Current through Register Vol. 30, No. 38, September 20, 2024
A. A pharmacist or a graduate intern or
pharmacy intern under the supervision of a pharmacist shall perform the
following professional practices in dispensing a prescription medication from a
prescription order:
1. Receive, reduce to
written form, and manually initial oral prescription orders;
2. Obtain and record the name of the
individual who communicates an oral prescription order;
3. Obtain, or assume responsibility to
obtain, from the patient, patient's agent, or medical practitioner and record,
or assume responsibility to record, in the patient's profile, the following
information:
a. Name, address, telephone
number, date of birth (or age), and gender;
b. Individual history including known
diseases and medical conditions, known drug allergies or drug reactions, and if
available a comprehensive list of medications currently taken and medical
devices currently used;
4. Record, or assume responsibility to
record, in the patient's profile, a pharmacist's, graduate intern's, or
pharmacy intern's comments relevant to the patient's drug therapy, including
other information specific to the patient or drug;
5. Verify the legality and pharmaceutical
feasibility of dispensing a drug based upon:
a. The patient's allergies,
b. Incompatibilities with medications the
patient currently takes,
c. The
patient's use of unusual quantities of dangerous drugs or narcotics,
d. A medical practitioner's signature,
and
e. The frequency of
refills;
6. Verify that
a dosage is within proper limits;
7. Interpret the prescription order, which
includes exercising professional judgment in determining whether to dispense a
particular prescription;
8.
Compound, mix, combine, or otherwise prepare and package the prescription
medication needed to dispense individual prescription orders;
9. Prepackage or supervise the prepackaging
of drugs by a pharmacy technician or pharmacy technician trainee under
R4-23-1104. For drugs prepackaged by a pharmacy technician or pharmacy
technician trainee, a pharmacist shall:
a.
Verify the drug to be prepackaged;
b. Verify that the label meets the official
compendium's standards;
c. Check
the completed prepackaging procedure and product; and
d. Manually initial the completed label;
or
e. For automated packaging
systems, manually initial the completed label or a written log or initial a
computer-stored log;
10.
Check prescription order data entry to ensure that the data input:
a. Is for the correct patient by verifying
the patient's name, address, telephone number, gender, and date of birth or
age;
b. Is for the correct drug by
verifying the drug name, strength, and dosage form;
c. Communicates the prescriber's directions
precisely by verifying dose, dosage form, route of administration, dosing
frequency, and quantity; and
d. Is
for the correct medical practitioner by verifying the medical practitioner's
name, address, and telephone number;
11. Except as provided in subsection (A)(12),
make a final accuracy check of the completed prescription label including
verification of medication, accuracy of patient's name, consistency with
prescription order, and drug utilization review and initial in handwriting or
by another method approved by the Board or its designee the finished
label;
12. If a technology-assisted
verification of product program is used, make a final accuracy check of the
completed prescription label including accuracy of patient's name, consistency
with prescription order, and drug utilization review and initial in handwriting
or by another method approved by the Board or its designee the finished label.
If a technology-assisted verification of product program is used, verification
of product is not required.
13.
Record, or assume responsibility to record, a prescription serial number and
date dispensed on the original prescription order;
14. Obtain, or assume responsibility to
obtain, permission to refill a prescription order and record, or assume
responsibility to record on the original prescription order:
a. Date dispensed,
b. Quantity dispensed, and
c. Name of medical practitioner or medical
practitioner's agent who communicates permission to refill the prescription
order;
15. Reduce to
written or printed form, or assume responsibility to reduce to written or
printed form, a new prescription order received by:
a. Fax
b. E-mail, or
c. Other means of communication;
16. Verify, or assume
responsibility to verify, that a completed prescription medication is sold only
to the correct patient, patient's care-giver, or authorized agent;
17. Record on the original prescription order
the name or initials of the pharmacist, graduate intern, or pharmacy intern who
originally dispenses the prescription order; and
18. Record on the original prescription order
the name or initials of the pharmacist, graduate intern, or pharmacy intern who
dispenses each refill.
