Quimby2

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1) Do all Rx's need both dea and lic? For some reason i was thinking you only need dea for narcotics. what about rx strength motrin?

2) is my CA license good in MA?

3) can you phone in scripts for narcotics without a written script?

4) why does the pharmacist at my work not know the answers to any of these questions?
 

Apollyon

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Quimby2 said:
1) Do all Rx's need both dea and lic? For some reason i was thinking you only need dea for narcotics. what about rx strength motrin?

2) is my CA license good in MA?

3) can you phone in scripts for narcotics without a written script?

4) why does the pharmacist at my work not know the answers to any of these questions?
1. Depends on your state - the DEA discourages use of the DEA number as an identifier for anything but what it was meant for, but, if a state law says you have to use it, the more strict wins out.

2. No. Why would it be? Every locality (meaning all states, DC, Guam, the Virgin Islands, Puerto Rico, and American Samoa, and 2 more I'm forgetting) has their own licensure procedures, and you have to jump through each hoop.

3. Yes. However, for schedule II, a hard copy has to follow (I think within 7 days), and you cannot refill scheduled meds (on the phone or on paper).

4. I don't know - the pharmacists I've worked with (a BUNCH at Duke, at the Durham VA, in NYC - Elmhurst) all, to a person, knew all the intricacies in and out of all these questions (where do you think I got all these answers that relate to meds?)
 

southerndoc

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Apollyon said:
3. Yes. However, for schedule II, a hard copy has to follow (I think within 7 days), and you cannot refill scheduled meds (on the phone or on paper).
I think it's 72 hours.

There are also limitations on quantity (maximum 30-day supply) and refills (I believe the maximum is 3 at one time) for narcs.
 

kungfufishing

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southerndoc said:
Really? I thought I read that there was a maximum of 3. Either way, I never offer refills on narcs from the ED.

I never give more than 10 refills at a time for any given narcotic. Figure that they should come back in and get that toothache looked at if they've gone through that many Lortab.
 

bulgethetwine

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Apollyon said:
I thought there was no refill on narcs.
Maybe it's different state to state. I think Apollyon is correct for most of the southeastern states, anyway.
 

psychoandy

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Quimby2 said:
1) Do all Rx's need both dea and lic? For some reason i was thinking you only need dea for narcotics. what about rx strength motrin?

2) is my CA license good in MA?

3) can you phone in scripts for narcotics without a written script?

4) why does the pharmacist at my work not know the answers to any of these questions?
I'm a pharm intern in MA browsing around here...

1.) All we needed is DEA, even for something as lame as 600mg ibuprofen. Some pads had license numbers but I don't think it's mandatory.

2.) No idea, that's the only question i doubt a pharmacist would know

3.) Phone RX's are only in an emergency and they have to be followed up with a hard copy; normal SOP is usually fax the script, then give it to the pt, so that the percocets are all filled and all we need is the hard signed copy. BTW, federal law states that you cant give any refills for C-II narcs, and only 6 months for C-III.

4.) They probably expect you to know it, since you're the one with the dispensing power.
 

ZigZag

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When I was working as a pharmacy tech, we needed a dea number for any script in order to process it through insurance. So, until pharmacy has you registered in their system with the dea number it is not able to bill patient's insurance company for the script. At least that was the case 4 years ago.
 

12R34Y

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Our NPI (National provider identification) number will be replacing this in 2007. Required by law.

So from now on when you write for something like Bactrim all the pharm will require is your NPI for most scripts.

DEA will ONLY be for narcs

The law takes effect in like june of 2007.

I know everyone in our residency (all 3 years) has their NPI numbers.

later
 

ntubebate

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K, Lemme clear this up for you.

1) Do all Rx's need both dea and lic? For some reason i was thinking you only need dea for narcotics. what about rx strength motrin?

You were thinking correctly. Only controlled substances need your DEA number. In fact, the DEA encourages you to NOT have your DEA number printed on your non-controlled scripts to help prevent fraud.

2) is my CA license good in MA?
Sorry, nope. You must obtain a license to practice medicine in the STATE you are working in. Every state has a different medical board and you are bound by the rules in the particular state you are practicing in.

