Inventory may be prepared on the regular physical inventory date which is nearest to and does not vary by more than 6 months from the biennial date -Record of CS shall in each case show: date of receipt, name and address of the person from who received, kind and quantity of CS. -Record of all CS sold, admin, disp, or disposed shows: date of selling, admin, disp, correct name, and address of pt or pet owner, the kind and quantity of CS sold, admin, disp. - Every inventory or record req including Rx records shall be maintained: separately from all other records of the registrant or in the case of CIII, IV, V in such form that info req is readily retrievable from the ordinary business records of the registrant -either case, records shall be kept and made available for a period of at least 2 years for inspection and copying by law enforcement officers whose duty is to enforce the laws of this state relating to CS.

In Fl, the inventory of CS should be done every: a. year b. 2 years c. 3 years d. 5 years

False "BRAND MEDICALLY NECESSARY" in own handwriting (Stamping is NOT Allowed) -For verbal Rx, Rxer will let PharmD know -For electronic, Rxer will put it in note Any pharmacist who substitutes: -any drug shall notify the person presenting the prescription of such substitution, together with the existence and amount of the retail price difference between the brand name drug and the drug substituted for it, and shall inform the person presenting the prescription that such person may refuse the substitution. -a less expensive drug product shall pass on to the consumer the full amount of the savings realized by such substitution. -in accordance with an institutional formulary for the resident of a nursing home facility if the prescriber has agreed to the use of such institutional formulary for the patient. PharmD may not therapeutically substitute a medicinal drug pursuant to the facility's institutional formulary if the prescriber indicates on the prescription "NO THERAPEUTIC SUBSTITUTION" or overtly indicates that therapeutic substitution is prohibited.

T/F A Rx stamped with red color ink indicating "BRAND MEDICALLY NECESSARY" SHALL NOT be submitted by a dispensing PharmD.

True A medical marijuana treatment center may engage in Internet advertising and marketing under the following conditions: a. All advertisements must be approved by the department. b. An advertisement may not have any content that specifically targets individuals under the age of 18, including cartoon characters or similar images. c. An advertisement may not be an unsolicited pop-up advertisement. d. Opt-in marketing must include an easy and permanent opt-out feature.

T/F A medical marijuana tx center may engage in internet advertising and marketing.

True

T/F A qualified physician may NOT issue a physician certification for marijuana in a form for smoking to a patient under 18 years of age unless the patient is diagnosed with a terminal condition, the qualified physician determines that smoking is the most effective route of administration for the patient, and a second physician who is a board-certified pediatrician concurs with such determination.

True The course content shall include the following: (a). Ensuring access to controlled substances for all patients with a valid prescription. (b). Use of the Prescription Drug Monitoring Program's Database. (c). Assessment of prescriptions for appropriate therapeutic value. (d). Detection of prescriptions not based on a legitimate medical purpose. (e). The laws and rules related to the prescribing and dispensing of controlled substances. (f). Proper patient storage and disposal of controlled substances. (g). Protocols for addressing and resolving problems recognized during the drug utilization review to include but not limited to the following: 1. Drug/drug interactions. 2. Side effects; and 3. High dose/low dose guidelines(h). Education on the provision, Emergency treatment for suspected opioid overdoses and on the State Surgeon General's Statewide Standing Order for Naloxone for as long as the Order is valid and effective. (i). Pharmacist initiated counseling of patients with opioid prescriptions; and (j). Available treatment resources for opioid physical dependence, addiction, misuse, or abuse. All licensed pharmacists shall complete the required course during the biennium ending on September 30. A 2-hour course shall be taken every biennium thereafter. The course shall count towards the mandatory 30 hours of CE required for licensure renewal. All newly licensed pharmacists must complete the required course before the end of the first biennial renewal period. Every pharmacy permit holder shall maintain a computerized record of controlled substance prescriptions dispensed. A hard copy printout summary of such record, covering the previous 60 day period, shall be made available within 72 hours following a request for it by any law enforcement personnel entitled to request such summary which shall include information from which it is possible to determine the volume and identity of controlled substance medications being dispensed under the prescription of a specific prescriber, and the volume and identity of controlled substance medications being dispensed to a specific patient.

