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Texas Pharmacy Act and Selected Rules Exam Already Graded A+, Exams of Health sciences

Texas Pharmacy Act and Selected Rules Exam Already Graded A+

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Texas Pharmacy Act and Selected Rules
Exam Already Graded A+
The Texas Pharmacy Act Definition - correct answer 1. The primary law governing the practice of
pharmacy in Texas
2. Establishes the Texas State Board of Pharmacy (TSBP) and provides the board with certain authorities
and responsibilities in regulating the practice of pharmacy
3. The purpose of the Act and the board is to preserve and protect the public health, safety, and welfare
of Texans
Classes of Pharmacies - correct answer Class A: Community
Class B: Nuclear Pharmacy
Class C: Institutional (Hospital)
Class D: Clinic pharmacy
Class E: Non resident pharmacy
Class A, C, and E pharmacies that compound sterile products must be licensed as class A-S, C-S, and E-S
Medication order vs Prescription Drug order - correct answer Medication orders are for drugs to be
administered (inpatient setting) and Prescription drug orders are for drugs to be dispensed (outpatient).
Orders in a nursing home are considered prescription drug orders as those are dispensed by a pharmacy
and sent to a nursing home, but TSBP allows for alternative labeling for these prescriptions that are
similar to medication orders as they are administered.
Texas State Board of Pharmacy Members - correct answer 11 total
7 pharmacists
i) must include representation from both Class A and Class C pharmacies
ii) must be a Texas resident
iii) Licensed for 5 years preceding appointment
iv) In good standing with TSBP
v) actively practicing pharmacy
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Texas Pharmacy Act and Selected Rules

Exam Already Graded A+

The Texas Pharmacy Act Definition - correct answer 1. The primary law governing the practice of pharmacy in Texas

  1. Establishes the Texas State Board of Pharmacy (TSBP) and provides the board with certain authorities and responsibilities in regulating the practice of pharmacy
  2. The purpose of the Act and the board is to preserve and protect the public health, safety, and welfare of Texans Classes of Pharmacies - correct answer Class A: Community Class B: Nuclear Pharmacy Class C: Institutional (Hospital) Class D: Clinic pharmacy Class E: Non resident pharmacy Class A, C, and E pharmacies that compound sterile products must be licensed as class A-S, C-S, and E-S Medication order vs Prescription Drug order - correct answer Medication orders are for drugs to be administered (inpatient setting) and Prescription drug orders are for drugs to be dispensed (outpatient). Orders in a nursing home are considered prescription drug orders as those are dispensed by a pharmacy and sent to a nursing home, but TSBP allows for alternative labeling for these prescriptions that are similar to medication orders as they are administered. Texas State Board of Pharmacy Members - correct answer 11 total 7 pharmacists i) must include representation from both Class A and Class C pharmacies ii) must be a Texas resident iii) Licensed for 5 years preceding appointment iv) In good standing with TSBP v) actively practicing pharmacy

vi) members and spouses cannot be lobbyists on behalf of a profession regulated by the board and an officer, employee or paid consultant to a Texas Trade association in the healthcare field 1 pharmacy technician 3 public members i) members and spouses cannot be registered, certified, or licensed by an occupational regulatory agency (nurse, physician, etc) ii) members and spouses cannot be employed or participate in the management of a business or other entity regulated by the Board or receiving funds form the Board iii) Cannot be an owner or person who controlls mroe than a 10% interest in a business or other entity regulated by the board or receiving funds from the Board iv) Cannot be an officer, employee, or paid consultant to a Texas trade association in the healthcare field Appointment and terms of service for TSBP members - correct answer 1. Appointed by the governor with advice and consent of the Senate

  1. Appointed for a 6 year term
  2. Cannot serve more than 2 consecutive full terms Board Powers and Duties - correct answer 1. Administering and enforcing the Texas Pharmacy Act and rules and other laws related to the practice of pharmacy
  3. Regulating the practice of pharmacy by: i) issuing and renewing licenses ii) determining and issuing standards for recognizing and approving degree requirements for colleges of pharmacy iii) specifying and enforcing the requirement for practical training including internship iv) regulating the training, qualifications, and employment of pharmacist interns and pharmacy technicians
  4. TSBP does not regulate drug wholesalers nor pharmaceutical manufacturers' representatives Licensing - correct answer 1. It is unlawful to practice in Texas without a license or to fraudulently obtain a license
  5. A person may not use the title "registered pharmacist" or "R.Ph." unless the person is licensed to practice pharmacy in Texas