B. Only a pharmacist, graduate intern, or
pharmacy intern shall provide oral consultation about a prescription medication
to a patient or patient's care-giver in an outpatient setting, including a
patient discharged from a hospital. The oral consultation is required whenever
the following occurs:
1. The prescription
medication has not been previously dispensed to the patient in the same
strength or dosage form or with the same directions;
2. The pharmacist, through the exercise of
professional judgment, determines that oral consultation is warranted;
or
3. The patient or patient's
care-giver requests oral consultation.
C. Oral consultation shall include:
1. Reviewing the name and strength of a
prescription medication or name of a prescription-only device and the labeled
indication of use for the prescription medication or prescription-only
device;
2. Reviewing the
prescription's directions for use;
3. Reviewing the route of administration;
and
4. Providing oral information
regarding special instructions and written information regarding side effects,
procedure for missed doses, or storage requirements.
D. When, in the professional judgment of the
pharmacist or graduate intern or pharmacy intern under the supervision of a
pharmacist, or when circumstance precludes it, oral consultation may be omitted
if the pharmacist, graduate intern, or pharmacy intern:
1. Personally provides written information to
the patient or patient's care-giver that summarizes the information that would
normally be orally communicated;
2.
Documents, or assumes responsibility to document, both the circumstance and
reason for not providing oral consultation by a method approved by the Board or
its designee; and
3. Offers the
patient or patient's care-giver the opportunity to communicate with a
pharmacist, graduate intern, or pharmacy intern at a later time and provides a
method for the patient or patient's care-giver to contact a pharmacist,
graduate intern, or pharmacy intern at the pharmacy.
E. The pharmacist or graduate intern or
pharmacy intern under the supervision of a pharmacist, through the exercise of
professional judgment, may provide oral consultation that includes:
1. Common severe adverse effects,
interactions, or therapeutic contraindications, and the action required if they
occur;
2. Techniques of
self-monitoring drug therapy;
3.
The duration of the drug therapy; and
4. Prescription refill information.
F. Nothing in subsection (B)
requires a pharmacist, graduate intern, or pharmacy intern to provide oral
consultation if a patient or patient's care-giver refuses the
consultation.
G. Using a method
approved by the Board or its designee, a pharmacist, graduate intern, or
pharmacy intern shall document, or assume responsibility to document, that oral
consultation is or is not provided.
H. Oral consultation documentation. When oral
consultation is required as specified in subsection (B), a pharmacist, graduate
intern, or pharmacy intern shall:
1.
Document, or assume responsibility to document, that oral consultation is
provided; or
2. When a patient
refuses oral consultation or a person other than the patient or patient's
care-giver picks up a prescription and oral consultation is not provided,
document, or assume responsibility to document, that oral consultation is not
provided; or
3. When a pharmacist,
graduate intern, or pharmacy intern determines to omit oral consultation under
subsection (D) and oral consultation is not provided, document, or assume
responsibility to document, both the circumstance and reason that oral
consultation is not provided; and
4. Document, or assume responsibility to
document, the name, initials, or identification code of the pharmacist,
graduate intern, or pharmacy intern who did or did not provide oral
consultation.
I. When a
prescription is delivered to the patient or patient's care-giver outside the
immediate area of a pharmacy and a pharmacist is not present, the prescription
shall be accompanied by written or printed patient medication information that,
in addition to the requirements in subsection (C), includes:
1. Approved use for the prescription
medication;
2. Possible adverse
reactions;
3. Drug-drug, food-drug,
or disease-drug interactions;
4.
Missed dose information; and
5.
Telephone number of the dispensing pharmacy or another method approved by the
Board or its designee that allows a patient or patient's care-giver to consult
with a pharmacist.
J. A
prescription medication or prescription-only device, delivered to a patient at
a location where a licensed health care professional is responsible for
administering the prescription medication to the patient, is exempt from the
requirement of subsection (C).
K. A
pharmacist, graduate intern, or pharmacy intern shall wear a badge indicating
name and title while on duty.
L.
Nothing in this Section prevents a hospital pharmacist from accepting a
prescription order according to rules pertaining specifically to hospital
pharmacies.