T/F All PharmD shall complete a BOP 2h CE course on the validation and counseling of Rx for CS and opioid under the FL Law.

False Under the inventory of the providing pharmacy and under supervision of pharmD (which does not have to be on-site)

T/F Medicinal meds stored in bulk or unit of use in an automated pharm system servicing a LTCF are considered to be the part of the inventory of that LTCF.

True *Emergency action effective March 19, 2020.* 1. A permit for an Institutional pharmacy may not be issued unless a licensed pharmacist is designated as the consultant pharmacist of record. 2. An application for a Special Assisted Living Facility pharmacy permit requires the supervising licensed pharmacist be designated as the consultant pharmacist of record. 3. Applications for Special Sterile Compounding Permits associated with an Institutional pharmacy require the pharmacist-in-charge be designated as the consultant pharmacist of record. 4. No later than ten (10) days after a change of designated consultant pharmacist for an Institutional, or Special Assisted Living Facility pharmacy, or a Special Sterile Compounding Permittee, both the pharmacy permittee and the newly designated consultant pharmacist of record shall notify the Board of the change and the identity of the newly designated consultant pharmacist. 5. All Institutional, Special Assisted Living Facility, and, if applicable, Special Sterile Compounding Pharmacy permittees shall continuously maintain a designated consultant pharmacist of record at all times the pharmacy is open and in operation. 6. The consultant pharmacist of record for a Class I, Class II, Modified Class II, or Class III Institutional permit shall conduct Drug Regimen Reviews as required by Federal or State law, inspect the facility and prepare a written report to be filed at the permitted facility at least monthly. 7. A consultant pharmacist licensed in Florida may remotely access a facility or pharmacy's electronic database from outside the facility or pharmacy to conduct any services additional or supplemental to regular drug regimen reviews, subject to the pharmacy or facility establishing policies and procedures to ensure the security and privacy of confidential patient records, including compliance with applicable Federal HIPAA regulations.

T/F: A consultant PharmD licensed in FL may remotely access a facility or pharmacy's electronic database from outside the facility or pharmacy to conduct any services additional or supplemental to regular drug regimen reviews.

True

T/F: A person whose license to practice pharmacy has been denied, suspended or restricted for disciplinary purposes is not eligible to register as a pharmacy technician.

True ...such as reasonable hours any pharmacy, hospital, clinic, wholesale est, mfr, physician office or any other place in the state in which meds/supplies are mfg, packed, packages, made, sold, stored, or kept for sale in the purpose of: -determining if any provision or any adopted rule is being violated -securing samples or specimens of any drug/supply after paying or offering to pay for such -securing other evidence as needed for prosecution.

T/F: According to FL law, duly authorized agents and employees of the DOH shall have the power to inspect in a lawful manner at any pharmacy.

True No permit shall be issued unless a duly licensed and qualified nuclear pharmacist is designated as being responsible for activities.

T/F: The nuclear pharmacy permittee shall notify the department within 10 days of any change of the licensed pharmD responsible for the compounding and dispensing of nuclear pharmaceuticals.

d. all The department shall create and maintain a secure, electronic, and online medical marijuana use registry for physicians, patients, and caregivers as provided under this section. The medical marijuana use registry must be accessible to law enforcement agencies, qualified physicians, and medical marijuana treatment centers to verify the authorization of a qualified patient or a caregiver to possess marijuana or a marijuana delivery device and record the marijuana or marijuana delivery device dispensed. The medical marijuana use registry must also be accessible to practitioners licensed to prescribe prescription drugs to ensure proper care for patients before medications that may interact with the medical use of marijuana are prescribed. The medical marijuana use registry must prevent an active registration of a qualified patient by multiple physicians.