License Renewal - correct answer 1. Licenses shall be renewed annually or biennially

  1. Licenses expire on the last day of the assigned month (birth month)
  2. Timely receipt of renewal application and fee means received in the Board's office on the last day of the expiration month. There is no grace period. Most people now renew online
  3. If a license is expired for fewer than 90 days, the licensee may renew the license by paying a renewal fee that is equal to 1.5 times the renewal fee and report the required hours of CE
  4. If a license is expired for more than 90 days but less than one year, the licensee may pay a renewal fee to 2 times the renewal fee and report the required number of CE hours
  5. After 1 year the license cannot be renewed and the licensee must reexamine or go through alternatives
  6. Inactive status - pharmacists not actively practicing pharmacy can place their license in an inactive status - cannot practice and must stil pay license renewal fee. To activate license you must pay a fee and meet specific CE requirements Continuing Education - correct answer 1. To renew a pharmacist license a pharmacist must complete at least 30 contact hours of CE (3.0 CEUs) during the preceding license period (2 years)
  7. For renewals received after 8/31/21 and before 9/1/23 at least 1 contact hour (0.1 CEU) annually for a total of 2 contact hours (0.2 CEU) must be related to best practices, alternative treatment options, and multi-modal approaches to pain management - must be 1 contact hour annually and not 2 contact hours during the renewal period
  8. At least 2 contact hours (0.2 CEUs) must be related to approved procedures of prescribing an monitoring controlled substances. This one-time requirement must be met by 09/01/21 and be reported on the next license renewal after 09/01/
  9. For renewals received after 8/31/20 and before 09/01/22 a pharmacist must have completed a human trafficking prevention course approved by the Texas Health and Human Services Commission. - one time requirement would only count toward general CE requirement if it is also an ACPE accredited course
  10. For renewals received after 08/31/21 and before 09/01/23 at least one contact hour (0.1 CEU) shall be related to mental health awareness - one-time requirement Methods of obtaining CE - correct answer 1. Any accreditation Council for Pharmacy Education ACPE accredited course
  11. Successfully completing during the preceding license period one credit hour course or each year of his or her license period which is part of the professional degree program (accredited by ACPE) in a college of pharmacy
  1. Taking and passing the NAPLEX as a pharmacist during the preceding license period which shall be equivalent to 30 contact hours of CE
  2. In addition to ACPE accredited courses, TSBP allows other methods for obtaining CE that include i) Completing courses that are part of the professional degree program of a college of pharmacy ii) Completing a CPR course (1hr) iii) Completing Advanced Cardiac Life Support courses leading to initial certifications (12 hours) iv) Completing Advanced Cardiac Life Support courses leading to recertification (4 hours) v) Attending a Texas State board of pharmacy meeting (3 hours) vi) Participating in a Texas State board of pharmacy appointed Task Force (3 horus) vii) Attending programs presented by TSBP viii) Completing a n Institute for Safe Medication Practices Medication Safety Self-Assessment (3 hours) iv) Passinga certain Board of Pharmaceutical Specialties Certification Examination administered by the Board of Pharmaceutical Specialties (3 hours) x) Completing programs accredited by accreditation council for continuing medical education as category 1 continuing Medical education (CME)
  3. Must keep CE records for 3 years - only records that TSBP requires to be kept for 3 years - others for 2 years CPE Monitoring Services - correct answer 1. The CPE monitoring Service is a joint effort of ACPE and NABP which allows pharmacists to electronically tract pharmacist continuing education from ACPE
  4. Pharmacists should set up a NABP eprofile at NABP CPE Monitor website and obtain an eprofile ID. The CPE monitor eprofile ID should be provided when obtaining continuing education from ACPE accredited provier Licensing of Pharmacies - correct answer 1. The use of the term "pharmacy" or "apothecary" in a business that would lead the public to believe the business is a pharmacy is not permitted unless the business is a licensed pharmacy
  5. A separate license is required for every location
  6. Only one license may be issued to a location. If a hospital is operating a class A pharmacy under its class C license it is not required to have a class A license. However, it must follow class a rules.
  7. There are detailed requirements for a pharmacy license some of which include i) Signature from the PIC

Dispensing directive for written prescriptions - correct answer 1. a practitioner may prohibit the substitution of a generically equivalent drug or interchangeable biological product by writing across the face of the prescription in the practitioner's own handwriting, the phrase "brand necessary"

