Prescribing, Controlled Substances, and Anesthesia/Sedation Rules
Prescribing and controlled substances
Prescribing authority follows licensure, registration, and applicable federal and state law. Arizona licensees who prescribe controlled substances must hold the required DEA registration and comply with state controlled substance requirements, including querying the prescription monitoring program where required and maintaining accurate records. A prescription must be issued for a legitimate medical purpose within the course of professional practice. Traps include prescribing to family members or self without proper basis, prescribing without an examination or established relationship, and failing to document the rationale.
Anesthesia and sedation
Arizona regulates sedation and general anesthesia through permits and standards that vary by the depth of sedation and the setting. Know that minimal sedation, moderate sedation, deep sedation, and general anesthesia carry escalating requirements for training, permits, monitoring, equipment, emergency drugs, and recovery. Expect items on the pre-sedation evaluation, fasting status, continuous monitoring, documentation of vital signs, and the requirement for a qualified practitioner and appropriate rescue capability.
Traps in questions
Watch for items that treat a permit as optional, that conflate moderate and deep sedation requirements, or that allow an unqualified auxiliary to administer or monitor sedation. Also expect questions on the duty to report adverse events and on recordkeeping for controlled substances.
Rule of thumb
Match the drug and the depth of sedation to the required permit, training, and monitoring. If the described setting lacks the monitoring or rescue capability the depth requires, the conduct is improper.
Worked example
An item describes moderate sedation provided without the required permit and without continuous monitoring. Both the permit requirement and the monitoring standard are violated; the correct answer rejects the conduct on either ground.