Prescriptions, Dispensing, Labeling, and Records
This domain covers the life of a prescription: what makes it valid, how it is dispensed, what the label must say, and what records must be kept. A valid prescription requires a legitimate prescriber-patient relationship, required elements (patient, drug, directions, date, prescriber signature/authorization), and compliance with both federal and Texas requirements. Texas specifies labeling content for dispensed drugs, including pharmacy and patient information, directions, and required cautions; federal law adds specific cautions for controlled substances and certain legend drugs.
Dispensing rules include generic substitution (Texas permits substitution unless the prescriber indicates otherwise, with patient notification and recordkeeping), counseling obligations, and requirements for records retention. Prescription records must be readily retrievable and maintained for the period required by Texas rules; controlled substance records have their own federal retention period. Refills are permitted only as authorized, and prescriptions expire under state rules.
Traps: assuming any prescriber signature satisfies the rule (electronic and oral prescriptions have specific conditions); forgetting that substitution requires prescriber or patient consent mechanics and documentation; and confusing record retention periods between legend and controlled drugs. Questions may test whether a pharmacist may add or change information on a prescription - generally limited corrections are allowed with documentation, but substantive changes require prescriber authorization.
Rule of thumb: a prescription must be valid at every stage - authorization, content, dispensing, labeling, and record. Worked example: a patient requests a generic - the pharmacist may substitute unless the prescriber prohibited it, must notify the patient, and must record the substitution per Texas requirements.