Rx: albuterol HFA inhaler, 200 actuations per canister. Sig: 2 puffs by inhalation q4-6h prn wheezing. Disp: 1 inhaler. Using the most the Sig allows per day, and dropping any partial day, what is the days' supply?
- A16 days
- B17 days
- C25 days
- D33 days
Show the answer and why
Correct answer: A
For as-needed (prn) Sigs, CMS guidance says to use the maximum allowed daily doses. A range of q4-6h means the patient may use it as often as every 4 hours, which is 6 times in 24 hours, so 6 × 2 puffs = 12 puffs a day. 200 ÷ 12 = 16.7, and a partial day is dropped, giving 16 days.
- ACorrect: q4h at most = 6 doses × 2 puffs = 12 puffs a day; 200 ÷ 12 = 16.7, which drops to 16 whole days.
- BThis rounds 16.7 up, counting a day the canister cannot fully cover.
- CThis uses q6h (4 doses, 8 puffs a day) instead of the maximum allowed frequency.
- DThis counts 1 puff per dose instead of 2 (200 ÷ 6).
Source: CMS Medicaid Program Integrity, Pharmacy Auditing and Dispensing Job Aid: Billing Oral Products · DailyMed: Albuterol sulfate HFA inhalation aerosol (Teva) label