The medical marijuana use registry must be accessible to: i. law enforcement agencies. ii. qualified physicians. iii. medical marijuana treatment centers. a. i only b. i & ii only c. ii & iii only d. all

d. all Generally, FDA will continue to defer to state authorities regarding less significant violations of the Act related to pharmacy compounding of human drugs. FDA anticipates that, in such cases, cooperative efforts between the states and the Agency will result in coordinated investigations, referrals, and follow-up actions by the states. However, when the scope and nature of a pharmacy's activities raise the kinds of concerns normally associated with a drug manufacturer and result in significant violations of the new drug, adulteration, or misbranding provisions of the Act, FDA has determined that it should seriously consider enforcement action. In determining whether to initiate such an action, the Agency will consider whether the pharmacy engages in any of the following acts: 1. Compounding of drugs in anticipation of receiving prescriptions, except in very limited quantities in relation to the amounts of drugs compounded after receiving valid prescriptions. Compounding very large quantities of particular drug before receiving valid prescriptions is considered as manufacturing. 2. Compounding drugs that were withdrawn or removed from the market for safety reasons. Appendix A provides a list of such drugs that will be updated in the future, as appropriate. 3. Compounding finished drugs from bulk active ingredients that are not components of FDA approved drugs without an FDA sanctioned investigational new drug application (IND) 4. Receiving, storing, or using drug substances without first obtaining written assurance from the supplier that each lot of the drug substance has been made in an FDA-registered facility. 5. Receiving, storing, or using drug components not guaranteed or otherwise determined to meet official compendia requirements. 6. Using commercial scale manufacturing or testing equipment for compounding drug products. 7. Compounding drugs for third parties who resell to individual patients or offering compounded drug products at wholesale to other state licensed persons or commercial entities for resale. 8. Compounding drug products that are commercially available in the marketplace or that are essentially copies of commercially available FDA-approved drug products. -In certain circumstances, it may be appropriate for a pharmacist to compound a small quantity of a drug that is only slightly different than an FDA-approved drug that is commercially available. -In these circumstances, FDA will consider whether there is documentation of the medical need for the particular variation of the compound for the particular patient. 9. Failing to operate in conformance with applicable state law regulating the practice of pharmacy.

The pharm engagement in which of the following acts may consider by the FDA the violation of the new drug, adulteration or misbranding provisions of the Act? i. Compounding very large quantities of particular drug before receiving valid prescriptions. ii. Compounding drug products that are commercially available in the marketplace. iii. Compounding drugs that were withdrawn or removed from the market for safety reasons. a. i only b. i & ii only c. ii & iii only d. all

c. 2 years IF: -FDA has determined that the substitute for the prescribed biological product is biosimilar to and interchangeable for the prescribed -Prescribing HC provider does not express preference against substitution in writing, verbally or electronically. -PharmD who practices in class II or Mod Class II institutional pharm shall comply with the notification provisions of paragraph by entering the substitution in the institution written or electronic medical record system -BOP shall maintain on its website a current list of biological products the FDA has determined to be biosimilar

The pharmacist who substitutes interchangeable biosimilar products shall retain a written or electronic record of the substitution for at least: a. 6mo b. 1 year c. 2 years d. 4 years

d. All 1. Appropriate environmental control devices capable of maintaining at least class 100 conditions in the work place where critical objects are exposed and critical activities are performed; furthermore, these devices must be capable of maintaining class 100 conditions during normal activity.Examples of appropriate devices include laminar airflow hoods and zonal laminar flow of high efficiency particulate air (HEPA) filtered air. 2. Appropriate disposal containers for used needles, syringes, and if applicable, for antineoplastic waste from the preparation of chemotherapy agents. 3. Appropriate environmental control including approved biohazard cabinetry when antineoplastic drug products are prepared. 4. Appropriate temperature and transport containers. 5. Infusion devices and equipment, if appropriate. The pharmacy shall maintain and use supplies adequate to preserve an environment suitable for the aseptic preparation of sterile preparations, such as: 1. Gloves, masks, shoe covers, head and facial hair covers, and non-shedding gowns. 2. Needles and syringes of various standard sizes. 3. Disinfectant cleaning agents. 4. Clean towels. 5. Hand washing materials with bactericidal properties. 6. Vacuum containers and various transfer sets. 7. "Spill kits" for antineoplastic agent spills.