  1. Two line prescription forms, check boxes, or other notations on an original prescription drug order which indicate "substitution instructions" are not valid methods to prohibit substitution and a pharmacist may substitute on these types of prescriptions
  2. The dispensing directive may not be preprinted, rubber stamped, or otherwise reproduced on the prescription Dispensing directives - verbal prescriptions - correct answer 1. Practitioner must specify brand medically necessary or brand necessary
  3. On a verbal prescription for a Medicaid patient, the practitioner must also mail or fax a written prescription within the written dispensing directive to the pharmacy within 30 days dispensing directive - electronic prescriptions - correct answer 1. may substitute by stating "brand medically necessary"
  4. On an electronic prescription for a Medicaid patient, the practitioner must also mail or fax a written prescription within the written dispensing directive to the pharmacy within 30 days Dispensing directive for out of state prescriptions - correct answer For out of state Canadian or Mexican practitioners or practitioners in federal facilities the rx must authorize substitution rather than prohibit it Pharmacist responsibilities - correct answer 1. Patient notification - must inform the patient that a less expensive generically equivalent drug or interchangeable biological is available for brand prescribed in addition the pharmacist must ask the patient to choose between the generically equivalent drug/interchangeable biological product and the brand prescribed
  5. Communication with prescriber. No later than 3 days after dispensing a biological product, the dispensing pharmacist or designee shall communicate to the prescribing practitioner the specific product provided to the patient including the name of the product and the manufacturer or NDC - only required if the biological product dispensed has been substituted
  6. Selection of drug products. The determination of the drug or product to be dispensed is the professional responsibility of the pharmacist. For drugs listed in approved drug products with therapeutic equivalents (Orange book) the pharmacist may only interchange A rated drugs. Biological products must be listed as interchangeable in purple book
  7. Labeling. The rx label must include "substituted for brand prescribed"

Substitution of dosage form - correct answer 1. A pharmacist may dispense, with the patient's consent and notification to the prescriber, a dosage form of a drug product different from that prescribed, such as a tablet instead of a capsule or a liquid instead of a tablet

