Florida FDLR practice questions: Prescribing and sedation permits

Answer D: Indicate "ACUTE PAIN EXCEPTION" on the prescription and document the lack of alternative treatments in the chart.

Under s. 456.44, F.S., a Schedule II opioid for acute pain is limited to 3 days unless the prescriber believes more is medically necessary, indicates "ACUTE PAIN EXCEPTION" on the prescription, and documents the lack of alternative treatments in the record. Distractor A uses the wrong phrase. Distractor B misses the notation on the script itself. Distractor C is a prerequisite for any controlled substance script but does not by itself authorize a deviation from the 3-day limit.

Common trap: Assuming professional judgment and chart documentation are sufficient without the "magic words" on the physical prescription.

Source: s. 456.44, F.S. — Controlled substance prescribing

Answer C: No, because propofol may only be administered by a dentist with a general anesthesia permit.

Rule 64B5-14.002(5) lists specific drugs, including propofol and ketamine, that may only be employed by a dentist holding a valid general anesthesia permit. The intended level of sedation or the dose administered does not waive this requirement.

Common trap: The "intended level" trap—assuming a light dose of a heavy drug is permitted under a lower permit. In Florida, the drug itself triggers the permit requirement.

Source: Fla. Admin. Code R. 64B5-14.002 — Prohibitions

Answer B: The dentist is exempt from consulting E-FORCSE because the patient is under 16.

s. 893.055(8), F.S. requires a prescriber or designee to consult the system before prescribing or dispensing a controlled substance for a patient "age 16 or older." Distractor A and D describe reasons why a check might be needed for an adult, but ignore the age threshold. Distractor C incorrectly implies a check is required.

Common trap: Applying the 3-day/7-day opioid rules (which apply to all ages) to the E-FORCSE consultation duty (which has an age-16 floor).

Source: s. 893.055, F.S. — Prescription drug monitoring program

Answer A: The dentist must give written notice within 48 hours and file a complete written report within 30 days.

Rule 64B5-14.006(1) defines an adverse occurrence to include injuries requiring ER or hospital treatment resulting from any anesthesia, including minimal sedation, nitrous oxide, or local anesthesia; Rule 64B5-14.006(2) sets the dentist's 48-hour written notice and the 30-day complete written report for an occurrence in the dentist's outpatient facility. This item deliberately does not test the recipient of the notice, on which the statute and the rule's mailing subsection differ.

Common trap: The "permit-free" trap—thinking that because a level doesn't require a permit (nitrous/local), complications don't need to be reported.

Source: Fla. Admin. Code R. 64B5-14.006 — Reporting Adverse Occurrences

Answer C: Chronic nonmalignant pain

s. 456.44(1)(f), F.S. defines chronic nonmalignant pain as pain unrelated to cancer that persists beyond the usual course or "more than 90 days after surgery." This classification triggers "registrant" duties for the dentist. Distractor A and D describe specific exclusions from the acute pain definition. Distractor B is a notation for acute pain, not a classification for pain lasting over 90 days.

Common trap: Attempting to treat long-term post-surgical pain under the "acute pain" framework.

Source: s. 456.44, F.S. — Controlled substance prescribing