The pharmacy compounding parenteral and sterile preps shall have? i. laminar airflow hoods ii. hand washing materials with bactericidal properties iii. zonal laminar flow of HEPA filter air a. i only b. i & ii only c. ii & iii only d. All

b. i & ii only i. and only when authorized by a licensed practitioner. A consultant pharmacist -may provide medication management services in a health care facility within the framework of a written collaborative practice agreement between the pharmacist and a health care facility medical director or a licensed physician, a licensed podiatric physician, or a licensed dentist who is authorized to prescribe medicinal drugs. -may only provide medication management services, conduct patient assessments, and order and evaluate laboratory or clinical testing for patients of the health care practitioner with whom the consultant pharmacist has a written collaborative practice agreement that outlines the circumstances underwhich a consultant pharm must 1. Order and evaluate any laboratory or clinical tests to promote and evaluate patient health and wellness, and monitor drug therapy and treatment outcomes. 2. Conduct patient assessments as appropriate to evaluate and monitor drug therapy. 3. Modify or discontinue medicinal drugs as outlined in the agreed upon patient-specific order or preapproved treatment protocol under the direction of a physician. However, a consultant pharmacist may not modify or discontinue medicinal drugs prescribed by a health care practitioner who does not have a written collaborative practice agreement with the consultant pharmacist. 4. Administer medicinal drugs. 5. This subsection does not authorize a consultant pharmacist to diagnose any disease or condition. ii. and 1 hour for recertification, and shall cover the following subjects: (a). Requirements for monitoring laboratory values, (b). Interpretation of laboratory values, (c). Use of laboratory data to monitor and improve drug therapy ,(d). Legal aspects, restrictions, and requirements for obtaining laboratory studies, (e). Use of laboratory data and therapeutic outcomes, (f). Documentation of interventions, and (g). Laboratory studies as an element of complete patient care.

Under FL Law, a consultant pharmD or doc of pharmacy may order or evaluate any lab or clinical test for a a person if: i. judgment of the consultant pharmacist or doctor of pharmacy, such activity is necessary for the proper performance of his or her responsibilities. ii. receives 3 hours of CE relating to laboratory and clinical testing as established by the BOP. iii. Such action shall not be permitted. a. i only b. i & ii only c. iii only d. All

d. All i. recognized by FL DOH & BOP- hrs include: -Radiation physics and instrumentation (85 hours). -Radiation protection (45 hours) -Mathematics pertaining to the use and measurement of radioactivity (20 hours). -Radiation biology (20 hours). -Radiopharmaceutical chemistry (30 hours). ii. training and experience with: -Ordering, receiving and unpackaging in a safe manner, radioactive material, including the performance of related radiation surveys. -Calibrating dose calibrators, scintillation detectors, and radiation monitoring equipment. -Calculating, preparing and verifying patient doses, including the proper use of radiation shields. -Following appropriate internal control procedures to prevent mislabeling. -Learning emergency procedures to safely handle and contain spilled materials, including related decontamination procedures and surveys. -Eluting technetium-99m from generator systems, assaying the eluate for technetium-99m and for molybdenum-99 contamination and processing the eluate with reagent kits to prepare technetium-99m labeled radiopharmaceuticals. -Clinical practice concepts.

What are requirement(s) to become a licensed nuclear pharmacist? i. Submit to the BOP a certificate of training which provides a min of 200 clock hours of formal didactic training. ii. The min on-the-job training which shall be included in a radiopharmacy internship is 500 hours of training and experience in the handling of unsealed radioactive material under the supervision of a licensed nuclear pharmacist. iii. If the didactic and experiential training required have not been completed within the last seven (7) years, the applicant must have been engaged in the lawful practice of nuclear pharmacy in another jurisdiction at least 1080 hours during the last seven (7) years. a. i only b. i & ii only c. ii & iii only d. All

c. ii & iii only and -name and address of such practitioner (not the pharm) -pt name or if CS for animal- statement describing the species of animal - clear, concise warning that it is a crime to transfer the CS to any person other than pt to whom Rxed.

When a CS is dispensed by a Rxing practitioner, which of the following shall be placed on the dispensing container? i. name and address of pharmacy ii. date of delivery iii. directions of use for CS a. i only b. i & ii only c. ii & iii only d. All

d. All Identification- all employees must be id-ed by means of badge or monogrammed smock showing their name and if they are pharmD, intern tech. Techs must also communicate they are techs during conversations via in person or on the phone.

