Patient Info & Rx Evaluation
31%of exam
Clinical Practice & Jurisprudence
36%of exam
Pharmacy Operations & Jurisprudence
33%of exam
Quick Facts
- Exam
- CPJE
- Credential
- CA Pharmacist License
- Questions
- 90 (75 scored)
- Time
- 2 hours
- Pass
- 75 scaled (0-99)
- Format
- Computer, 4-option MC
- Level
- Licensure
- Blueprint
- June 1, 2022
CPJE Domain Weights
31 Patient Info, 36 Clinical, 33 Operations
CPJE vs MPJE
CPJE
- California only
- Law + clinical practice
MPJE
- Most other states
- Law only, no clinical
CA never uses MPJE
CS Prescription Requirements
- Schedule II Rx
- Written or e-Rx; no verbal
- Schedule II fill window
- Must fill within 6 months
- Verbal Schedule II
- Emergency only, written follow-up
- Schedule III-V Rx
- Written, oral, or fax OK
- E-prescribing mandate
- Required since Jan 2022
Emergency Refill vs Partial Fill
Emergency refill (4064)
- Sch III-V; excludes CII
- Prescriber unavailable
CII partial fill
- Controlled Schedule II
- Patient or prescriber request
Different drugs, different rules
Partial Fills & Transfers
- CII partial (stock)
- Complete within 72 hours
- CII partial (patient ask)
- Complete within 30 days
- III-V transfer
- One-time only between pharmacies
- Shared database exception
- Multiple transfers up to max refills
- Schedule II transfer
- Not transferable between pharmacies
Emergency Supply & Refills
- B&P 4064
- Refill without prescriber if unavailable
- Pharmacist judgment
- Interruption would harm patient care
- Required steps
- Attempt contact, document, notify prescriber
- Patient notice
- Inform patient of emergency refill
- Sch III-V allowed
- Excludes Schedule II only
Prescription Label Requirements
- SB 472
- Standardized patient-centered label mandate
- LEP support
- Interpreter services during pharmacy hours
- Translated SIGs
- Spanish, Chinese, Korean, Russian, Vietnamese
- Impairment warning
- Label if drug impairs driving
- Large print
- Available on patient request
CSA Schedule Abuse Order
I highest abuse, V lowest abuse
CA Duty to Consult vs OBRA Offer
California (1707.2)
- Proactive consultation required
- New Rx or change
OBRA '90 model
- Offer only
- Patient may decline
CA is stricter
What Can Pharmacist Furnish?
- Opioid overdose risk→Furnish naloxone(No Rx needed)
- Patient needs contraception→Furnish hormonal contraceptive(Self-screening required)
- HIV exposure risk→Furnish PrEP or PEP(Protocol-based)
- International travel planned→Furnish CDC travel meds(No diagnosis needed)
- Patient wants to quit smoking→Furnish nicotine replacement(OTC or Rx)
- Refill needed, prescriber unreachable→Emergency refill, B&P 4064(Sch III-V, not CII)
Controlled Substance Schedules
- Schedule I
- No accepted use; heroin, LSD
- Schedule II
- High abuse; oxycodone, fentanyl, Adderall
- Schedule III
- Moderate abuse; ketamine, steroids, testosterone
- Schedule IV
- Low abuse; Xanax, Ambien, tramadol
- Schedule V
- Lowest abuse; low-dose codeine syrup
- CSA
- Federal Controlled Substances Act
Pharmacist Furnishing Menu
Naloxone, Contraceptives, PrEP/PEP, Travel, Nicotine
Schedule II vs III-V Rules
Schedule II
- No refills allowed
- Not transferable
Schedule III-V
- Up to 5 refills/6 mo
- One-time transfer OK
Refill and transfer differ
When Must Pharmacist Counsel?