  1. Requirements i) must contain identical amounts o the active ingredient as the dosage prescribed ii) Is not an enteric-coated or time-released product iii) Does not alter clinical outcomes Display of license - correct answer 1. Pharmacies shall display their pharmacy license in public view - pharmacies and pharmacy technicians are no longer required to post their license or renewal certificates
  2. Class a and C pharmacies must display the word "pharmacy" or similar word or symbol in front of the pharmacy if they serve the general public
  3. A pharmacy shall make available to the public on request proof that each pharmacist, pharmacy intern, pharmacy technician, and pharmacy technician trainee holds the appropriate license or registration Emergency Refills - correct answer A pharmacist may exercise professional judgement in refilling a rx for a drug other than a cII (CIII-V allowed with caution) without authorization from the prescriber if:
  1. failure to refill the rx might result in an interruption of therapeutic regimen or create patient suffering
  2. Either a natural or manmade disaster has occurred that prohibits the pharmacist from being able to contact the prescriber
  3. The quantity of the prescription does not exceed a 72 hour supply 4)If the governor declares a disaster and if notified by TSBP the pharmacist may dispense a 30 day supply
  4. By policy TSBP permits dispensing the entire unit of use products such as oral contraceptives, inhalers, and ophthalmic solutions 6)The pharmacist informs the patient at the time of dispensing that the refill is being provided without the prescriber's authorization and the authorization of the prescriber is needed for future refills and i) The pharmacist informs the practitioner of the emergency refill at the earliest reasonable time ii)The pharmacist maintains a record of the emergency refill containing the information required to be maintained on a prescription iii) The pharmacist labels the refill as a prescription
  1. A physician or person who has been delegated prescriptive authority (APRN or PA) may issue an order for an epi auto injector to be stored at specific types of entities and must contain i) The name and signature of the prescribing physician or other person ii) The name of the entity to which the order is issued iii) The quantity iv) The date the order was issued
  2. Prescriptions for epi autoinjectos may be dispensed by a pharmacy pursuant to a valid prescription without requiring the name or any other IDifying information fo the user for i) law enforcement agencies ii) day care centers iii) child care faciliteis iv) day camps or youth camps v) private or independent institutions of higher education vi) amusement parks vii) restaurants viii) sports venues ix) youth center x) any other entity designated by rule of Texas health and human services commission
  3. an rx for epi autoinjector and asthma medication may be dispensed without requirkng name or any idfying info for: i) a school district ii) an open-enrollment charter school and iii) a private school Notifications to TSBP - correct answer 1) change in pharmacist name or address - by pharmacist - within 10 days
  1. change in pharmacist employment - by pharmacist - within 10 days
  2. Permanent closing of a pharmacy - by pharmacy - within 10 days of closing
  3. Change in pharmacy ownership - by pharmacy - within 10 days and new license required
  1. Change of pharmacy location - by pharmacy- new license filed 30 days prior to change
  2. Change of pharmacy name - by pharmacy - new license filed 10 days prior to change
  3. change of managing officers or partnership/corporation - by pharmacy - within 10 days
  4. change in PIC - incoming PIC - within 10 days
  5. sale or transfer of drugs as a result of closing or change in ownership - by pharmacy - within 10 days
  6. fire or other disaster, accident or emergency that may affect the strength, purity, or labelling of a drug or medical device - by pharmacy/PIC - 2ithin 10 days
  7. significant loss or theft of controlled substances or dangerous drugs - pharmacy- immediately upon discovery 12)significant loss of data from pharmacy computer system - by pharmacy - within 10 days
  8. A license or registrant obtaining dangerous drugs or controlled substances from a forged prescription - by pharmacy - immediately upon discovery
  9. A final order against the pharmacy license holder or PIC by the regulatory licensing agency of the state in which the pharmacy is located (if in another state) - by pharmacy - within 10 days Administration and Provision of Dangerous Drugs by Physicians - correct answer 1. Texas does not permit physician dispensing
  1. Exceptions: i) A physician may provide a 72 hours supply of dangerous drugs (no controlled substances) to a patient in the physician's office to meet the patient's immediate therapeutic needs ii_ Physicians in certain rural areas and where there is no pharmacy may dispense dangerous drugs to patients and be reimbursed for the cost iii) Veterinarians are allowed to dispense to their own patients without being licensed as a pharmacy Peer review program - correct answer 1. a peer review committee may be set up by pharmacy owners or pharmacy associations to evaluate the quality of care in pharmacies by reviewing errors or near errors or other quality issues
  2. In effort to encourage pharmacies to establish these committees the statute provides legal protection of peer review documents in civil litigation
  3. Setting up peer review committee is voluntary; however, some pharmacies may be mandated to establish a committee as part of the disciplinary action against the pharmacy license usually as a result of a medication error
  1. Services to patients under 14 years of age may be provided only if referred by a physician except that a pharmacist may administer an influenza vaccination to a patient over the age of 7 without established physician- patient relationship
  2. May only be given at a location provided in the protocol; cannot b e provided where patient resides except for nursing homes or hospitals
  3. Pharmacist certification requires an ACPE approved course which includes the following: i) BLS certification ii) 20 hours of CDC training iii) 3 hours of CE every 2 years relating to disease states, drugs, and administration of immunizations of vaccines
  4. Notifications i) pharmacist must notify physician who issued the protocol within 24 hours of administrations ii) The primary care physician of the patient must be notified within 14 days of administration Drug therapy management under protocol - correct answer 1. Pharmacists may perform drug therapy management as authorized by a physician under written protocol
  5. Drug therapy management may include: i) Collecting and reviewing patient drug use histories ii) ordering or performing routine drug therapy related patient assessment procedures such as temperature, pulse, and respiration iii) Ordering drug therapy related laboratory tests iv) implementing or modifying drug therapy following diagnosis ,initial patient assessment, and ordering of drug therapy by a physician as detailed in protocol v) signing a prescription drug order for a dangerous drug (no controlled substances if):
  • The delegation follows a diagnosis, initial patient assessment, and drug therapy order by a physician,
  • The pharmacists practicies in a federally qualified health center (FQHC), hospital, hospital based clinic, or an academic healthcare institution and
  • The place of practice has bylaws and a medical staff policy that permit a physician to delegate to a pharmacist the management of a patient's drug therapy vi) Any other drug therapy related act delegated by a physician

Written protocol for drug therapy management - correct answer 1. Must identify the supervising physician and the pharmacist authorized to perform DTM

