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| A) | This is a training requirement, not a CE requirement. | ||
| B) | It's necessary to obtain 1 credit hour on the topic each year. | ||
| C) | This requirement doesn't apply during the initial license period. | ||
| D) | It's necessary to obtain 2 credit hours on the topic each license renewal period. |
When you renew, you must report that you've completed 30 hours of continuing education (CE) [3]. Of those 30 hours, 1 hour must be related to Texas-specific pharmacy laws and/or rules, which this course is designed to help you meet. The remaining 29 hours can be on any subject and can consist of any special CE requirements, if applicable (e.g., immunization, sterile compounding, preceptorship) [4,5]. In addition, all pharmacists must complete a Texas Health and Human Services Commission (HHSC)-approved human trafficking prevention training course [4,6]. Note that while this is a training requirement and not a CE requirement, some courses may offer CE credit. If the course you take provides CE credit, it may count towards your CE hour requirement. You can find HHSC-approved human trafficking courses, including at least one course that is available without charge (a requirement of the statute) on the HHSC Health Care Practitioner Human Trafficking Training website [6].
| A) | 1 | ||
| B) | 2 | ||
| C) | 4 | ||
| D) | 7 |
Pharmacists who prepare sterile compounds or supervise pharmacy technicians that prepare sterile compounds must initially complete a single course on sterile compounding of at least20 hours of instruction and experience. This training can be obtained through completion of a recognized course from an accredited college of pharmacy, or a course sponsored by an ACPE-accredited provider. Pharmacists must also complete a structured on-the-job didactic and experiential training program at the pharmacy where the sterile compounding takes place. The training should include the facility's specific sterile compounding processes and procedures. This training cannot be transferred to another pharmacy unless the pharmacies are under the same ownership and use the same training program. After the initial training, moving forward upon license renewal, pharmacists must complete at least two hours of CE credit on sterile compounding if the pharmacist is engaged in compounding low- or medium-risk sterile preparations, or four hours of CE credit if the pharmacist is engaged in compounding high-risk sterile preparations [8].
| A) | The pharmacy license | ||
| B) | The licenses for all staff pharmacists | ||
| C) | Pharmacist-intern certificates of registration | ||
| D) | Pharmacy technician certificates of registration |
The Texas State Board of Pharmacy also requires that you maintain at the pharmacy and make available to the public on request, proof that each pharmacist, pharmacist-intern, pharmacy technician, and pharmacy technician trainee holds the appropriate license or registration [16]. In addition, the pharmacist-in-charge must display their license so that it is visible to the public.
The license for the pharmacy must also be posted so that it is visible to the public [16].
| A) | Patients may not refuse counseling. | ||
| B) | Counseling is required for all prescription refills. | ||
| C) | Written information should also be provided at the time of verbal counseling. | ||
| D) | Oral counseling is mandated even when the prescription is delivered to the patient's home. |
Written information (either in hard-copy or electronic format, such as by email, if requested by the patient) must also be provided at the time of verbal counseling for reinforcement. This info must be in simple language and easy for patients to read (no smaller than 10-point Times New Roman font). For compounded meds, the major active ingredient(s) should determine what written information is provided [19].
| A) | 6 months | ||
| B) | 12 months | ||
| C) | 2 years | ||
| D) | 3 years |
All pharmacies in Texas must maintain a system for keeping information on patients whenever new or refill prescriptions are dispensed, known as a patient medication record (or patient profile). You and all other pharmacy personnel must make a reasonable effort to obtain, record, and maintain patient information. All patient records or profiles must be maintained for at least two years from the date of the last entry [20,21].
| A) | She needs to get 5 CE credit hours every year. | ||
| B) | She will have to renew her pharmacy technician trainee registration every 2 years. | ||
| C) | She cannot begin training on sterile compounding until she becomes registered as a pharmacy technician. | ||
| D) | She must pass a Board-approved national certification exam before she can be eligible to register as a pharmacy technician. |
Technicians who are waiting to take and pass one of the national certification exams can still work in a pharmacy. But they must first apply for registration as a pharmacy technician trainee. This registration as a trainee is only good for two years, and it's NOT renewable. This means that pharmacy technician trainees can't work as a technician-in-training for more than two years. To work in the pharmacy after that time, they must have passed one of the Board-approved national certification exams AND have obtained pharmacy technician registration from the Board. Maintaining national certification is completely voluntary. The Texas State Board of Pharmacy only requires that technicians be nationally certified for their initial registration, not to maintain their certification [25]. However, registration with the Board must be maintained at all times that a pharmacy technician will be working in a pharmacy [23].
