................................................................................................... Creating a Methadone Mixture Pharmacy Technology Solutions May, 2013
Methadone: Creating a Methadone Mixture Before dispensing methadone, it must be set up in PharmaClik Rx as a dynamic mixture A dynamic mixture allows the methadone prescription to be dispensed in milligrams as opposed to volume being dispensed Before creating the dynamic methadone mixture, it may be necessary to create free-form drugs for distilled water and tang. Please refer to Creating a Free-Form Drug for details. 1. From the Workbench, press or click the More button and then select the Mixture button. 2
2. Type MG METHADONE 5MG/ML in the Generic Name field. In this example we are using a 5mg/ml stock solution If your pharmacy uses a different strength, the name of the mixture must reflect that i.e., MG METHADONE 10MG/ML for a solution of 10mg/ml 3. Press or click the Search button. 4. Press or click the New button. 3
5. Type the word Compound in the field below the mixture name. 6. Enter the following information for a dynamic methadone mixture: Compound = Internal Use Liquid Schedule = Schedule I Default SIG Type in a SIG to be automatically used each time this mixture is filled, if desired Mixture Qty = 1 Mixing Time = 5 Narcotic checkbox = ON Reportable checkbox = ON Methadone checkbox = ON Dynamic Qty checkbox = ON Narcotic Print checkbox = ON NMS checkbox = ON 7. Remove the check from the Pro-Rate Mixing Time checkbox. 4
Three ingredients will be added to this mixture If the ingredient does not exist, refer to Adding a Free-Form Drug 8. Using the Add button, search for and add Distilled Water. 9. Press or click the OK button. 10. Enter the following information for Distilled Water: Select the pack Size of 4000 This allows the distilled water to be dispensed in milliliters for a 4 litre container Select Qty from the Qty drop-down list This allows the quantity of water to be calculated from the quantity used in the prescription Select the / (forward slash) from the drop-down list Enter the value in the Opr field The Opr field should equal the number of mg/ml in the stock solution When using a 5mg/ml stock solution, the Opr would be 5 When using 10mg/ml stock solution, the Opr would be 10 Select Millitre from the Unit drop-down list 5
11. Using the Add button, search for and add Tang. 12. Press or click the OK button. 13. Enter the following information for Tang: Select the most appropriate pack size If the correct pack size does not exist, you will have to create it Enter 100 in the Qty field This allows for 100ml to be dispensed and billed for each methadone prescription filled Select Millilitre from the Unit drop-down list 6
14. Using the Add button, search for and add methadone powder. 15. Press or click the OK button. 16. Enter the following information for methadone powder: Select the pack Size of 25000 mg Methadone must be changed from grams to milligrams because it is dispensed in milligrams per milliliter If the correct pack size does not exist, you will have to create it - Refer to the curriculum of Creating a Pack Size Select Qty from the Qty drop-down list Select Milligram from the Unit drop-down list 17. Press or click the Save button. 18. Press or click the Alternatives tab. 7
The Alternatives tab is where pseudo-dins are added to this mixture for submission to third party plans Custom Class of methadone allows for pricing rules to be set specifically for methadone prescriptions 19. Press or click the Add button beside the Alternatives and Fixed Unit Cost area of the screen to add a pseudo-din to a specific third party. 20. Select the third party from the drop-down list that the pseudo-din is linked to. 21. Type the pseudo-din in the PIN field. Pseudo-DINs for specific third parties can be obtained by calling the third party 22. Uncheck Compound Type checkbox IF that specific third party requires the Compound Type to be OFF. To determine if the Compound Type needs to be on or off, you must call the third party. 23. Press or click the Add button beside the Custom Class area of the screen. 24. Select *All*- All from the Third Party Plan drop-down list. This allows the custom class pricing to be incorporated in every billing scenario 25. Select Methadone from the Custom Class drop-down list. The Custom Class links the mixture to all pricing rules and reports 26. Press or click the Save button. 8
Methadone: Creating a Methadone Mixture @ a Glance Name field Both lines of the Name field appear on the label set Type the word COMPOUND on the second line; this helps narrow future search results Compound field Select a compound type from the drop-down list For methadone this must be Internal Use Liquid This type is linked to a code that is used for online adjudication Schedule field Select the drug schedule from the drop-down list Default SIG field You may type dispensing directions, or choose a SIG from the drop-down list, which will automatically be used when filling this mixture Mixture Qty field The total quantity for this mixture Mixture Qty should be 1 for methadone Mixing Time field The amount of time needed to prepare the mixture based on the mixture quantity Pro-Rate Mixing Time checkbox When selected, the mixing time will be calculated based on the quantity dispensed in the prescription This should be turned off for dynamic mixtures Shrink Label checkbox Prints a smaller font on the label for the vial Inactive checkbox Identifies the mixture as inactive when checked, as active when not checked (empty) 9
Methadone: Creating a Methadone Mixture @ a Glance (cont d) Narcotic checkbox Indicates that this mixture contains a narcotic ingredient Reportable checkbox Indicates that this mixture contains a reportable narcotic ingredient Methadone checkbox Indicates this mixture as a methadone mixture and enables methadone options in Rx Detail Last Rx Date field This will display the last date the mixture was filled Dynamic Qty checkbox Allows you to create a mixture with one ingredient s quantity as a constant, and other ingredients quantities as variables based on the quantity being dispensed This is mainly used for methadone mixtures Narcotic Print checkbox Select this option to include this mixture on the Narcotic Report NMS checkbox The Narcotics Monitoring System must be selected to ensure any prescriptions filled for narcotics or controlled substances, are submitted to the governments database to prevent use or misuse 1 0