  1. Must identify the type of DTM decisions the pharmacist is authorized to make
  2. Must state mechanisms and time schedule for pharmacist to report to physician Notification and CE requirements for drug therapy mgmt - correct answer 1. Must notify TSBP before engaging in DTM
  3. Must complete at least 6 hours of CE annually related to drug therapy Supervision for DTM - correct answer 1. physician must review protocol and any deviations from protocol at least annually
  4. Physician must have physician patient relationship with each patient
  5. Physician must be geographically located to be physically present daily
  6. Physician must receive periodic status reports on a schedule defined in protocol
  7. Physician must be available through telecommunication for consultation
  8. There is no limit to the number of physicians for whom a pharmacist may perform DTM and there is not limit to the number of pharmacists with whom a physician can enter into a protocol. Records for DTM - correct answer 1. must be kept for 2 years
  9. must keep a copy of the written protocol and any patient specific deviations rom the protocol
  10. Must document all interventions
  11. Must review protocol annually Inventory requirements - General reqs - correct answer 1. PIC is responsible for ensuring all inventories are taken
  12. Inventories must be maintained in pharmacy , filed separately from other records, and be available for inspection for 2 years
  13. Inventories include all stock "one hand" of controlled substances including expired drugs
  14. Persons taking inventory and PIC shall sign and date the inventory and indicate the time the inventory was taken
  15. The signature of the PIC and date of the inventory shall be notarized within 72 hours or 3 working days for all inventories except for the initial inventory and change in PIC inventory

i) within 10 days, the PIC must provide TSBP a written notice of the actual date of closing, the pharmacy license, a statement that the inventory was conducted, the manner in which dangerous drugs and controlled substances were transferred or disposed of and the name and address of the pharmacy to which records were transferred ii)If the pharmacy is registered to possess controlled substances a notification must be sent to DEA divisional office explaining that the pharmacy has closed along with the DEA registration certificate and any unused DEA Forms 222 Remote pharmacy services - correct answer 1) TSBP recognizes four types of remote pharmacy practices in which drugs may be stored and/or dispensed from locations where a pharmacist is not present: i) Emergency medication kits at nursing homes ii) automated pharmacy systems for routine dispensing of drugs at certain healthcare facilities including nursing homes iii) Telepharmacy systems used for dispensing drugs at remote dispensing sites and certain remote healthcare sites iv) automated storage and delivery systems (kiosks) at locations outside a pharmacy Remote pharmacy services using an emergency medication kit - correct answer 1. This rule allows for Class A or C pharmacy or a class E pharmacy located within 20 miles of a facility to provide pharmacy services to facilities licensed under health and safety code chapter 242 or chapter 252 for nursing homes or intermediate care for mentally handicapped, using an emergency medication kit. It also allows for the VA pharmacy or other federal pharmacy to provide pharmacy services using an Emergency medial kit.

  1. An application to TSBP is required before providing these services
  2. DEA requires automated dispensing systems in LTC facilities to be registered with the DEA. However if the automated system is being used solely as an emergency kit and not for routine dispensing of controlled substances a DEA registration is not required.
  3. Access to the emergency medication kit is limited to the pharmacists and healthcare personnel employed by the facility
  4. Contents of the emergency medication kit shall be determined by the consultant pharmacist , PIC, medical direction, and director of nursing, and shall be limited to those drugs necessary to meet the resident's emergency medication needs. This refers to a situation in which a drug cannot be supplied by a pharmacy within a reasonable time.
  5. Stocking of drugs in an automated pharmacy system must be done by a pharmacist, pharmacy technician, pharmacy technician trainee, unless the system uses barcoding, microchip, or other

technologies to ensure that the containers or unit dose drugs are accurately loaded and other specific requirements are met.

