MO MPJE cheat sheet

The Missouri Board of Pharmacy is a licensing body within the Division of Professional Registration; it adopts rules implementing the Pharmacy Practice Act.

The practice of pharmacy includes dispensing, compounding, interpreting prescriptions, patient counseling, drug utilization review, and administering immunizations under authorized protocol.

Each Missouri pharmacy must have a pharmacist-in-charge responsible for compliance, security, recordkeeping, and daily operations.

Pharmacy technicians must be registered with the Board before performing technician duties; registration is distinct from pharmacist licensure.

A pharmacist must perform final verification of a prescription before dispensing; technicians cannot perform the final check.

Unprofessional conduct includes dispensing without a valid prescription, falsifying records, impaired practice, and failing to comply with Board orders.

Board rules require pharmacies to maintain required policy and procedure documents and make them available for inspection.

The Board may inspect pharmacies and investigate complaints; it can suspend, revoke, or restrict licenses.

The federal Controlled Substances Act places controlled substances in Schedules I through V based on abuse potential and accepted medical use.

Schedule I substances have no currently accepted medical use; Schedule II substances have high abuse potential but accepted medical use.

DEA registration is location-specific and required for controlled substance dispensing, distribution, or storage.

Schedule II prescriptions cannot be refilled; a new prescription is required for additional dispensing.

Schedule III through V prescriptions may be refilled up to five times within six months of the issue date unless the prescriber limits refills.

Emergency oral Schedule II orders require the prescriber to furnish a written or electronic prescription within seven days.

Missouri adopts controlled substance schedules and may add substances; the Board publishes schedule changes.

Theft or significant loss of controlled substances requires DEA Form 106 and may require Missouri Board notification.

A prescription must contain patient name and address, drug name, strength, quantity, directions, prescriber information and DEA number, date, and refills.

Schedule II prescriptions cannot be refilled; if the pharmacist cannot supply the full quantity, the remainder may be dispensed within 72 hours.

Oral prescriptions for Schedule III through V controlled substances are permitted but must be reduced to writing and retained.

Labels must include pharmacy name and address, prescription number, date, patient name, prescriber, directions, drug name and strength, quantity, and expiration or beyond-use date.

A pharmacist has corresponding responsibility to resolve red flags before dispensing a controlled substance prescription.

Prescription transfers between pharmacies must follow federal and Missouri requirements, and records of the transfer must be retained.

Electronic prescriptions for controlled substances must meet DEA electronic prescription requirements.

Missouri prescription records must be readily retrievable for at least two years.

A Missouri pharmacy license is issued by the Board of Pharmacy and must be renewed and displayed as required.

Pharmacist license renewal requires continuing education under Board rule, and documentation must be retained for audit.

Pharmacy technician registration must be renewed with the Board as required by Board rules.

DEA registration is separate from state licensure and is renewed every three years.

A change in pharmacy ownership or principal location requires a new DEA registration and Board notification.

A change of pharmacist-in-charge must be reported to the Board of Pharmacy as required by Board rules.

Out-of-state pharmacies dispensing to Missouri patients must comply with Missouri registration and dispensing requirements.

Licensees must report required address changes to the Board.

DEA requires an initial controlled substance inventory and a biennial inventory every two years.

Schedule II inventory counts must be exact; Schedule III through V counts may be estimated unless the container holds more than 1,000 units.

DEA Form 222 is used to procure Schedule I or II controlled substances; CSOS may substitute for the paper form.

DEA Form 106 is used to report theft or significant loss of controlled substances.

Controlled substance records must be kept for two years and be available for inspection by authorized officials.

Prescription and dispensing records must be retained and readily retrievable.

A reverse distributor is an authorized entity that receives and disposes of returned or expired controlled substances from pharmacies.

Controlled substance transactions with reverse distributors and other registrants must be documented.

A pharmacist must offer counseling on new or changed prescriptions; the patient may decline the offer.

Prospective drug utilization review evaluates therapeutic duplication, drug interactions, allergies, dose, and contraindications before dispensing.

Medication guides approved by the FDA are required for specified drugs and must be provided when dispensing.

Counseling provided or the patient's refusal should be documented according to pharmacy policy.

Counseling includes directions for use, storage, precautions, interactions, and refill information.

Patient records should include allergies, medical conditions, and current medications to support pharmaceutical care.

HIPAA privacy requirements apply to protected health information handled by pharmacy staff.

Pharmacists must provide meaningful counseling rather than relying only on the prescription label.

USP Chapter 795 sets standards for nonsterile compounding, including facilities, equipment, training, and beyond-use dates.

USP Chapter 797 governs sterile compounding, including ISO cleanroom requirements, garb, environmental monitoring, and process validation.

USP Chapter 800 sets standards for handling hazardous drugs, including containment, PPE, and closed system transfer devices.

A compounded preparation's beyond-use date is assigned using USP default tables based on water content, preservative use, storage, and stability information.

A master formulation record documents the formula, ingredients, quantities, equipment, and procedures for a compounded preparation.

A compounding record documents each preparation, including lot numbers, personnel, and beyond-use date assigned.

Bulk active pharmaceutical ingredients used in compounding must be USP or NF grade and accompanied by a certificate of analysis.

Compounding a copy of a commercially available drug product is generally prohibited unless a clinical need is documented.