Which is TRUE about displaying the current license of pharmD under FL law? i. Every pharmD, intern and tech must maintain proof of current licensure such that it is readily retrievable upon request by any representative of the DOH or BOP or public. ii. Pharm may display a notice easily accessible to the public that license or registrations of each employee is available for viewing upon request. iii. Pharm may display the license or registration of each pharm employee. a. i only b. i & ii only c. ii & iii only d. All

d. All -Any clerical or recordkeeping error, such as a typographical error, scrivener's error, or computer error regarding a document or record required under the Medicaid program does not constitute a willful violation and is not subject to criminal penalties without proof of intent to commit fraud. -A pharmacist may use the physician's record or other order for drugs or medicinal supplies written or transmitted by any means of communication for purposes of validating the pharmacy record with respect to orders or refills of a legend or narcotic drug. -A finding of an overpayment or underpayment must be based on the actual overpayment or underpayment and may not be a projection based on the number of patients served having a similar diagnosis or on the number of similar orders or refills for similar drugs. -Each pharmacy shall be audited under the same standards and parameters. -A pharmacist must be allowed at least 10 days in which to produce documentation to address any discrepancy found during an audit. -The period covered by an audit may not exceed 1 calendar year. -An audit may not be scheduled during the first 5 days of any month due to the high volume of prescriptions filled during that time. -The audit report must be delivered to the pharmacist within 90 days after conclusion of the audit. A final audit report shall be delivered to the pharmacist within 6 months after receipt of the preliminary audit report or final appeal, as provided for in subsection (2), whichever is later

Which is TRUE about the Medicaid Audit in FL? i. Agency conducting the audit give the pharmD at least 1 week's prior notice of the initial audit for each audit cycle. ii. Audit must be conducted by pharmD licensed in FL. iii. Audit may not be scheduled during first 5 days of any month. a. i only b. i & ii only c. ii & iii only d. All

d ii & iii only

Which is TRUE regarding FL pharm techs? i. may take a new verbal order from a licensed practitioner ii. for registration renewal, 20h of CE but be done biennially iii. may initiate or receive communication from a practitioner/agent on behalf of a pt, regarding refill authorization request. a. i only b. ii only c. iii only d. ii & iii only

d. All -After contacting the Rxer, pharmD add missing notation of date or quantity. May NOT change the date. -If Rxer not able to verify Rx, PharmD may dispese the CS but may insist the on pt providing valid photo-ID

Which is TRUE regarding writing a Rx for a CS listed in CII, CIII, or CIV? i. Must include both a written and numerical notation of the quantity of the CS prescribed on the face of the Rx. ii. Must include notation of the date in numerical, month/day/year format, or with the (abbreviated or in whole) month written out. iii. If a Rx includes a numerical notation of the quantity of a CS of date but does not include the quantity or date written out textual format, PharmD may dispense the CS without verification by the prescriber of the quantity or date if the pharm prev dispensed another Rx for the person to whom the Rx was written. a. i only b. i & ii only c. ii & iii only d. All

b. i & ii only iii. To qualify as a supervisor for an automated pharmacy system, the pharmacist need NOT be physically present at the site of the automated pharmacy system and may supervise the system electronically. The Legislature does not intend this section to limit the current practice of pharmacy in this state. This section is intended to allow automated pharmacy systems to enhance the ability of a pharmacist to provide pharmacy services in locations that do not employ a full-time pharmacist. This section does not limit or replace the use of a consultant pharmacist.

Which is/are TRUE ABOUT an automated pharmacy system in FL? i. The operation of an automated pharmacy system must be under the supervision of a FL-licensed PharmD. ii The FL-licensed PharmD shall be required to develop and implement p&p designed to verify that the medicinal drugs delivered by the automated dispensing system are accurate and valid and that the machine is properly restocked. iii. To qualify as a supervisor for an automated pharmacy system, the pharmacist must be physically present at the site of the automated pharmacy system. a. i only b. i & ii only c. ii & iii only d. all

