Prescription Processing, Dispensing, and Recordkeeping
This is a high-volume exam area. Questions test whether a prescription is valid on its face, whether it may be filled or transferred, what must appear on the label, and how long records must be kept.
Valid prescription elements
- Patient name and address; drug name, strength, dosage form, quantity; directions; date; prescriber name, address, and signature or electronic signature.
- For controlled substances: prescriber DEA number, schedule, and compliance with refill and transmission rules.
- A pharmacist may clarify ambiguous directions with the prescriber but may not add or change substantive prescriber intent.
Dispensing and records
- Perform prospective drug utilization review; verify dose, interactions, allergies, and duplication.
- Label with pharmacy identity, prescription number, date, patient, directions, drug and strength, quantity, and cautions. Include a beyond-use date for compounded products.
- Michigan requires prescription records be retained for at least 5 years; federal controlled-substance records require at least 2 years. Keep the longer period.
- CIII–V may be refilled up to five times within six months of issue; CII cannot be refilled. Transfers must follow federal and state rules and be documented.
Worked example
A CII prescription is missing the date but is otherwise complete. You cannot fill it. A missing date prevents determination of timeliness and is a required element. Calling the prescriber to add a date after the fact is not a routine clarification because it changes a required prescription element. Return it for a compliant prescription.
Traps
- Filling a CII with refills authorized.
- Treating a verbal CII order as routine rather than emergency-only.
- Recording a transfer without required information.
- Applying the 2-year federal minimum to all Michigan records.