Current through Reg. 49, No. 38; September 20, 2024
(a) A therapeutic optometrist may administer
and prescribe any drug authorized by Section 351.358 of the Act.
(b) To prohibit substitution of a generically
equivalent drug product on a written prescription drug order, a therapeutic
optometrist must write across the face of the written prescription, in the
therapeutic optometrist's own handwriting, "brand necessary" or "brand
medically necessary." If the therapeutic optometrist does not clearly indicate
"brand necessary" or "brand medically necessary," the pharmacist may substitute
a generically equivalent drug product in compliance with the Texas Pharmacy
Act, (Tex. Occ. Code Sections 562.008 and 562.009), and §
309.3 of this title (relating to
Substitution Requirements).
(c) All
prescriptions shall contain the following information:
(1) the date of issuance;
(2) the name and address of the patient for
whom the drug is prescribed;
(3)
the name, strength, and quantity of the drug, medicine, or device
prescribed;
(4) the direction for
use of the drug, medicine, or device prescribed;
(5) the name and address of the therapeutic
optometrist;
(6) the manually
written signature of the prescribing therapeutic optometrist; or an electronic
signature provided that the prescription is electronically signed by the
practitioner using a system which electronically replicates the practitioner's
manual signature on the written prescription, and provided:
(A) that security features of the system
require the practitioner to authorize each use; and
(B) the prescription is printed on paper that
is designed to prevent unauthorized copying of a completed prescription and to
prevent the erasure or modification of information written on the prescription
by the prescribing practitioner; and
(7) the license number of the prescribing
therapeutic optometrist including the therapeutic designation.
(d) The prescribing therapeutic
optometrist issuing verbal or electronic prescription drug orders to a
pharmacist shall furnish the same information required for a written
prescription, except for the written signature. If the therapeutic optometrist
does not clearly indicate "brand necessary" or "brand medically necessary" when
communicating the prescription to the pharmacist, the pharmacist may substitute
a generically equivalent drug product in compliance with the Texas Pharmacy Act
and §
309.3 of this title (related to
Substitution Requirements).
(e) A
therapeutic optometrist may charge a reasonable fee for drugs administered
within the optometric office, but a therapeutic optometrist shall not charge
for any drugs supplied to the patient as take-home medication. Any drug
supplied by a therapeutic optometrist other than an over-the counter drug shall
be labeled in compliance with the following information in compliance with the
Texas Dangerous Drug Act (Health and Safety Code, Chapter 483), and it shall
contain the following:
(1) the name, address,
and telephone number of the therapeutic optometrist;
(2) the date of dispensing;
(3) the name of the patient;
(4) the name and strength of the drug;
and
(5) the directions for
use.
(f) A therapeutic
optometrist may administer and prescribe all:
(1) ophthalmic devices;
(2) over-the-counter medications including
oral and other treatments; and
(3)
appropriate prescription topical pharmaceutical agents used for diagnosing and
treating visual defects, abnormal conditions, and diseases of the human eye and
adnexa.
(g) The authority
of an optometric glaucoma specialist to prescribe antiglaucoma drugs is defined
by Section 351.3581 of the Act.
(h)
A therapeutic optometrist may possess and administer cocaine eye drops for
diagnostic purpose. The cocaine eye drops must be no greater than 10 percent
solution in prepackaged liquid form.
(1) A
therapeutic optometrist must observe all requirements of the Texas Controlled
Substances Act, the Health and Safety Code, Chapter 481, and all requirements
of the Texas Department of Public Safety (DPS) Drug Rules in making application
and maintaining renewal of a United States Drug Enforcement Administration
(DEA) registration number for possession of the cocaine eye drops, a Schedule
II controlled substance.
(2) The
therapeutic optometrist must use the required DEA form for the purchase of the
cocaine eye drops and shall maintain a complete and accurate record of
purchases (to include samples received from pharmaceutical manufacturer
representatives) and administration of controlled substances. The maximum
amount to be purchased and maintained in an office of practice shall be no more
than two vials, one opened and one in inventory.
(3) The recordkeeping listed in this section
shall be subject to inspection at all times by the Texas Department of Public
Safety, the U.S. Drug Enforcement Administration, and the Texas Optometry
Board. Any officer or employee of the governmental agencies shall have the
right to inspect and copy records, reports, and other documents and inspect
security controls, inventory, and premises where such cocaine eye drops are
possessed or administered.
(4)
Minimum security controls shall be established to include but not limited to:
(A) establishing adequate security to prevent
unauthorized access and diversion of the controlled substance;
(B) during the course of business activities,
not allowing any individual access to the storage area for controlled
substances except those authorized by the therapeutic optometrist;
(C) storing the controlled substance in a
securely locked, substantially constructed cabinet or security cabinet which
shall meet the requirements under the DPS Drug Rules; or
(D) not employ in any manner an individual
that would have access to controlled substances who has had a federal or state
application for controlled substances denied or revoked, or have been convicted
of a felony offense under any state or federal law relating to controlled
substances or been convicted of any other felony, or have been a licensee of a
health regulatory agency whose license has been revoked, canceled, or
suspended.
(5) Failure of
the therapeutic optometrist to maintain strict security and proper
accountability of controlled substances shall be deemed to be a violation of
the Act, §351.501 and §351.551.