a. i only In the event a pharmacist receives a request for a prescription refill and the pharmacist is unable to readily obtain refill authorization from the prescriber, the pharmacist may dispense: (a). A one-time emergency refill of up to a 72-hour supply of the prescribed medication; or (b). A one-time emergency refill of one vial of insulin to treat diabetes mellitus. If the Governor issues an emergency order or proclamation of a state of emergency, the pharmacist may dispense up to a 30-day supply in the areas or counties affected by the order or proclamation, provided that: (a). The prescription is not for a medicinal drug listed in C II (C III, IV and V are allowed). The medication is essential to the maintenance of life or to the continuation of therapy in a chronic condition. (c). In the pharmacist's professional judgment, the interruption of therapy might reasonably produce undesirable health consequences or may cause physical or mental discomfort. (d). The dispensing pharmacist creates a written order containing all of the prescription information required by this chapter and chapters 499 and 893 and signs that order. (e). The dispensing pharmacist notifies the prescriber of the emergency dispensing within a reasonable time (Not within 7-day time-limit) after such dispensing.

Which is/are TRUE about refilling a prescription med/device when the pharmacist fails to obtain authorization from the prescriber? i. If they think that it's required for continuation of therapy for chronic conditions. ii. The dispensing pharmacist notifies the prescriber of the emergency dispensing within 7 business days after such dispensing. iii. If the refill of the prescription is not for a CS. a. i only b. i & ii only c. ii & iii only d. All

d. all List of C IV controlled drugs: Tramadol (Ultram) Carisoprodol (Soma) 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) Propoxyphene (dosage forms) Diazepam (Valium, Valrelease) Dichloralphenazone (Midrin) Difenoxin 1 mg/ Atropine 25 mcg (Motofen) Estazolam (ProSom, Domnamid, Eurodin, Nuctalon) Ethchlorvynol (Placidyl) Fenfluramine (Pondimin, Ponderal) Flurazepam (Dalmane) 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) Quazepam (Doral, Dormalin) Sibutramine (Meridia) Temazepam (Restoril) Triazolam (Halcion) Zaleplon (Sonata) Zolpidem (Ambien) Zopiclone (Imovane) Eszopiclone (Lunesta)

Which of the followign are classified as CIV meds? i. oxazepam ii. zaleplon iii. butorphanol a. i only b. i & ii only c. ii & iii only d. all

c. 41 Destruction of Controlled Substances - Class I Institutional Pharmacies - Nursing Homes-- -CS that have been dispensed and not used by the patient shall not be returned to the pharmacy and shall be securely stored by the nursing home until destroyed. -for each CS destroyed, documentation must be completed showing the name and quantity of the drug, strength and dosage form, patient's name, prescription number and name of the institution. Destruction of the controlled substance shall be witnessed and signed by at least two (2) of the following individuals: (a) Consultant pharmacist. (b) Director of nursing (c) Facility administrator. (d) A licensed physician, mid-level practitioner, nurse, or another pharmacist employed by or under contract or written agreement with the facility, or( e) A sworn law enforcement officer. The consultant pharmacist shall be responsible for the creation and implementation of p&p to ensure that CS are disposed of in accordance with applicable state and federal laws and rules. Furthermore, the consultant pharmacist shall review all controlled substance destruction documentation monthly to ensure compliance with this rule and federal and state law. Destruction of Controlled Substances All Permittees -CS that cannot be retained as usable shall be securely stored in the prescription department of the permittee pharmacy until destroyed. -form 41: at the time of destruction, shall be witnessed and signed by the prescription department manager or the consultant pharmacist of record and D.E.A. agent, or a Department inspector. --copy sent to DEA office within area within 1 business day after destruction. Another method of destruction shall be conducted by at least two persons: One will be the PDM or the CPoR. The other will be one of the following: medical director or his/her physician designee, director of nursing or his/her licensed nurse designee, or a sworn law enforcement officer. --which serve as witnesses for the the form 41 instead of above: CS may also be shipped to reverse distributors for destruction in conformity with federal guidelines.