  1. A record must be maintained of all drugs sent to and returned from the remote location and should be kept separate from the records of the provider pharmacy and from other remote site records.
  2. A perpetual inventory of all controlled substances must be maintained for each remote location and each r Remote pharmacy services using automated pharmacy systems (primarily in nursing homes) - correct answer 1. Allows a Class A or C pharmacy to provide pharmacy services to facilities such as i) Home and community support service agencies including hospices ii) Nursing homes iii)ALFs iv) Mentally disabled homes v) jails or prisons
  3. Drugs may only be maintained in an automated pharmacy system
  4. If controlled substances are to be stored and dispensed from the automated system at the remote location, a DEA registration must be obtained for the remote location in the name of the pharmacy providing the remote pharmacy service
  5. An application to TSBP is required prior to providing these services
  6. A pharmacist may supervise operation of the system electronically and a pharmacist shall control all operations of the automated pharmacy system and approve the release of the initial dose after receiving a valid prescription drug order
  7. Drugs dispensed using the automated pharmacy system must meet the labeling requirements
  8. Drugs used in the automated pharmacy system must be in the original manufacturer's container or be packaged in the provider pharmacy
  9. Stocking of drugs in an automated pharmacy system must be done by a pharmacist, pharmacy technician or pharmacy technician trainee, unless the system uses removable cartridges or containers and other specific requirements are met
  10. A record must be kept of all drugs sent to and returned from the remote location and should be kept separate from the records of the provider pharmacy and from other remote site records.
  11. A perpetual inventory of all controlled substances must be maintained for each remote location and each remote location's controlled substances must be inventoried on the same day as the provider pharmacy's
  1. A remote dispensing site may not be located within 22 road miles of a class A pharmacy. If a class A pharmacy opens within that range the remote dispensing site may continue to operate.
  2. A remote dispensing site may not dispense CIIs
  3. If it dispenses an average of more than 125 rxs a day, it must apply for a class A license
  4. A pharmacist employed by a provider must make at least monthly onsite visits and most reconcile the perpetual inventory of controlled substances to the on-hand count at the remote dispensing site Rules for telepharmacy systems at remote healthcare sites and remote dispensing sites - correct answer
  5. If a controlled substance is to be stored at the remote location DEA registration must be obtained for the remote location
  6. Drugs dispensed at a remote location through a telepharmacy system may only be delivered to the patient at the remote site
  7. A provider pharmacy may not supervise more than 2 remote sites
  8. An application to TSBP is required before providing these services
  9. Perpetual inventory of all controlled substances must be maintained for each remote location. Each remote locations controlled substances must be inventoried on the same day as the provider pharmacy
  10. Original rx records shall be kept at the remote site, and the provider pharmacy shall have electronic access to those records Remote Pharmacy services using automated storage and delivery systems (kiosks) - correct answer 1. Class A or C pharmacy may provide pharmacy services using an automated storage and delivery system at a remote delivery site. These systems are for delivery of previously verified rxs that have been dispensed by the Class A or C provider pharmacy
  11. An automated storage and delivery system is a mechanical system that delivers dispensed rxs to patients at a remote delivery site and maintains related transaction info - kiosks
  12. A provider pharmacy may only provide remote pharmacy services using kiosks at Board-approved remote delivery sites. an application for approval must be submitted to the Board and be renewed every 2 years with the provider pharmacy's license 4.Only dispensed drugs may be stored in kiosks
  13. A provider pharmacy shall comply with appropriate controlled substance restrictions for each remote delivery site if dispensed controlled substances are maintained within a kiosk - unclear if DEA considers these controlled substances to be dispensed and therefore no needing a DEA registration or if DEA registration is needed at each site - should clarify with DEA
  1. Patients obtaining their rxs from an automated storage and delivery system shall receive counseling via direct link to audio or video communication by a Tx licensed pharmacist who has access to the complete patient medication records
  2. Pharmacists must be accessible at all times to respond to patients' or other healthcare professionals' questions
  3. AN automated storage and delivery system must be locked to prohibit access to unauthorized personnel along with security system (cameras) that record a digital image of the person accessing the system to pick up a prescription
  4. Access to an automated storage and delivery system is limited to pharmacists and pharmacy technicians or pharmacy technician trainees under direct supervision of the pharma Destruction and Disposal of dangerous drugs - correct answer (note this process is not the same as a transfer of controlled substances to a DEA registered reverse distributor for destruction) Drugs dispensed to patients in nursing homes - destruction of dangerous drugs - correct answer 1. Destruction of dangerous drugs by a consultant pharmacist i) inventory is required ii) drugs must be destroyed in a manner to render the drugs unfit for human consumption and disposed of in compliance with all applicable state and federal requirements iii) Destruction is witnessed by a peace officer or agent of the Board, Texas dep of HHS, or Tex department of State Health Services, or two of the following persons from the facility: the facility administrator, the director of nursing, or a licensed nurse
  5. Destruction of dangerous drugs by waste disposal service i)Inventory is required ii) Drugs are placed in a sealed container in presence of a witness (same as above) iii) drugs must be destroyed in the same manner as above iv) Waste disposal service provides the facility with proof of destruction Destruction of drugs returned to a pharmacy - correct answer 1) Dangerous drugs i) drugs must be destroyed in a manner to render the drugs unfit for human consumption and disposed of in compliance with all applicable state and federal requirements ii) document date of destruction, name and address of dispensing pharmacy, prescription number, name and strength of drug, and signature of the pharmacist