The Dentist's Drug and Prescription Guide. Mea A. Weinberg

      1 Q. What is a legend drug?

      2 A. A legend drug is a drug that can only be dispensed by a pharmacist with a prescription. Labels on these medications carry the legend: “Caution! Federal law prohibits dispensing without a prescription.”

      3 Q. What is the chemical name of a drug?

      4 A. The chemical name describes the chemical make‐up of a drug. For example, the chemical name for acetaminophen is N‐acetyl‐p‐aminophenol.

      5 Q. What is the proprietary name of a drug?

      6 A. Other terms for proprietary name are brand or trade name and refer to the drug name assigned by the specific manufacturer which is protected by copyright. For example, one of the brand names for ibuprofen is Motrin® (McNeil).

      7 Q. How long is a prescription valid until it is filled?

      8 A. Every state has different rules which apply to prescriptions. A nonnarcotic prescription is valid for 365 days (one year) from the date on the prescription. Check with the local state boards for state‐specific laws.

      9 Q. How is the quantity of the drug being dispensed written?

      10 A. The symbol # is acceptable to indicate number and informs the pharmacist to dispense tablets, capsules or liquid ounces. Sometimes the prescriber will write Disp: before the #, meaning “dispense.” For example: Disp: # 12.

      11 Q. What does “Sig” refer to?

      12 A. Sig refers to the Latin word signatura, meaning “write,” “make” or “label.” This is the direction to the patient on how to take the medication.

      13 Q. Should the dosage form of the drug be indicated on the prescription?

      14 A. Yes. Tablets, capsules, suspension, or solution must be indicated on the prescription. For example, amoxicillin 500 mg Disp: # 28 capsules.

      15 Q. Should the drug strength be written on the prescription?

      16 A. Yes. The correct strength of the drug prescribed must be clearly written on the prescription. For example, amoxicillin 500 mg.

      17 Q. Should the route of administration be specified on the prescription?

      18 A. Yes. The dentist must indicate the correct route of administration of the drug prescribed even if it is orally.

      19 Q. Should the duration of the drug prescribed be specified on the prescription?

      20 A. Yes. The number of days or weeks must be written on the prescription. For example, penicillin V, 500 mg tid for seven days.

      21 Q. Does the number of refills need to be written on the prescription?

      22 A. Yes. If no refills are required, then “NR” or “zero” should be checked or written on the prescription. The number of refills should be spelled out. Do not just write “0.” Some prescriptions have a checkoff box for “None.”

      23 Q. How many refills are allowed for nonscheduled and scheduled drugs?

      24 A. The prescriber can write for no refills, indicated by NR (no refills). Prescription drugs may be refilled for only one year after the date of the prescription. A prescription for a controlled substance listed in Schedule III–V can only be refilled for six months or five refills, whichever comes first, after the date on such a prescription. After five refills or six months, whichever occurs first, a new prescription is required. For Schedule II drugs, there are no refills allowed.

      25 Q. What is the law for dispensing a controlled substance for office use?

      26 A. A blanket prescription cannot be written to provide a medical/dental office with medications for administration. If the office requires C‐II medications, a DEA 222 form must be used to transfer the C‐II stock. For all other medications, an invoice must be utilized.

      27 Q. What does “label” on the prescription mean?

      28 A. When the prescriber wants the patient to know the name of the drug, the box on the prescription form marked “label” should be checked.

      29 Q. Can I phone in a prescription for a medication?

      30 A. Yes. A nonnarcotic medication (e.g., antibiotics, nonsteroidal antiinflammatory drugs [NSAIDs]) can be phoned into the pharmacist and does not require a follow‐up written prescription to be sent to the pharmacist.When phoning in a controlled substance (e.g., Vicodin® C‐II, Tylenol® with codeine C‐III, Percocet C‐II), the rules are different. Schedule II drugs cannot be phoned into the pharmacy except in an emergency and must be followed up with a written prescription usually within 72 hours (states may require that the prescription be sent to the pharmacist in a shorter time frame and the more restrictive clause prevails) and only for a three‐day supply. Schedule III drugs can be dispensed by an oral (verbal) or written prescription and does not need a follow‐up written prescription (the pharmacist writes all information which is equivalent to a written prescription). Renewal of Schedule III–V drugs can be called in to the pharmacy.

      31 Q. Is there a limit on the quantity prescribed for a Schedule II, III, or V narcotic?

      32 A. Although some states and many insurance companies limit the quantity of controlled substances dispensed to a 30‐day supply or 120 doses, whichever is less, there are no specific federal limits to quantities of drugs dispensed by a prescription. Review the law in individual states. Remember the most restrictive clause will prevail, whether state or federal.

      33 Q. Can a Schedule II narcotic (e.g., Percocet) be phoned into the pharmacy?

      34 A. Yes, but only for emergency situations. Federal law requires the prescriber to follow up with a written prescription sent to the pharmacy within 72 hours, but different states have different time limits. No refills are allowed.

      35 Q. What is the purpose of e‐prescribing?

      36 A.In 2010, the DEA legalized e‐prescribing of controlled substances to reduce drug fraud and abuse. All nonnarcotic prescriptions can be e‐prescribed. New York has the I‐STOP law (Internet System for Tracking Over Prescribing) which requires all prescriptions to be sent to pharmacies through e‐prescribing. In addition, as of 2016, all prescribers have to monitor patient use of controlled substance prescriptions via the PDMP.According to the DEA, as of 1 June 2010, it is permissible to have e‐prescribing for controlled substances in all 50 states; however, not all states are using it. E‐prescribing software must meet the DEA requirements and have the required certifications before e‐prescribing is allowed. In addition, some state laws and regulations will require changes before controlled substance e‐prescribing will be fully legal. E‐prescribing helps to reduce medication errors associated with prescribing (https://decisionresourcesgroup.com/drg‐blog/health‐reform/states‐require‐e‐prescribing‐combat‐fraud‐abuse).

      37 Q. Can a Schedule II prescription be faxed to the pharmacy?

      38 A. According to the DEA, in order to expedite the filling of a prescription, a prescriber may transmit a Schedule II prescription to the pharmacy by fax, but the original prescription must be presented to the pharmacist before the drug can be dispensed. The faxed copy is just an alert to the pharmacist that the patient is on the way with an original prescription. Otherwise, a fax for a Schedule II drug is not accepted.

      39 Q. In which situations can a faxed C‐II prescription serve as an original prescription?

      40 A. A faxed C‐II prescription can serve as an original for patients in a long‐term care facility (LTCF), community‐based care, enrolled in hospice, or receiving home infusion/IV pain management therapy. The fax must be signed by the prescriber.

      41 Q. Can a