| (C) A pharmacist may not dispense a facsimile prescription
drug order for a dangerous drug or controlled substance issued by
a practitioner licensed in the Dominion of Canada or the United Mexican
States unless the practitioner is also licensed in Texas.
(6) Original prescription drug order records.
(A) Original prescriptions may be dispensed only in
accordance with the prescriber's authorization as indicated on the
original prescription drug order including clarifications to the order
given to the pharmacist by the practitioner or the practitioner's
agent and recorded on the prescription.
(B) Original prescriptions shall be maintained by the
pharmacy in numerical order and remain legible for a period of two
years from the date of filling or the date of the last refill dispensed.
(C) If an original prescription drug order is changed,
such prescription order shall be invalid and of no further force and
effect; if additional drugs are to be dispensed, a new prescription
drug order with a new and separate number is required. However, an
original prescription drug order for a dangerous drug may be changed
in accordance with paragraph (10) of this subsection relating to accelerated
refills.
(D) Original prescriptions shall be maintained in three
separate files as follows:
(i) prescriptions for controlled substances listed
in Schedule II;
(ii) prescriptions for controlled substances listed
in Schedules III-V; and
(iii) prescriptions for dangerous drugs and nonprescription
drugs.
(E) Original prescription records other than prescriptions
for Schedule II controlled substances may be stored in a system that
is capable of producing a direct image of the original prescription
record, e.g., digitalized imaging system. If original prescription
records are stored in a direct imaging system, the following is applicable:
(i) the record of refills recorded on the original
prescription must also be stored in this system;
(ii) the original prescription records must be maintained
in numerical order and separated in three files as specified in subparagraph
(D) of this paragraph; and
(iii) the pharmacy must provide immediate access to
equipment necessary to render the records easily readable.
(7) Prescription drug order information.
(A) All original prescriptions shall bear:
(i) name of the patient, or if such drug is for an
animal, the species of such animal and the name of the owner;
(ii) address of the patient, provided, however, a prescription
for a dangerous drug is not required to bear the address of the patient
if such address is readily retrievable on another appropriate, uniformly
maintained pharmacy record, such as medication records;
(iii) name, address and telephone number of the practitioner
at the practitioner's usual place of business, legibly printed or
stamped and if for a controlled substance, the DEA registration number
of the practitioner;
(iv) name and strength of the drug prescribed;
(v) quantity prescribed numerically and if for a controlled
substance:
(I) numerically, followed by the number written as
a word, if the prescription is written;
(II) numerically, if the prescription is electronic;
or
(III) if the prescription is communicated orally or
telephonically, as transcribed by the receiving pharmacist;
(vi) directions for use;
(vii) intended use for the drug unless the practitioner
determines the furnishing of this information is not in the best interest
of the patient;
(viii) date of issuance;
(ix) if a faxed prescription:
(I) a statement that indicates that the prescription
has been faxed (e.g., Faxed to); and
(II) if transmitted by a designated agent, the name
of the designated agent;
(x) if electronically transmitted:
(I) the date the prescription drug order was electronically
transmitted to the pharmacy, if different from the date of issuance
of the prescription; and
(II) if transmitted by a designated agent, the name
of the designated agent; and
(xi) if issued by an advanced practice nurse or physician
assistant in accordance with Subtitle B, Chapter 157, Occupations
Code the:
(I) name, address, telephone number, and if the prescription
is for a controlled substance, the DEA number of the supervising practitioner;
and
(II) address and telephone number of the clinic where
the prescription drug order was carried out or signed.
(B) At the time of dispensing, a pharmacist is responsible
for documenting the following information on either the original hard
copy prescription or in the pharmacy's data processing system:
(i) unique identification number of the prescription
drug order;
(ii) initials or identification code of the dispensing
pharmacist;
(iii) initials or identification code of the pharmacy
technician or pharmacy technician trainee performing data entry of
the prescription, if applicable;
(iv) quantity dispensed, if different from the quantity
prescribed;
(v) date of dispensing, if different from the date
of issuance; and
(vi) brand name or manufacturer of the drug or biological
product actually dispensed, if the drug was prescribed by generic
name or interchangeable biological name or if a drug or interchangeable
biological product other than the one prescribed was dispensed pursuant
to the provisions of the Act, Chapters 562 and 563.
(8) Refills.
(A) General information.
(i) Refills may be dispensed only in accordance with
the prescriber's authorization as indicated on the original prescription
drug order except as authorized in paragraph (10) of this subsection
relating to accelerated refills.
(ii) If there are no refill instructions on the original
prescription drug order (which shall be interpreted as no refills
authorized) or if all refills authorized on the original prescription
drug order have been dispensed, authorization from the prescribing
practitioner shall be obtained prior to dispensing any refills and
documented as specified in subsection (l) of this section.
(B) Refills of prescription drug orders for dangerous
drugs or nonprescription drugs.
(i) Prescription drug orders for dangerous drugs or
nonprescription drugs may not be refilled after one year from the
date of issuance of the original prescription drug order.
(ii) If one year has expired from the date of issuance
of an original prescription drug order for a dangerous drug or nonprescription
drug, authorization shall be obtained from the prescribing practitioner
prior to dispensing any additional quantities of the drug.
(C) Refills of prescription drug orders for Schedules
III-V controlled substances.
(i) Prescription drug orders for Schedules III-V controlled
substances may not be refilled more than five times or after six months
from the date of issuance of the original prescription drug order,
whichever occurs first.
(ii) If a prescription drug order for a Schedule III,
IV, or V controlled substance has been refilled a total of five times
or if six months have expired from the date of issuance of the original
prescription drug order, whichever occurs first, a new and separate
prescription drug order shall be obtained from the prescribing practitioner
prior to dispensing any additional quantities of controlled substances.
(D) Pharmacist unable to contact prescribing practitioner.
If a pharmacist is unable to contact the prescribing practitioner
after a reasonable effort, a pharmacist may exercise his professional
judgment in refilling a prescription drug order for a drug, other
than a controlled substance listed in Schedule II, without the authorization
of the prescribing practitioner, provided:
(i) failure to refill the prescription might result
in an interruption of a therapeutic regimen or create patient suffering;
(ii) the quantity of prescription drug dispensed does
not exceed a 72-hour supply;
(iii) the pharmacist informs the patient or the patient's
agent at the time of dispensing that the refill is being provided
without such authorization and that authorization of the practitioner
is required for future refills;
(iv) the pharmacist informs the practitioner of the
emergency refill at the earliest reasonable time;
(v) the pharmacist maintains a record of the emergency
refill containing the information required to be maintained on a prescription
as specified in this subsection;
Cont'd... |