| A) | Complete a drug regimen review on a refilled prescription | ||
| B) | Process a request from a patient to refill their prescription | ||
| C) | Transfer a controlled substance prescription to another pharmacy | ||
| D) | Take an oral prescription order for a controlled substance over the phone |
Examples of duties a registered pharmacy technician is allowed to do [15]:
Access and restock automated medication supply systems after proper training
Affix labels to prescription containers
Bulk compound or batch preparation
Compound non-sterile and sterile preparations
Distribute routine orders for stock supplies to patient care areas
Enter prescription data into the pharmacy computer system
Fill medication carts
Initiate and receive refill authorization requests
Load unlabeled drugs into an automated dispensing system
Prepackage and label prepackaged drugs
Prepare and package drug orders, including counting pills, measuring liquids, and placing them in containers
Reconstitute medications
Remove stock bottles from the shelf to help prepare prescriptions
| A) | Written and manually signed prescription for lisinopril | ||
| B) | Written and manually signed prescription for hydrocodone | ||
| C) | Verbally called-in prescription for lisinopril | ||
| D) | Verbally called-in prescription for hydrocodone |
Pharmacists can accept prescriptions issued by prescribers licensed in other states, but there are specific rules for controlled substances. For Schedule III through V prescriptions from out-of-state practitioners, the prescription can be filled if it is issued by a physician, dentist, veterinarian, or podiatrist who is legally authorized to prescribe controlled substances in the state they practice (controlled substance prescriptions from out-of-state nurse practitioners or physician assistants may not be filled). However, in order to fill prescriptions from out-of-state prescribers for Schedule II prescriptions, your pharmacy must have a plan approved by and on file with the Board which allows the activity [15,34].
Prescriptions from prescribers licensed in Canada or Mexico in a health field that is recognized by the state of Texas as one that is legally authorized to prescribe drugs (e.g., physician, dentist, veterinarian, or podiatrist), may also be filled under certain circumstances. The prescription cannot be for a controlled substance, and it must be an original, written prescription with a manual signature [15].
| A) | Texas law does not allow for partial filling of Schedule II prescriptions. | ||
| B) | Texas law only allows for partial fills of Schedule II prescriptions when requested by the prescriber. | ||
| C) | Federal law states that remaining portions can continue to be filled for up to 30 days after the date of issue. | ||
| D) | Federal law requires that partial fill requests from patients always be filled within 72 hours, otherwise the remaining quantity is void. |
Texas allows for partial filling of Schedule II controlled substances in accordance with federal law [33]. According to federal law, partial filling of Schedule II controlled substance prescriptions is allowed at the request of the prescribing practitioner or patient as long as the total quantity dispensed in all partial fillings doesn't exceed the total quantity prescribed. In addition, remaining portions of a partially filled Schedule II prescription cannot be filled beyond 30 days after the date the prescription was written [33,42]. If a Schedule II prescription is partially filled due to a pharmacy stock issue, DEA regulations specify that the remainder must be dispensed within 72 hours, otherwise the remaining quantity is voided, and the prescriber must be notified [32].
| A) | Annually for both noncontrolled and controlled substances | ||
| B) | Biennially for both noncontrolled and controlled substances | ||
| C) | Annually for noncontrolled substances and biennially for controlled substances | ||
| D) | Biennially for noncontrolled substances and annually for controlled substances |
Under federal law, controlled substances must be inventoried every two years. This is another area where Texas law is stricter than federal law regarding scheduled medications. Pharmacies in Texas must inventory controlled substances every year. This coincides with the annual inventory requirement for noncontrolled drugs as well. However, inventory records for Schedule II drugs must be maintained separately from other controlled substances, and inventory records for Schedule III, IV, and V drugs must be maintained separately from noncontrolled drugs or be readily retrievable [15].