Prescribing, Controlled Substances, and Pharmaceutical Law
Prescribing questions combine DEA registration, state controlled-substance law, prescription-monitoring databases, and professional standards for opioids and antibiotics. The exam tests schedule rules, refills, oral orders, documentation, and diversion prevention.
Controlled-substance basics
- DEA registration is required in addition to a state license; both must be current.
- Schedule II drugs have no refills and stricter ordering rules; schedules III–V allow limited refills within a set period.
- Oral orders for schedule II are tightly restricted and generally require a written or electronic prescription.
- Check the prescription drug monitoring program as required before prescribing opioids.
- Store, inventory, and dispose of controlled substances according to federal and state rules.
Clinical prescribing
Document the indication, dose, duration, and monitoring. Dental opioid prescriptions should be limited to the expected duration of acute pain, with non-opioid alternatives considered. Antibiotics require a documented indication; prophylaxis follows current guidelines, not routine practice.
Worked example
A dentist prescribes hydrocodone 30 tablets with two refills and does not check the monitoring database. Hydrocodone is schedule II, so refills are prohibited. The quantity and duration may exceed acute dental pain limits under state law, and the missing database check is a separate violation. The prescription alone exposes the dentist to federal and state action.
Traps
- Believing DEA registration alone authorizes prescribing.
- Calling in a schedule II prescription because the pharmacy is convenient.
- Prescribing to self, family, or staff outside a documented patient relationship.
- Ignoring state opioid limits and mandatory database checks.
- Failing to secure prescription pads and electronic credentials.
Exam focus
Check the drug schedule, refill authority, database duty, and documentation before approving the order.