- New drug for patient→Mandatory oral consultation(16 CCR 1707.2)
- Same drug, new strength→Mandatory oral consultation(Not just an offer)
- Mail-order or remote patient→Written notice + phone line(40 hrs/week min)
- Patient declines counseling→Document refusal, skip consult(Patient's right)
- Drug impairs driving ability→Add impairment warning label(B&P 4074)
Corresponding Responsibility & Red Flags
- Corresponding responsibility
- Pharmacist shares duty with prescriber
- 21 CFR 1306.04
- Federal corresponding responsibility rule
- Cash red flag
- Cash payment for controlled substances
- Distance red flag
- Long patient-prescriber-pharmacy distance
- Doctor-shop red flag
- Same drug from multiple prescribers
Patient Counseling Duty
- 16 CCR 1707.2
- Duty to Consult regulation
- CA standard
- Mandatory consultation, not just offer
- Trigger
- New drug, strength, or directions
- Content
- Directions, storage, precautions, warnings
- Remote patient
- Written notice + phone access
- Response time
- 10-min avg or 1-hr callback
- Opt-out
- Patient may refuse consultation
Federal Law Foundations
- OBRA '90
- DUR + offer-to-counsel origin
- HIPAA
- Privacy, minimum necessary disclosure
- DEA registration
- Renew every 3 years
- FDA authority
- Approval, recalls, REMS programs
- CSA scheduling
- DEA classifies by abuse potential
Loss Reporting Timing
Theft = 14 days, Other = 30
CURES Query Duty vs Registration
Prescribers
- Must query before Rx
- Every 6 months
Pharmacists
- Register for access only
- No mandatory query duty
Prescriber duty, not pharmacist
Controlled Substance Action Picker
- Schedule II lost or stolen→Report to Board + DEA 106(14 or 30 days)
- Suspect diversion pattern→Refuse fill, document reasoning(Corresponding responsibility)
- New CII patient visit→Check CURES (prescriber duty)(Pharmacist just registers)
- Schedule III-V refill elsewhere→One-time transfer allowed(Unless shared database)
- CII qty incomplete at fill→Partial fill: 72 hrs if stock(30 days if patient asked)
- Biennial count due→Complete full CS inventory(Every 2 years)
Employee Theft vs Other Loss
Employee theft
- Any amount reportable
- 14-day deadline
Other loss
- Threshold-based reporting
- 30-day deadline
Theft has no minimum
CURES / PDMP Rules
- CURES
- CA's PDMP, run by DOJ
- Mandatory query
- Prescribers only, not pharmacists
- Query trigger
- New Schedule II-IV patient
- Query interval
- Every 6 months if continuing
- Pharmacist duty
- Register for CURES access
- Timing rule
- Within 24 hrs before prescribing
Quality Assurance & Errors
- 16 CCR 1711
- Quality assurance program mandate
- Investigation window
- Start within 2 business days
- QA record retention
- 1 year, immediately retrievable
- Self-assessment 17M-13
- Community/outpatient pharmacy self-audit
- Self-assessment retention
- Keep on file 3 years
Inventory Loss & Theft Reporting
- Employee theft
- Report any amount, 14 days
- Other loss
- Report within 30 days
- Tablet threshold
- 99 dosage units aggregate
- Injectable threshold
- 10 single-dose units aggregate
- Multi-dose threshold
- 2+ vials or bags
- CS inventory count
- Biennial, every 2 years
Technician Ratios & Supervision
- B&P 4115 ratio
- 2:1 additional, 1:1 solo
- Solo pharmacist
- Max 1 technician on duty
- Hospital/inpatient ratio
- 1 pharmacist per 2 techs
- Direct supervision
- Pharmacist verifies all tech work
- Tech scope limit
- No counseling, no clinical judgment
APh & License Renewal
- Certification criterion
- Board-certified specialty (BPS, etc.)
- Residency criterion
- Accredited PGY, 50%+ direct care
- Protocol criterion
- One year clinical services, protocol
- License renewal
- Every 2 years, birth-month deadline
- CE requirement
- 30 hrs; 2 law-ethics; 1 cultural
Common Traps
CURES Query Duty ≠ Pharmacist
Prescriber must query ≠ Pharmacist just registers
Offer to Counsel ≠ CA Rule
Other states offer only ≠ CA requires actual consultation
Schedule II ≠ Refillable
Zero refills allowed ≠ New Rx each time
CPJE ≠ MPJE
CA has own exam ≠ MPJE not used here
Theft ≠ Threshold-Based Loss
Theft reports any amount ≠ Loss needs threshold met
Emergency Refill: CII Excluded Only
Applies to dangerous drugs + Sch III-V ≠ Only Schedule II excluded (4064)
APh ≠ Automatic Upgrade
Requires 2 of 3 criteria ≠ Extra application and fee
Last Minute
- 1.Weights: 31% / 36% / 33%
- 2.90 Qs, 75 scored, 2 hrs
- 3.Pass = 75 scaled (0-99)
- 4.CURES duty = prescribers, not pharmacists
- 5.CA requires consultation, not just offer
- 6.Schedule II: no refills, no transfer
- 7.Furnish naloxone, contraceptives, PrEP-PEP, travel meds
- 8.Theft: report any amount, 14 days
- 9.Other loss: threshold-based, 30 days
- 10.Tech ratio max 2:1 (varies)
- 11.CPJE is California-only, not MPJE
- 12.E-prescribing mandatory for controlled substances
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