codes of conduct:

error or uncertain Rx

No pharmacist or pharmacy intern/extern shall compound or dispense any prescription, which, in his/her professional opinion, contains any error omission, irregularity or ambiguity.

the pharmacist, pharmacy intern/extern shall contact the prescriber and confer with him/her before dispensing the prescription.

coded of conduct:

coded rx

No pharmacist, pharmacy intern, or extern shall compound or dispense any prescription that is coded

code of conduct:

Changes in Prescriptions.

No pharmacist, pharmacy intern or extern shall supply medications or devices which contain an ingredient or article different in any manner from the medication or device that is prescribed upon a prescription unless prior approval has been obtained from the prescriber thereof. Such difference shall immediately be recorded upon said prescription after being approved by said prescriber, showing the date, time and method of ascertaining the said approval.

code of conduct:

Independent Judgment and Practices

No pharmacist shall offer or engage in professional pharmaceutical services under any terms and conditions that shall tend to interfere with or impair the free and complete exercise of professional judgment and skill of a pharmacist or enter into any agreement that denies the public the right of free choice of pharmacists or pharmacies.

code of conduct:

return of Prescription

no pharmacist or employer or employee of a pharmacy may knowingly place in the stock of any pharmacy any part of any prescription dispensed to, or compounded for, any patient of any pharmacy and returned by said patient.

code of conduct:

refusal to fill rx

it shall not be considered unprofessional conduct for any pharmacist to refuse to fill any prescription based on his/her professional judgment or ethical or moral beliefs.

code of conduct:

valid rx drug orders

Prescription drugs shall be dispensed only pursuant to a valid prescription drug order. A pharmacist shall not dispense a prescription that is not valid. A pharmacist shall have the same corresponding liability for prescriptions as an issuing practitioner as set forth in 21 C.F.R. as such regulation exists on January 1, 2013. Valid prescription drug orders shall include those issued by a physician, dentist, podiatrist, veterinarian, or other person licensed, registered, or otherwise authorized under the laws of this state, or of any state or territory of the United States, to prescribe dangerous drugs or controlled substances or both.

4 Things that are NOT considered unprofessional conduct

Inappropriate attire
Showing up late
Traffic violations
Refusal to fill a prescription based on professional judgment or ethical/moral beliefs

Pharmacy licenses shall be renewed every -----years and expire on ---- of each year

2

June 30th odd year

Failure to renew pharmacy license before ----- of odd year = lapsed license

September 1st

License becomes null & void when you sell, transfer, or move locations

Required Equipment (Retail)

Copies and or computer access to Georgia Pharmacy Practice Act, Georgia Controlled Substances Act and Dangerous Drug Act, and official rules of the Georgia State board of pharmacy
●
Telephone number of poison control center
●
Refrigerator with thermometer
●
Sink with hot and cold running water
●
Class A torsion balance with an assortment of weights or a class I or II Electronic Balance
●
Appropriate Rx labels
●
Appropriate auxiliary labels
●
Typewriter, word processor, or computer with a label printer
●
2 spatulas
●
1 counting tray (note that 2 spatulas, but only 1 tray required)
●
Graduated cylinders of assorted sizes
●
2 mortars and pestles of assorted sizes
●
Ointment slab, tile, or paper pad
●
Stirring rods
●
An adequate supply of the most commonly prescribed drugs
●
Assorted sizes and types of child resistant containers

Physical Requirements (Retail)

Must be at least 150 square feet [note: different from hospital space requirements and nuclear]
Drive-Thru
●At least a 2x3 foot window
●Must be within line of sight of pharmacist
●Two lanes ok, the second lane cannot be more than 24 feet from window
●Window must be on wall of actual pharmacy, not a different department
●Pneumatic tubes are ok but they have to come out in the pharmacy

If it’s a stand-alone pharmacy that uses only an electronic security system, may not close for more than----hours/day or more than ---- hours at a time

3

1.5

Pharmacist Wall Certificates
What are the 3 rules for PRN, full-time and part-time Pharmacists?

●
On display for each full-time pharmacist
●
Board-issued pocket license for part-time pharmacists
●
PRN pharmacists not required to do this (still need to keep pocket license though)

Syringes and needles are kept -----

behind the counter

Absent Pharmacist (Retail)

Not more than ---- hours/day or ---- hours at one time

3

1.5

Absent Pharmacist

Must post a “Prescription Department Closed” sign with letters ≥--- inches in size

3

Can Pharmacy technicians and interns/externs continue preparation of RX when the pharmacist is in the immunization or consultation room or is providing pharmacy care services --

They can but CANNOT dispense or really do anything else though

Bathroom break” ----minutes sign not needed

<5

Retail Pharmacies Providing Home Health Services (Retail)

New RX order required every ---- months if physician doesn’t specify course of therapy

6

Retail Pharmacies Providing Home Health Services (Retail)

Must maintain patient-pharmacist relationship -- patient should be contacted by the pharmacist at least quarterly (every----months) and this should be documented in patient profile

3 months or quarterly

Retail Pharmacies Providing Home Health Services (Retail)

May issue sterile drug IV maintenance kits to RNs who are employed or contracted by a HHA. What are theonly drugs allowed in the kit?

sterile water

sterile saline

diluted heparin

Retail Pharmacies Providing Home Health Services (Retail)
After a drug is utilized, the pharmacy must be notified within --- hours
●Kit must be inspected at least monthly

72

Retail

Patient profiles kept for at least---- years after last entry

Prescriptions, inventory, etc. for at least ---- years
CMS requires them kept for at least ----- years

5

2

10

Stock of drugs (dangerous drugs) should be examined at least once every ----months to check for outdated or deteriorated drugs