3) can you phone in scripts for narcotics without a written script?
Yes! CS V, CS IV & CS III can be called in w/o any problems. You can even provide up to five refills. CS II however can only be called in during an EMERGENCY. If you are calling in a CS II you must convince the pharmacist that there is no other theraputic option and you are limited to a seven day supply. Within three days following your emergency RX you must provide to the pharmacist a written copy of your prescription. You will also (in my experience) need to kiss their ass for taking a CS II call in.

4) why does the pharmacist at my work not know the answers to any of these questions?

Probably because you asked a pharmacist at an academic facility. Not saying that these guys are not as smart, simply saying they know different stuff than your typical retail pharmacists.

Just an FYI but your local DEA office should also be able to provide you with this sort of information. I've found them more than willing to educate me on why I shouldn't be prescribing controlled substances :rolleyes:

ntubebate
 

Squad51

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psychoandy said:
4.) They probably expect you to know it, since you're the one with the dispensing power.
Unless, of course, the pharmacist objects to the dispensation on moral grounds. Then they have the power. Can't have it both ways, i.e., we don't need to know the rules because we don't write the orders and we won't fill the order because we are too busy drinking the Kool-aid.

BTW - whoever defended academic pharmacists, oh please, please, try and tell an academic pharmacist there is something they don't know. From the MS-IV perspective all they do all day long is tell doctors how wrong they are...

:cool:
 

Apollyon

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ntubebate said:
1) Do all Rx's need both dea and lic? For some reason i was thinking you only need dea for narcotics. what about rx strength motrin?

You were thinking correctly. Only controlled substances need your DEA number. In fact, the DEA encourages you to NOT have your DEA number printed on your non-controlled scripts to help prevent fraud.
Once again, I will say it - even though it is NOT what it was meant for, some states require a DEA number on ALL Rx's. The DEA recommends against it, but, as I said, if the state law requires it, the state law wins out.
 

Apollyon

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Squad51 said:
BTW - whoever defended academic pharmacists, oh please, please, try and tell an academic pharmacist there is something they don't know. From the MS-IV perspective all they do all day long is tell doctors how wrong they are...
I have, and we have a collegial professional relationship. There were several at the facility I was a resident at that were difficult, but they were outnumbered about 4 to 1 by the ones that weren't (especially in the MICU, PICU, and our ED pharmacist - they are all people I would work with by choice, hands down, every day). There are about 80 pharmacists where I was at.

The PICU pharmacist is also a total sweetheart, and absolutely gorgeous.
 

southerndoc

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Squad51 said:
BTW - whoever defended academic pharmacists, oh please, please, try and tell an academic pharmacist there is something they don't know. From the MS-IV perspective all they do all day long is tell doctors how wrong they are...
One thing I've noticed is that physicians are intimidated by people who know about certain areas of medicine than they do. Pharmacists are experts in pharmacology. They know the nuances of pharmacodynamics and pharmacokinetics. They have caught many prescribing errors among our colleages, and they have caught prescribing errors I have made. Many know the pharmacology literature more than physicians, especially at hospitals where formularies are restricted and they must routinely defend to physicians why a particular drug is not available.

I view our pharmacists as a valuable resource. In fact, I do not hesitate to call them with prescribing questions or even questions requesting literature about certain prescribing situations, which antibiotic is best for a particular infection, etc.

Try not to become offended by their presence.
 

ntubebate

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Apollyon said:
Once again, I will say it - even though it is NOT what it was meant for, some states require a DEA number on ALL Rx's. The DEA recommends against it, but, as I said, if the state law requires it, the state law wins out.
Apollyon is totally right about that. Didn't mean to leave that part out. Should be obvious as my state requires this :cool:

ntubebate
 

Seaglass

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I second what SouthernDoc said - a good pharmacist kicks ass and is worth their weight in gold. BTW NC requires a DEA on all scripts, but this is not necessarily enforced.
 

Jeff698

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Squad51 said:
BTW - whoever defended academic pharmacists, oh please, please, try and tell an academic pharmacist there is something they don't know. From the MS-IV perspective all they do all day long is tell doctors how wrong they are...
From a physician's standpoint, I'm very glad to have our academic pharmacists working with us. I lost count of the number of times they bailed my intern butt out last year.

I have no problem answering a question they have about filling one of my orders. With more experience at this than I care to admit, the question is usually a very polite way of pointing out that I made a mistake.

I'm glad they're there to help and I certainly value that help.

I've had less experience with retail pharmacists, but what experience I have had has always been positive.

Take care,
Jeff