Which of the following DEA forms is required to destroy CS? a. 106 b. 222 c. 41 d. 82

c. ii & iii only List of C II controlled drugs: 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, tincture, granulated, powdered, raw Oxycodone (OxyContin, Percocet, Tylox, Roxicodone, Roxicet) Oxymorphone (Numorphan) Pentobarbital (Nembutal) Poppy Straw Concentrate Remifentanil (Ultiva) Secobarbital (Seconal, Tuinal) Sufentanil (Sufenta) Tapentadol (Nucynta)

Which of the following are classified as CII meds? i. heroin ii. morphine iii. pentobarbital a. i only b. i & ii only c. ii & iii only d. all

a. atenolol d. misoprostol (a). The drug meets the United States Food and Drug Administration's standards related to safety, effectiveness, misbranding, and adulteration; (b). Importing the drug would not violate federal patent laws; (c). Importing the drug is expected to generate cost savings; and (d). The drug is not: 1. A controlled substance; 2. A biological product; 3. An infused drug; 4. An intravenously injected drug; 5. A drug that is inhaled during surgery; or 6. A drug that is a parenteral drug, the importation of which is determined by the United States Secretary of Health and Human Services to pose a threat to the public health.

Which of the following meds can be imported by eligible importers (US) from eligible Canadian supplier? (select all that apply) a. atenolol b. Acetaminophen c. IV azithromycin d. misoprostol

a. epilepsy b. PTSD c. parkinson's dz "Qualified patient" means a resident of this state who has been added to the medical marijuana use registry by a qualified physician to receive marijuana or a marijuana delivery device for a medical use and who has a qualified patient identification card. "Qualified physician" means a person who holds an active, unrestricted license as an allopathic physician or as an osteopathic physician. (a). Cancer. (b). Epilepsy. (c). Glaucoma. (d). Positive status for HIV. (e). AIDS. (f). Posttraumatic stress disorder. (g). Amyotrophic lateral sclerosis. (h). Crohn's disease. (i). Parkinson's disease. (j). Multiple sclerosis. (k). Medical conditions of the same kind or class as or comparable to those enumerated in paragraphs (a)-(j). (l). A terminal condition diagnosed by a physician other than the qualified physician issuing the physician certification. (m). Chronic nonmalignant pain.

Which of the following qualifying medical conditions qualifies a pt to receive marijuana? (select all that apply) a. epilepsy b. PTSD c. parkinson's dz d. HTN

a. marijuana ... is classified as Schedule I controlled drug. It requires a DEA 222 order form for purchase

Which of the following require DEA 222 for purchase? a. marijuana b. pemoline c. modafinil d. clonazepam

c. all The department shall quantify by rule a daily dose amount with equivalent dose amounts for each allowable form of marijuana dispensed by a medical marijuana treatment center. The department shall use the daily dose amount to calculate a 70-day supply. 1. A qualified physician may request an exception to the daily dose amount limit, the 35-day supply limit of marijuana in a form for smoking, and the 4-ounce possession limit of marijuana in a form for smoking. The request shall be made electronically on a form adopted by the department in rule and must include, at a minimum: a. The qualified patient's qualifying medical condition. b. The dosage and route of administration that was insufficient to provide relief to the qualified patient. c. A description of how the patient will benefit from an increased amount.d. The minimum daily dose amount of marijuana that would be sufficient for the treatment of the qualified patient's qualifying medical condition. 2. A qualified physician must provide the qualified patient's records upon the request of the department. 3. The department shall approve or disapprove the request within 14 days after receipt of the complete documentation required by this paragraph. The request shall be deemed approved if the department fails to act within this time period. (g). A qualified physician must evaluate an existing qualified patient at least once every 30 weeks before issuing a new physician certification.

Which of the following statements are TRUE about issuing a physician cert to a pt for marijuana? i. A qualified physician may not issue a physician certification for more than three 70-day supply limits of marijuana. ii. A qualified physician may not issue a physician certification for more than six 35-day supply limits of marijuana in a form for smoking. iii. A qualified physician must evaluate an existing qualified patient at least once every 30 weeks before issuing a new physician certification. a. i only b. i & ii only c. all d. none of the above

b. Governor Governor shall appoint members to the board in accordance members' terms expire or as a vacancy occurs until the composition of the board complies. and confirmed by the Senate

Who appoints the members for the Florida State Board of Pharmacy? a. Director of Pharmacy Board b. Governor c. Drug inspector of the state d. healthcare admin of the state