6

Retail

Filing RXs: What are the three ways of filling rx

●C2s and C3-5s (at least 1 inch tall red C) and dangerous drugs
●C2s, C3-5s, and dangerous drugs
●[Georgia requires C2s to be filed separately]

LTCF, Hospice, Nursing Home Services (Retail)

Consultant Pharmacist

●Must have a contract in writing for services
●Must notify the Board about the contract and when services terminate
● Inspect drugs monthly and maintain written reports at the facility
●Remove drugs for proper disposal that have expired or been discontinued

Vendor Pharmacist:

supervises proper dispensing and delivery of drugs to these
facilities and establishes standards to store drugs properly

● Manages drugs that patients bring into facility
●Responsible for destruction of expired/discontinued drugs

The pharmacy may receive eligible drugs for credit if meets the 5 criteria

• Drugs were originally dispensed by that pharmacy/pharmacist
• Drugs were originally dispensed by that pharmacy/pharmacist
• Pharmacist has assurance from person in charge of drugs at facility that they have been stored per manufacturer’s recommendations and USP standards
• Drugs are still in manufacturer’s packaging with expiration date, lot number, and integrity of the product/package intact
• Drugs are not expired and have a minimum of 6 months remaining on expiration date
• Under pharmacist’s professional judgment, drugs are appropriate for
  return/reuse

Automated / Robotic Pharmacy Systems

who is responsible for upkeep?

PIC

They are usually located within the pharmacy

Pharmacists, interns/externs, and technicians can fill/stock meds

Central Filling

Central fill pharmacy must be independently licensed in GA
●Contractual relationship or share a common owner
●
“-------” must be on hard copy RX

CENTRAL FILL

Central fill pharmacy is NOT responsible for counseling

Should patients be notified about central filling pharmacy ?

Must notify patients that you’re outsourcing through a visible/readable sign [R&R does not require text to be at least 3 inches in size]-- patients can choose to opt out

Central filling

who is reponsible for verifying receipts of CS

RPh is responsible for verifying receipts of all CS

Personnel must sign for receipt of all OTHER RX received

Central filling

who is responsible for maintaining compliance to PDMP and maintaining all records

Original pharmacy

Remote Order Entry

For each primary dispensing pharmacy, there must only be --- secondary remote entry pharmacy (must be INDEPENDENTLY licensed as a retail pharmacy)
●
Must be located in GA

ONE

Shall have the same owner OR have written contract describing scope of services to be provided and responsibilities of each pharmacy
●
Primary dispensing pharmacy responsible for counseling

Must notify patients that their order may be processed by another pharmacy and give that pharmacy’s name
○
Must have a sign that says “Remote Order Processing Utilized Here” with letters at least 3 inches in size
○
Must have 1 time written consent from patients

Hospital Pharmacy

● GDNA will conduct inspections at least once every --- years

2

Can service patients of nursing homes, LTCF, or hospices as long as they are under the same ownership as the hospital pharmacy

Hospital Pharmacy

license renewal: same as retail pharmacies :______

june 30 th of the odd year

Physical Requirements (Hospital)

At least ----sq feet / hospital bed
●Mental health/substance abuse facilities exempt from this requirement

10

Hospital

C2s must be stored in an enclosed controlled room with limited access capable of showing forced entry is preferable OR -----

a safe or metal cabinet adequately locked that is permanently affixed to the structure

Security: locked by key or combination to prevent unauthorized access

Access to Pharmacy in the hospital: who can have access to pharmacy hospital?

One nursing supervisor (Licensed Practicing Nurse or Registered Nurse aka LPN or RN) in any given shift may have access to pharmacy and may remove drugs in immediate care situation

what are the criteria for accessing the pharmacy ( hospital)

Shall be designated in writing by Director and must be properly trained

Any time they do this, must designate licensed pharmacist in the event of an emergency to come to the hospital

Nurse must provide copy of the order and document name, strength, amount of drug removed, date and time removed, and sign form
Pharmacist must document that they have received this

Remote Order Entry (Hospital)

when is remote order entry permitted?

*Hospital must keep records of the name and address of such a pharmacist, evidence of current licensure, and address of each location where the pharmacist will maintain records of remote entries (kept for 2 years)*

• Pharmacist not physically present, the pharmacy is closed, and licensed pharmacist will be physically present within 24 hours or next business day
• At least 1 pharmacist physically present
• It is a weekend and at least 1 pharmacist is physically present in another hospital in the state that remotely works on weekends not more than 4 other hospitals under the same ownership which have an average daily census <12 acute patient

outpatient clinic pharmacy

PIC conducts inspections every ------

physical requirement is ____

monthly

150 sq feet

For outpatient clinic pharmacies : they cannot dispense ___ on RXS

Refill

must obtain retail pharmacy license to do so

skipped page 19-29

repeat

PHARMACIST REQUIREMENTS

licensure requirement

Completed application
● “Age of majority” aka ≥18 years old
● Must be a graduate from a pharmacy school and received professional degree
● Have paid appropriate fees
● Have completed internship program (1500 hours)

In addition, what else is required?

○passed exam

Must obtain permission from the board if needing to take exams more than 3 times
○ Can only take exams for a maximum of 5 times

license renewal

Renew license every 2 years
● Licenses not renewed by ---- of the even number years may be late renewed by
----- of the following year by payment of the current renewal fee, plus an -----

December 31st

January 31st

additional late
renewal fee of 50% of the renewal fee

license renewal

Any license not renewed by January 31st of the year following the renewal date deadline,
shall automatically become classified as-------

Administratively Revoked

Active duty service members have an additional ----- months after being discharged from
active duty or being relocated to this state to renew their license if it has expired

6

When you request that your license be inactivated = inactive, may reapply later for reactivation
● Exempt from CE requirements
Must notify Board of any change in employment or change in business address within ---- days after
such change

10

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